RhinoplastySpecialist
Revision Rhinoplasty Surgery by Rhinoplasty Specialist Dr. Paul S. Nassif
To see this video in it's entirety visit www.rhinoplastyspecialist.com/mediapage.asp
LIZ: The first time the doctor made my tip too narrow and I didn't look like myself. The second time the doctor made my tip too wide, and actually took out (removed) extra bone from the side of my nose. That didn't need to be taken out (removed)
My initial consultation with Dr. Nassif was fantastic! He treated me liker his own daughter, and was very caring and thorough. He went over everything!
My desired outcome would be to put the bone back inside my nose and to make the tip more narrow so its just not so bulbous. That's really it, and to make it just EVEN. Its not even right now, so that's the goal!
DR. NASSIF: Liz came into me for a revision rhinoplasty. She told me that shes had two previous rhinoplasties. She was unhappy with the way her nose appeared on her face. She felt it was asymmetric, the tip was kind of bulbous, or large appearing, especially when she looked up, this view, it was very asymmetric. And so, her whole goal was to make it look better, hopefully make it her LAST surgery, and also to help with her breathing.
With my examination of Liz, I found that most of the septo-cartilage, which is the septum inside here between the two nostrils, which is a great source of cartilage was GONE! The next thing we can go to is the ear. The problem with the ear cartilage is that its too soft and too curved, and if you want to do something strong for the nose and give it really good shape, you cant use the ear. So, we had a talk about using rib cartilage.
One of the things that's very important about revision rhinoplasty that you always have to consider is; What are you going to find in there? Even though you can feel the nose, you can palpate it, you can look at it, and you can guess what the other doctors have performed; your first up-hill battle is to see how much scar tissue you're going to be able to identify with. So when you have to open up the nose, you have to remove the scar tissue, identify it: whats there, whats present, whats been removed. Then after you do that, and you have cartilage now ready for grafting, or fascia, or perichondrium, you have to start rebuilding it.
Rebuilding it (cartilage) is the second big stage after we've already carved everything; we've carved the cartilage. In that scenario when I'm playing with the nose, in regards to staring at the profile, staring at the front of the nose, I go back and forth and look inside and outside of the nose to make sure its as symmetric as possible. That takes a long time One of Liz's main complaints was that on her profile, that her tip stuck out too far. And so one of the things I had to do in surgery is called a medial cura tuck-up, I had to push the tip back, by pushing the tip back, it can make the tip look a little bit wider. But in this situation, I was able to bring everything in as much as I can. After I'm finished with everything, and I'm happy, then we go ahead and we start to close the nose. That's putting every little small stitch in perfectly, so that the scar will be minimally visible.
www.spaldingplasticsurgery.com
Spalding Drive Cosmetic Surgery and Dermatology
120 S. Spalding Drive Suite 315
Beverly Hills, Ca. 90212
Tel: (310) 275-2467
Revision Rhinoplasty Surgery by Rhinoplasty Specialist Dr. Paul S. Nassif
To see this video in it's entirety visit www.rhinoplastyspecialist.com/mediapage.asp
LIZ: The first time the doctor made my tip too narrow and I didn't look like myself. The second time the doctor made my tip too wide, and actually took out (removed) extra bone from the side of my nose. That didn't need to be taken out (removed)
My initial consultation with Dr. Nassif was fantastic! He treated me liker his own daughter, and was very caring and thorough. He went over everything!
My desired outcome would be to put the bone back inside my nose and to make the tip more narrow so its just not so bulbous. That's really it, and to make it just EVEN. Its not even right now, so that's the goal!
DR. NASSIF: Liz came into me for a revision rhinoplasty. She told me that shes had two previous rhinoplasties. She was unhappy with the way her nose appeared on her face. She felt it was asymmetric, the tip was kind of bulbous, or large appearing, especially when she looked up, this view, it was very asymmetric. And so, her whole goal was to make it look better, hopefully make it her LAST surgery, and also to help with her breathing.
With my examination of Liz, I found that most of the septo-cartilage, which is the septum inside here between the two nostrils, which is a great source of cartilage was GONE! The next thing we can go to is the ear. The problem with the ear cartilage is that its too soft and too curved, and if you want to do something strong for the nose and give it really good shape, you cant use the ear. So, we had a talk about using rib cartilage.
One of the things that's very important about revision rhinoplasty that you always have to consider is; What are you going to find in there? Even though you can feel the nose, you can palpate it, you can look at it, and you can guess what the other doctors have performed; your first up-hill battle is to see how much scar tissue you're going to be able to identify with. So when you have to open up the nose, you have to remove the scar tissue, identify it: whats there, whats present, whats been removed. Then after you do that, and you have cartilage now ready for grafting, or fascia, or perichondrium, you have to start rebuilding it.
Rebuilding it (cartilage) is the second big stage after we've already carved everything; we've carved the cartilage. In that scenario when I'm playing with the nose, in regards to staring at the profile, staring at the front of the nose, I go back and forth and look inside and outside of the nose to make sure its as symmetric as possible. That takes a long time One of Liz's main complaints was that on her profile, that her tip stuck out too far. And so one of the things I had to do in surgery is called a medial cura tuck-up, I had to push the tip back, by pushing the tip back, it can make the tip look a little bit wider. But in this situation, I was able to bring everything in as much as I can. After I'm finished with everything, and I'm happy, then we go ahead and we start to close the nose. That's putting every little small stitch in perfectly, so that the scar will be minimally visible.
www.spaldingplasticsurgery.com
Spalding Drive Cosmetic Surgery and Dermatology
120 S. Spalding Drive Suite 315
Beverly Hills, Ca. 90212
Tel: (310) 275-2467