Download PDF
Facial Plast Surg 2008; 24(3): 271-287
DOI: 10.1055/s-0028-1083082
© Thieme Medical Publishers

Revision Rhinoplasty: An Overview of Deformities and Techniques

Santdeep H. Paun1 , Gilbert J. Nolst Trenité2
  • 1Department of Otorhinolaryngology, St. Bartholomew's and The Royal London Hospitals, London, United Kingdom
  • 2Department of Otorhinolaryngology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
Further Information

Publication History

Publication Date:
24 October 2008 (online)

Also available at
    Permissions and Reprints

ABSTRACT

This article provides an overview of assessment, planning, and correction of deformities in revision rhinoplasty surgery. Common deformities are described with tips for preventing such postoperative problems, and corrective strategies are suggested. Assessment remains the key to successful rhinoplasty surgery, and its importance in revision operations is emphasized. The external approach is preferred for complex revision surgery due to its unparalleled exposure of the underlying anatomy, but closed approaches are still used for dorsal correction or minor tip deformities. The use of and options for graft material in reconstruction are detailed.

KEYWORDS

Rhinoplasty - revision - nasal - reconstruction - tip

REFERENCES

  • 1 Kridel R WH, Yee S. Psychological, financial and legal considerations in secondary rhinoplasty.  Facial Plast Surg Clin North Am. 1995;  3 347-351
    PubMedGoogle Scholar
  • 2 Walter C. Revision surgery. In: Nolst Trenite GJ Rhinoplasty: A Practical Guide to Functional and Aesthetic Surgery of the Nose, 2nd ed. Kugler Publications 1998: 209-223
    Google Scholar
  • 3 Vuyk H D, Zijlker T D. Psychological aspects of patient counselling and selection: a surgeon's perspective.  Facial Plast Surg. 1995;  11 55-60
    Article in Thieme ConnectPubMedGoogle Scholar
  • 4 Adamson P A. The failed rinoplasty. In: Current Therapy in Otolaryngology Head and Neck Surgery. Toronto, ON; BC Decker 1990: 137-144
    Google Scholar
  • 5 Toriumi D M, Johnson C M. Revision rhinoplasty. In: Krause CJ Aesthetic Facial Surgery. Philadelphia, PA; WB Saunders 1991: 411-456
    Google Scholar
  • 6 Nolst Trenite G J, Paun S. External rhinoplasty. In: Watkinson J Scott Brown's Otolaryngology, 7th ed. London, UK; Arnold 2008
    Google Scholar
  • 7 Vuyk H D, Watts S J, Vinayak B. Revision rhinoplasty: review of deformities, aetiology and treatment strategies.  Clin Otolaryngol Allied Sci. 2000;  25 476-481
    PubMedGoogle Scholar
  • 8 Parkes M L, Kanodia R, Michadia B K. Revision rhinoplasty and analysis of aesthetic deformities.  Arch Otolaryngol Head Neck Surg. 1992;  118 695-701
    CrossrefPubMedGoogle Scholar
  • 9 Kamer F M, McQuown S A. Revision rhinoplasty: analysis and treatment.  Arch Otolaryngol Head Neck Surg. 1988;  114 257-266
    PubMedGoogle Scholar
  • 10 Zijlker T D, Vuyk H, Adamson P A. Rhinoplasty: preoperative photographic analysis.  Clin Otolaryngol Allied Sci. 1992;  17 361-369
    PubMedGoogle Scholar
  • 11 Adamson P A. The failed rhinoplasty.  Curr Ther Otolaryngol Head Neck Surg. 1990;  4 137-144
    PubMedGoogle Scholar
  • 12 Tardy M E, Watson D, Chand M. Secondary rhinoplasty. In: Papel ID Facial Plastic and Reconstructive Surgery, 2nd ed. New York, NY; Thieme Medical Publishers 2002: 439-451
    Google Scholar
  • 13 Nolst Trenite G J. Grafts in nasal surgery. In: Nolst Trenite GJ Rhinoplasty: A Practical Guide to Functional and Aesthetic Surgery of the Nose, 3rd ed. Amsterdam; Kugler Publications 2005: 49-67
    Google Scholar
  • 14 Jackson I T, Yavuzer R, Silverstein P. AlloDerm for dorsal nasal irregularities.  Plast Reconstr Surg. 2001;  107 559-560
    CrossrefPubMedGoogle Scholar
  • 15 Lohuis P J, Watts S J, Vuyk H D. Augmentation of the nasal dorsum using Gore-Tex: intermediate results of a retrospective analysis of experience in 66 patients.  Clin Otolaryngol Allied Sci. 2001;  26 214-217
    CrossrefPubMedGoogle Scholar
  • 16 Nolst Trenite G J. Surgery of the osseocartilaginous vault. In Rhinoplasty: A Practical Guide to Functional and Aesthetic Surgery of the Nose, 3rd ed. Amsterdam; Kugler Publications 2005: 97-115
    Google Scholar
  • 17 Becker D G, Toriumi D M, Gross C W, Tardy M E. Powered instrumentation for dorsal nasal reduction.  Facial Plast Surg. 1997;  13 291-297
    Article in Thieme ConnectPubMedGoogle Scholar
  • 18 Leaf N. SMAS autografts for the nasal dorsum.  Plast Reconstr Surg. 1996;  97 1249-1252
    CrossrefPubMedGoogle Scholar
  • 19 Guerrerosantos J. Temperoparietal free fascia grafts in rhinoplasty.  Plast Reconstr Surg. 1984;  74 465-475
    CrossrefPubMedGoogle Scholar
  • 20 Larrabee W F. Open rhinoplasty and the upper third of the nose.  Facial Plast Surg Clin North Am. 1993;  1 23-28
    PubMedGoogle Scholar
  • 21 Sheen J H, Sheen A P. Aesthetic Rhinoplasty, 2nd ed. St Louis, MO; Quality Medical Publishing 1998
    Google Scholar
  • 22 Tardy M E, Schwartz M, Parras G. Saddle nose deformity: autogenous graft repair.  Facial Plast Surg. 1989;  6 121-134
    Article in Thieme ConnectPubMedGoogle Scholar
  • 23 Gunter J P, Rohrich R J. Augmentation rhinoplasty: dorsal onlay grafting using shaped autogenous septal cartilage.  Plast Reconstr Surg. 1990;  86 39-45
    CrossrefPubMedGoogle Scholar
  • 24 McCurdy J A. Cosmetic surgery of the Asian face. In: Papel ID Facial Plastic and Reconstructive Surgery, 2nd ed. New York, NY; Thieme Medical Publishers 2002: 322-343
    Google Scholar
  • 25 Colton J J, Berghaus G J. Use of mersilene in nasal augmentation.  Facial Plast Surg. 1992;  8 149-156
    Article in Thieme ConnectPubMedGoogle Scholar
  • 26 Hanasono M M, Kridel R W, Pastorek N J, Glasgold M J, Koch R J. Correction of the soft tissue pollybeak using triamcinolone injection.  Arch Facial Plast Surg. 2002;  4 26-30
    CrossrefPubMedGoogle Scholar
  • 27 Murakami C S, Cook T A, Guida R A. Nasal reconstruction with articulated irradiated rib cartilage.  Arch Otolaryngol Head Neck Surg. 1991;  117 327-330
    CrossrefPubMedGoogle Scholar
  • 28 Sheen J H. Spreader graft: a method of reconstructing the roof of the middle nasal vault following rhinoplasty.  Plast Reconstr Surg. 1984;  73 230-239
    CrossrefPubMedGoogle Scholar
  • 29 André R F, Paun S, Vuyk H. Endonasal spreader grafts placement: the use of endonasal spreader grafts as a treatment for internal nasal valve insufficiency.  Arch Facial Plast Surg. 2004;  6 36-40
    CrossrefPubMedGoogle Scholar
  • 30 Kridel R W, Konior R J, Shumrick K A, Wright W K. Advances in nasal tip surgery: the lateral crural steal.  Arch Otolaryngol Head Neck Surg. 1989;  115 1206-1212
    CrossrefPubMedGoogle Scholar
  • 31 Bull T R. The over-projected nasal tip. In: Nolst Trenite GJ Rhinoplasty: A Practical Guide to Functional and Aesthetic Surgery of the Nose, 3rd ed. Amsterdam; Kugler Publications 2005: 167-171
    Google Scholar
  • 32 Kridel R W, Scott B A, Foda H M. The tongue-in-groove technique in septorhinoplasty: a 10-year experience.  Arch Facial Plast Surg. 1999;  1 246-256
    CrossrefPubMedGoogle Scholar
  • 33 Nolst Trenite G J. Wedge resection in alar base surgery. In: Nolst Trenite GJ Rhinoplasty: A Practical Guide to Functional and Aesthetic Surgery of the Nose, 3rd ed. Amsterdam; Kugler Publications 2005: 143-149
    Google Scholar
  • 34 Gillman G S, Simons R L, Lee D J. Nasal tip bossae in rhinoplasty. Etiology, predisposing factors, management techniques.  Arch Facial Plast Surg. 1999;  1 83-89
    CrossrefPubMedGoogle Scholar
  • 35 Kamer F M, Pieper P G. Revision rhinoplasty. In: Bailey B Head and Neck Surgery: Otolaryngology. Philadelphia, PA; JB Lippincott 1998: 2263-2778
    Google Scholar
  • 36 Gilman G S, Simon R L, Lee D J. Nasal tip bossae in rhinoplasty. Etiology, predisposing factors, management techniques.  Arch Facil Plast Surg. 1999;  1 170
    PubMedGoogle Scholar
  • 37 Tardy M E, Patt B S, Walter M A. Alar reduction and sculpture: anatomic concepts.  Facial Plast Surg. 1993;  9 295-305
    Article in Thieme ConnectPubMedGoogle Scholar
  • 38 Tardy M E, Toriumi D M. Alar retraction: composite graft correction.  Facial Plast Surg. 1989;  6 101-107
    Article in Thieme ConnectPubMedGoogle Scholar

Santdeep H PaunF.R.C.S.(ORL-HNS) 

Department of Otorhinolaryngology–Head and Neck Surgery

St. Bartholomew's Hospital, West Smithfield, London, UK

Email: mail@spaun.co.uk