Secondary rhinoplasty – tip defect: nose appearance too small, too shortened, too high, too long with a drooping nose tip, crooked nose…
Forshortened and overrotated nose after a rhinoplasty
Secondary rhinoplasty on forshortened and overrotated nose, by Dr. Gerbault:
Some secondary rhinoplasty are complex reconstructions of the nose that require teamwork.
This young woman had two rhinoplasties and an infection as a result of the second, which greatly damaged the skin of the columella, while her skin was already very thin.
It was first necessary to improve the quality of this skin thanks to a nanofat injection performed by Dr. Alex Verpaele.
A secondary rhinoplasty with costal graft and use of many grafts to recreate a tip and lower the alae. The use of nanofat injected temporal fascia (MISTA, developed by Dean Toriumi) allowed the skin of the columella to heal well.
The result is shown 6 months after the operation.
Secondary rhinoplasty for inverted V deformity and residual deviation
Secondary rhinoplasty for inverted V deformity and residual deviation, by Dr. Gerbault:
The so-called inverted V deformities are a frequent complication of "classic" rhinoplasty which consists of removing a hump by breaking the bones and cutting the cartilage. The lack of reconstruction of the new dorsum leads not only to these deformities with a significant demarcation between bones and cartilages, but also to respiratory problems related to the dorsum pinching.
In this case, a residual deviation of the nasal septum was existing. The correction of these problems involves a reconstruction of the dorsum thanks to grafts positioned as beams (spreader grafts) often associated with a cover by an aponevrosis to smooth the new dorsum. The septum was of course put back straight on this occasion. These grafts open the pinched space to help breathe better.
Finally, in this case, the nose was smoothed by ultrasonic rhinoplasty and the tip reshaped by sutures on the cartilages and a good tip support.
The result is shown one year after the operation.
Upturned nose after a 1st rhinoplasty
Rhinoplasty on upturned nose with surgical look after a 1st rhinoplasty, by Dr. Gerbault:
In recent years, Dr. Gerbault often sees women who have undergone nose surgery who find their nose too hollowed out and too up, after a 1st rhinoplasty. These patients want natural feminine noses and not "Instagram" noses.
The correction by secondary rhinoplasty is unfortunately very complex and requires the use of several cartilaginous grafts to lower the tip, the alae.
He also had to refine a little more the bony and cartilaginous pyramid in this young woman thanks to ultrasonic rhinoplasty.
The result after more than a year is natural and feminine, but corrects the appearance of fake and operated nose.
The result at 6 months is still early, but it shows well the refinement that can be achieved even in this type of complex secondary rhinoplasty on a person with thick skin thanks to adapted structural rhinoplasty techniques.
Secondary rhinoplasty on nostrils too visible
Secondary rhinoplasty: too much cartilaginous trimming with conspicuous nostrils and retracted alae, by Dr. Gerbault:
Correction of aesthetic and breathing issues is common in secondary rhinoplasty. The appearance of very conspicuous nostrils after secondary rhinoplasty is very common, due to excessive resections of cartilage.
This young woman had a significant resection of her tip cartilages, and an incomplete correction of her deviated septum. She breathed worse after her rhinoplasty. She was very embarrassed by the appearance of her tip of the nose, the nostrils too conspicuous and retracted, the asymmetrical tip…
She benefited from an ultrasonic structural rhinoplasty with the use of costal grafts to reconstruct her nose, lower the tip and alae. These are long and complex operations that I continue to perform, having stopped secondary rhinoplasty for minor aesthetic and functional problems.
Nez trop raccourci, pointe trop remontée, rétraction des ailes du nez
Secondary rhinoplasty on an over shortened nose, with an over rotated tip and alar retractions, by Dr. Gerbault:
It’s rare that a patient can’t stop smiling as she discovers her new nose after the splint removal six days after her secondary rhinoplasty. This is what happened with this charming patient whose nose had been severely damaged after a first rhinoplasty performed 11 months earlier.
She arrived significantly affected psychologically by her foreshortened nose with an overrotated tip and a strong alar retraction creating an excess visibility of the inner part of her nose.
A global reconstruction of her nose has been done with a lowering of the tip and alae and a lengthening of the nose, while keeping a natural and feminine look of the nose.
The result at day 6 post-op shows a natural result without any stigmata of the surgery after 3 hours and a half spent in the OR.
Tip asymmetry with retraction of the left alar rim.
Structural secondary rhinoplasty establishing a good support to the tip.
Correction of the retraction of the left alar rim and refinement of the rest of the nose.
Nose having been restructured are more rigid at digital pressure
Correction of a failed rhinoplasty
Correction of a failed rhinoplasty.
Twisted nose with deviation of the septum and significant asymmetry of the tip after rhinoplasty
Secondary rhinoplasty with repositioning of the septum,
Tip repair with cartilage sutures and cartilaginous grafts.
Preventive camouflage because the skin is very thin
Result at 6 months
Secondary Ethnic Rhinoplasty
Secondary Ethnic Rhinoplasty
Iranian patient already operated for a hump and a broad tip.
Persistence of 2 problems with inverted V deformity.
Persistent septal deviation.
Secondary rhinoplasty with ultrasonic rhinosculpture.
Spreader grafts and rebuilding of the architecture of the nasal pyramid.