|
After
This is a young woman
with a history of rhinoplasty which
included a silicone
implant and narrowing of
the nostrils at a
private practice office
California. She
presented to our office
approximately three
months after her
original surgeon had
attempted repair of the
problems seen in the
left nostril area.
The planning of her
procedure required a
series of steroid
injections into areas of
scarring in the left
nostril, and a short
period of waiting in
anticipation of scar
changes and decrease in
swelling.
The results seen in
these pictures are
likely a result of poor
wound closure, improper
planning of nostril
width reduction, and the
patients own propensity
to form thick scars.
Repair was planned
with markings depicting
the desired width of the
left nostril base.
The curved line on
the left nostril depicts
a "rotational pedicled
flap" which was used to
widen the base of the
nostril on the left
side, and allow
repositioning of the
left nostril sidewall.
Initial steps in the
surgery involved
incisions to allow the
"flap" described above
to be rotated into the
nostril to allow
widening of the nostril.
Next the scar at the
corner of the left
nostril was removed.
A foil template was
used to help harvest a
"composite graft"
(portion of tissue
borrowed from the right
ear including skin and
cartilage) for
reconstruction of the
nostril.
The composite graft
was trimmed, prepared,
and inset into the
defect in the nostril.
The flap on the outside
of the nostril was
rotated inward to widen
the base of the nostril.
The incisions were
closed, and an oversized
silicone splint was
placed in the nostril.
This is a one month
follow-up photo
depicting an intact
graft and flap, well
healed incisions,
improved symmetry.
 
|
