This Medical Video:
This is my
plastic surgery before and after story as I have a closed
(endonasal) rhinoplasty in Beverly Hills, CA. My sister had a
rhinoplasty procedure before me that left her with undesirable
results. Learning from her experience, I did my research and chose
one of the Top Rhinoplasty Specialists in the world, Rhinoplasty
Specialist Dr. Paul S. Nassif, to perform my surgery.
rhinoplasty refers to procedures in which the incisions are confined
to the inside of the nose. Open rhinoplasty refers to procedures in
which an additional small incision is made between the nostrils on
the underside of the nose. Closed rhinoplasty results in no visible
scarring while open rhinoplasty results in a well-concealed,
As a patient, you wonder why this is happening to
me. You wonder why do I need a revision rhinoplasty 9 months
following my initial nose surgery. You wonder why everything looked
great and the next thing you notice is pinched nostrils and
progressive nasal obstruction. Well, you are not alone. Whether its
the result of aggressive surgery or scar contracture with the
healing process, unfortunately this problem is not that rare.
Nationally, approximately 5 12% of patients that undergo rhinoplasty
need a revision of some kind, whether it is major or minor. Even in
the hands of the best rhinoplasty surgeons across the country, the
need for revision sometimes occurs. Without a doubt, revision
rhinoplasty surgery is the most challenging procedure that we,
Facial Plastic Reconstructive Surgeons, perform.
important detail is to ascertain if you have nasal obstruction. I
will determine if the nasal obstruction was present preoperatively.
If the obstruction is a result of the surgery, a number of questions
need to be answered. Did you have reductive rhinoplasty surgery? I
will have you point out where the obstruction is. Is it static or
dynamic? Present with normal or deep inspiration? What alleviates
and worsens the nasal obstruction? What are the characteristics of
the nasal obstruction? Was septal surgery performed? With these
important questions answered I am now ready to perform the physical
Many procedures were performed on Luisas nose
including 1. Septoplasty Septal Battan Graft, 2. Turbinoplasty, 3.
Closed Rhinoplasty - Exposing Nasal Anatomy, 4. Removal of
Bony-Cartilaginous Dorsal Hump, 5. Columella Strut Placement, 6.
Bruised Infratip Lobular Graft, 7. Osteotomies, 8. Spreader Grafts
9. Closed Rhinoplasty - Closure of Intercartilaginous
DIAGNOSIS Nasal obstruction secondary to turbinate hypertrophy,
narrow middle vault, right rim narrowing and deviated
PROCEDURE Endonasal Rhinoplasty
1. Repair of nasal
vestibular stenosis secondary to right external valve collapse
secondary to right alar rim weakness with placement of right alar
2. Repair of bilateral nasal vestibular stenosis
secondary to bilateral internal valve collapse secondary to
narrow/subluxed upper lateral cartilages with placement of bilateral
3. Complex septal reconstruction, submucous
resection with major partial vomerectomy for correction of deviated
4. Submucous resection and partial resection of
right inferior turbinate.
5. Submucous resection and partial
resection of left inferior turbinate.
FINDINGSWeak right alar
rim causing collapse, right deviated septum with caudal deviation,
bilateral narrow middle vault.
COMMENT Post-op photos reveal
softer nasal appearance. Patient has experienced improvement in
breathing and is still healing.