Revision rhinoplasty can address a variety of different deformities from the excessive reduction of the nasal bridge to asymmetry in the nasal tip.
Revision rhinoplasty open roof deformity.
The edges of the bones separate and will create a bumps on the sides of the nose.
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Open roof deformity when this happens the middle part of the bridge will feel unnaturally flat.
Nasal tip deformities seen in revision rhinoplasty stem from vagaries of volume strength and shape of the lower lateral cartilages.
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On profile view a large dorsal hump causes the nose to look like it has a big bump.
This refers to an upside down v shaped indentation between the end of the nasal bones and the start of the upper lateral cartilages along the top of the bridge.
These deformities may occur singly or in combination and may relate as an x axis width.
Most revisions are complicated procedures that require an open approach.
Litner have extensive experience correcting these and many other rhinoplasty deformities.
Ideally revision rhinoplasty should not be performed until at least 12 months after the initial operation.
Open roof deformity is one of the most common and problematic deformities in revision rhinoplasties due to failure to perform or performing incomplete ineffective uneven or unilateral osteotomies between the nasal bones and the maxilla thus impeding a smooth medialization of the nasal bones after either hump resection or humpless dorsum narrowing.
Patients who have a large dorsal hump that is reduced and then have osteotomies to close an open roof are at risk for narrowing of the mid portion of the nose.
If a patient were to run their fingers along the sides of the bridge they would feel that this mid portion of the bridge feels indented on each side and narrower than the width of the nasal bones.
Persistence of a wide or bulbous tip is most commonly from too conservative a resection of the lateral crura.
Furthermore the outcome of revision rhinoplasty may be harder to predict due to the primary rhinoplasty.
To repair an open roof deformity the bones need to be brought back together.
One of the most common issues present in patients seeking revision rhinoplasty is the inverted v deformity.
At the time of rhinoplasty osteotomies will re position the nasal bones in such a way as to close the open roof and achieve a result that is natural in appearance.
