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. 2024 Sep 6;12(9):e6139.
doi: 10.1097/GOX.0000000000006139. eCollection 2024 Sep.

Decision-making in Nasal Dorsum Reconstruction in Revision Rhinoplasty

Norman Anco  1 , Gonzalo C Caballero  1 , Karen Valverde  2 , José Nuñez  3
Affiliations

Decision-making in Nasal Dorsum Reconstruction in Revision Rhinoplasty

Norman Anco et al. Plast Reconstr Surg Glob Open. .

Abstract

Background: The approach to revision rhinoplasty is a challenge that plastic surgeons often face. The objective of this communication is to describe a surgical algorithm for patients undergoing revision rhinoplasty based on the stability of the nasal dorsum.

Methods: The study included 18 patients, six men and 12 women, aged 19-54 years, who had previously undergone rhinoplasty and who visited our clinic to request a new procedure due to unsatisfactory results in those procedures. A surgical algorithm developed by the main author (N.A.) was followed for revision rhinoplasty, and then a validated rhinoplasty outcome evaluation questionnaire was applied 1 year after surgery to assess aesthetic outcomes.

Results: The questionnaire was applied to all participants, showing a significant increase in patient satisfaction. Before surgery, a minimum value of six and a maximum of 21 (mean of 12) were found. After revision rhinoplasty following the proposed surgical algorithm, a minimum value of 21 and a maximum of 30 (mean of 29) were found, and this difference was statistically significant (P < 0.001).

Conclusions: The surgical algorithm used for nasal dorsum reconstruction in patients undergoing revision rhinoplasty improved patient satisfaction and could be a feasible procedure to approach patients who have previously undergone rhinoplasty.

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Conflict of interest statement

The authors have no financial interest to declare in relation to the content of this article.

Figures

Fig. 1.
Fig. 1.
Nasal dorsum reconstruction algorithm in revision rhinoplasty.
Fig. 2.
Fig. 2.
Satisfaction with surgical algorithm.
Fig. 3.
Fig. 3.
Outcomes one year after rhinoplasty. Residual dorsal hump. Dorsal septal humpectomy, bilateral spreader flaps, costal cartilage septal extension grafts, and lateral, paramedian, and transverse osteotomy. Before (A) and after (B) pictures in lateral view. Before (C) and after (D) pictures in frontal view.
Fig. 4.
Fig. 4.
Outcomes one year after rhinoplasty. Saddle nose. Reconstruction of the keystone region with L-shaped costal cartilage fixed to nasal bones and anterior nasal spine, bilateral spreader grafts, costal graft of 30 × 8 mm wrapped in muscular fascia in nasal dorsum. Septal extension and alar rim graft. Paramedian, transverse, and lateral osteotomy. Before (A) and after (B) pictures in lateral view. Before (C) and after (D) pictures in frontal view.
Fig. 5.
Fig. 5.
Outcomes one year after rhinoplasty. Wide nasal dorsum residual. Ultrasonic osteotoplasty in the bony cap, paramedian, transverse, and lateral osteotomy, septal extension graft, and alar rim graft. Before (A) and after (B) pictures in lateral view. Before (C) and after (D) pictures in frontal view.
See this image and copyright information in PMC

References

    1. Sheen JH. Secondary rhinoplasty. Plast Reconstr Surg. 1975;56:137–145. - PubMed
    1. Bracaglia R, Fortunato R, Gentileschi S. Secondary rhinoplasty. Aesthetic Plast Surg. 2005;29:230–239. - PubMed
    1. Marin VP, Landecker A, Gunter JP. Harvesting rib cartilage grafts for secondary rhinoplasty. Plast Reconstr Surg. 2008;121:1442–1448. - PubMed
    1. Sterling DA, Deot N, Davila RO. Perceptions of attractiveness in dorsal aesthetic lines of the nose: a crowd sourcing analysis. Facial Plast Surg Aesthet Med. 2022;24:424–429. - PubMed
    1. Calderón G ME, Cuevas T P, Erazo C C, et al. . Rinoplastía: resultados desde la perspectiva del paciente. Validación lingüística y psicométrica del rhinoplasty outcome evaluation instrument. Rev Chil Cir. 2013;65:30–34.

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