Patient Photos

Revision Bridge Augmentation Rhinoplasty To Replace Malpositioned Silicone Implant With Rib Cartilage

This Bellevue revision rhinoplasty patient suffered a severe nasal fracture many decades ago in which his bridge was crushed in a motor vehicle accident. The injury was repaired at the time using a silicone implant over the bridge to efface the depressed nasal bone injury. Unfortunately, the patient's silicone implant ended up becoming shifted out of place such that it was too far toward the left and down by the tip. This resulted in a obvious asymmetry and also an unnatural pollybeak type deformity as seen on profile view. Additionally, the patient had twisted tip cartilages and right alar rim retraction. Using an open revision rhinoplasty technique, Dr. Thomas Lamperti removed the patient's malpositioned silicone implant. Tissue bank rib cartilage was then carved to augment the dorsum and form a new properly sized dorsal implant graft in which the depressed nasal bridge was rebuilt creating a strong, straight profile line. The patient's crooked tip cartilages were straightened and supported using a caudal septal extension graft and a right rim graft was also placed to correct the patient's alar retraction. The patient's left supra-alar pinching was corrected using an alar batten graft. In the 4 month postoperative  photos you can see how the patient now has a much more natural, masculine, symmetric appearing nose. The patient's excess columellar show has been improved along with the alar retraction. Most notably, the patient's profile line is smooth and straight as it transitions from the upper bridge down toward the tip.