I just saw one of my revision rhinoplasty patients in follow-up today and it reminded me to post a quick note on management of the narrow nasal tip following prior rhinoplasty. This particular patient had prior rhinoplasty performed by a different plastic surgeon years ago. He was unhappy with the fact his nasal tip was too narrow for his face. If you look at his preoperative frontal photo below left you can appreciate that his tip does appear excessively narrowed. In a male patient this can particularly distracting and an obvious indication of prior nasal reshaping. This patient elected to undergo revision rhinoplasty to help widen the tip and remove some of the stigmata of having had prior surgery. So how is this done technically? I performed an open rhinoplasty approach to afford me the best exposure possible. I then harvested ear cartilage, which was grafted to his existing nasal tip in order to widen the tip region as it transitioned to the sides of his nose. The red arrows below indicate precisely where the grafts were placed to widen the nasal tip. His postoperative rhinoplasty photo below right shows him following the surgery. Notice how his nasal tip is now wider with more appropriate balance when compared with the remainder of his nose and face. He still looks like the same patient, but with a more proportional nasal tip now.
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