Rhinoplasty Surgery ;
This 21-year-old woman presented with a bony and cartilaginous hump, inadequate tip projection, low columella-labial angle, a pointed nasal tip with weak cartilages in the dome area, and retracted alae. Eighteen months after rhinoplasty with the author’s perichondro-periosteal flap technique. An open approach was used to expose the dorsum. Perichondro-periosteal flaps were elevated. After a 2-mm bony and cartilaginous hump reduction, spreader flaps were placed to restore the cartilaginous dorsum and refine the dorsal aesthetic lines. Medial oblique and internal low-to-low osteotomies were performed. Perichondro-periosteal flaps were sutured after completion of dorsal reduction and restoration. Medial crura were advanced on a long columellar strut to increase tip projection. A subdomal graft was placed to strengthen weak domes, and an onlay tip graft was used to give an additional projection to the nasal tip. Bilateral alar rim grafts were also placed to correct the retracted alae. Note the patient’s smooth, straight nasal dorsum.
(Nov 1, 2016)