This patient can breathe like never before! She has had several previous surgeries on her nose by other surgeons.

This patient can breathe like never before! She has had several previous surgeries on her nose by other surgeons. Unfortunately, she had severe nasal obstruction and apnea. She also hoped for improved nasal symmetry. We performed an open cleft rhinoplasty, including release of scar tissue and reconstruction with multiple cartilage grafts (spreader, septal extension, columellar strut, lateral crural strut, and tip grafts). MTF … Read More

A gentle hump reduction and contouring of the dorsum can be done at the same time.

Nasal obstruction and a history of trauma? We can definitely help you breathe and sleep better, and straighten your nose. A gentle hump reduction and contouring of the dorsum can be done at the same time. Here, preservation techniques to bring the nasal bones down, and component septal resection and spreader grafts, all work together for a natural result at … Read More

This patient communicates beautifully and expressively with her eyes and smile, but her nose was distracting and causing progressively worse breathing problems.

Secondary rhinoplasty is a welcome challenge in my practice. This patient communicates beautifully and expressively with her eyes and smile, but her nose was distracting and causing progressively worse breathing problems. Anatomically, her septum and columella twisted to the left, and her lower lateral cartilage on the left with asymmetric amounts of lateral crural steal and medial crural excess. After … Read More

Functional rhinoplasty should also work hand in hand with your aesthetic goals.

Functional rhinoplasty should also work hand in hand with your aesthetic goals. Here, a deviated septum and narrow internal nasal valve were corrected with a septoplasty and spreader grafts, improving her nasal breathing. The dorsal hump was brought down and smoothed as planned. Under the hood, the turbinates are little humidifiers inside the nasal passages. These little outcroppings can be … Read More

Secondary nasal reconstruction after old trauma or rhinoplasty surgery.

Secondary nasal reconstruction after old trauma or rhinoplasty surgery falls into that overlap of 1) what I enjoy doing, and 2) where we get consistently satisfying results. This patient had a previous trauma with reduction of the fractures done appropriately after her injury. Unfortunately, over time the deviation and airway collapse continually worsened. Open approach, structural rhinoplasty was required to … Read More

Septorhinoplasty is usually the final surgery for a patient born with a cleft lip.

Septorhinoplasty is usually the final surgery for a patient born with a cleft lip. A few things combine to create common complaints: 1) Inherently different/less growth potential 2) Asymmetric and/or abnormal attachments of muscles and ligaments 3) Bony asymmetries 4) Scar tissue 5) Abnormal blood and lymphatic flow These inevitably lead to problems breathing, and often thick and scarred nasal … Read More

Here, septal deviation and airway collapse led to nasal obstruction, sleep apnea, and difficulty with daily activities.

Usually we wait until after skeletal maturity and jaw surgery before offering a cleft rhinoplasty. However, if nasal obstruction and symptoms are severe, nasal reconstruction before jaw surgery is sometimes done, knowing that a second surgery may be needed after the maxilla is moved forward. Here, septal deviation and airway collapse led to nasal obstruction, sleep apnea, and difficulty with … Read More