Category Archive

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

“It’s not a big deal to be able to breathe… but it really is a big deal. The left [nostril] especially works well.” She has a history of previous surgery but had chronic problems breathing through her nose. Closed septorhinoplasty (*no incision* across the columella) was done. Key maneuvers included septal resection, spreader and caudal septal extension grafts, and tip … Read More

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

He came to me with longstanding trouble breathing despite years of different medications and sprays. While correcting the deviated septum, we used that cartilage to make spreader grafts that support the airway further. We also opted to bring his dorsum down, but kept it masculine and not too upturned. His swelling is about half way down at this 1 month … Read More

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. 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 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. 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

This man is breathing well at 7 weeks after his cleft rhinoplasty and fat grafting to his upper lip. Septoplasty and spreader grafts, with tensioning of the upper lateral cartilages over the grafts, helped his breathing. This is like having an internal Breathe Right strip people use for snoring and nasal collapse. His contour and projection match his face well, … Read More

This young man is breathing well and confident 1 month after his cleft rhinoplasty and fat graft to his upper lip. Not every patient requires a rib graft, or total deconstruction and reconstruction of the nose. Here, we used a spreader graft on just the left side of the nose, columellar strut graft, and suture techniques to unite, reorient, and … Read More

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

This man came to us with severe facial asymmetry even after over 10 surgeries elsewhere for Parry Romberg Syndrome. Those surgeries included 2 free flap surgeries, but he still had a fair amount of asymmetry and tightness of the upper cheeks and soft tissue on the entire left side of his face. He has since gone through two surgeries with … Read More