Before & After Photo Gallery: Revision Rhinoplasty
This photo gallery represents a cross-section of my rhinoplasty practice
and includes patients of different age, gender, nasal shape, and ethnic
background. This gallery is not a collection of my best rhinoplasty
outcomes, but rather a representative sampling of my typical cosmetic
result. In
addition, a majority of these patients also had simultaneous correction
of severe nasal breathing difficulties, which cannot be appreciated in
photographs.
Although reviewing before and after photographs is an important element
in selecting the right rhinoplasty
surgeon, choosing your surgeon solely on the basis of website photos
is ill-advised. Indeed, countless disappointed rhinoplasty patients can
attest to the deceptive and misleading nature of many rhinoplasty websites.
Moreover, viewing online photos is no substitute for the consultation
visit, where I can share numerous other before and after photos, many
with noses similar in appearance to your own – a far more meaningful
comparison. Although I have been slow to incorporate internet marketing
into my rhinoplasty practice, the growing number of individuals who look
to the internet as their sole source of medical information cannot be
overlooked. Consequently, I offer this website as a source of candid
information to equip the prospective rhinoplasty patient with accurate
information and honest advice.
I am indebted to the generous patients who kindly authorized use of
their rhinoplasty photographs.
Richard E. Davis, MD, FACS
Revision Rhinoplasty: Patient 1
| Clinical History: |
Healthy female underwent two previous surgeries elsewhere;
residual hump, wide middle vault, pinched tip (from
collapsed/retracted tip cartilages), and flared nostrils |
| Procedures: |
External (open) nasoseptal reconstruction with hump reduction
(full osteotomies), middle vault reconstruction, and tip-plasty
with vertical dome division and multiple cartilage grafts |
| Graft Types: |
Right side spreader graft,
extension graft, and tip (shield and
cap) grafts (all from septal cartilage), left alar rim graft
(conchal cartilage), soft tissue (SMAS) tip onlay grafts |
| After Photos Taken: |
13 months post-op |
Revision Rhinoplasty: Patient 2
| Clinical History: |
Healthy young female with history of successful cosmetic
rhinoplasty at age 11, followed by a severe nasal
fracture (untreated) at age 15. Presented with crooked nose,
inverted-V and boxy tip, complaining of severe nasal obstruction
(secondary to septal deviation, nasal valve collapse, and
turbinate enlargement), recurrent sinusitis, and sinus headaches. |
| Procedures: |
External (open) nasoseptal reconstruction with middle vault
augmentation graft, tongue-in-groove nasal shortening, tip-plasty,
left alar cartilage reconstruction, septoplasty, and sub-mucous
(partial) turbinate reduction. |
| Graft Types: |
Dorsal onlay graft, septal extension graft, shield (tip)
graft, left alar rim graft, and left crural onlay (batten)
graft, all from septal cartilage. |
| After Photos Taken: |
8 months post-op |
| Comments: |
Breathing was restored and rhinogenic headaches resolved. |
Revision Rhinoplasty: Patient 3
| Clinical History: |
Healthy female underwent previous rhinoplasty in 1990’s;
over-resected bridge, left alar collapse, and severe
nasal obstruction (nasal valve collapse, septal deviation,
and turbinate enlargement) |
| Procedures: |
External (open) nasoseptal reconstruction with rib cartilage
augmentation grafts, septoplasty, and turbinate reduction |
| Graft Types: |
Two-layer dorsal onlay graft, septal extension
graft, tip (shield) graft, columellar batten
graft (all from rib cartilage), perichondrial graft to left
sidewall |
| After Photos Taken: |
13 months post-op |
Revision Rhinoplasty: Patient 4
| Clinical History: |
Healthy female underwent two previous surgeries elsewhere;
collapsed middle vault, crooked/pinched tip, small residual
hump, and caudal excess deformity |
| Procedures: |
External (open) nasoseptal reconstruction with hump reduction
(rasp and lateral osteotomies), middle vault augmentation
grafts, septal replacement graft, "tongue-in-groove" setback,
and tip-plasty using vertical dome division and onlay grafting |
| Graft Types: |
Right side spreader graft, tip (shield)
graft, columellar
batten graft (all from conchal cartilage), dorsal onlay graft,
septal replacement graft (both from septal cartilage) |
| After Photos Taken: |
5 months post-op |
Revision Rhinoplasty: Patient 5
| Clinical History: |
Healthy male underwent multiple surgeries elsewhere (including
nasal implant and ear cartilage graft); twisted bridge,
saddle nose deformity, and tip asymmetry |
| Procedures: |
External (open) nasal reconstruction with removal of synthetic
nasal bridge implant, rib cartilage augmentation grafts,
and partial turbinectomies |
| Graft Types: |
Dorsal onlay graft, columellar strut graft (both
from rib cartilage) |
| After Photos Taken: |
12 months post-op |
Revision Rhinoplasty: Patient 6
| Clinical History: |
Healthy female underwent one prior surgery elsewhere; wide,
asymmetric nose |
| Procedures: |
External (open) nasal reconstruction with lateral osteotomies
and revision (partial excision and/or repositioning) of existing
cartilage grafts |
| Graft Types: |
None |
| After Photos Taken: |
18 months post-op |
Revision Rhinoplasty: Patient 7
| Clinical History: |
Healthy female underwent two previous rhinoplasty surgeries elsewhere; presented complaining of nasal airway obstruction (from septal deviation and turbinate hypertrophy), and cosmetic deformity (from residual hump deformity, mild inverted-V deformity, wide, overprojected nasal tip, large infra-tip lobule and retracted nostril rims) |
| Procedures: |
External (open) nasoseptal reconstruction with hump reduction (full osteotomies), tip deprojection with "tongue-in-groove" setback, suture tip refinement with minimal cartilage excision, and columellar batten graft placement; synthetic chin implant placement via extra-oral skin incision |
| Graft Types: |
Columellar batten graft (septal cartilage) |
| After Photos Taken: |
14 months post-op (2 months after minor touch-up) |
