This website uses its own and third party cookies to provide a better service. If you continue to browse, you are deemed to have accepted their use. See our Cookies Policy and Legal Notice and Terms of Service
PROMOTIONS: Check discounts from our Combo Specials and Day Specials. We implement the Safe Surgery protocol to offer maximum guarantees.

This case exemplifies the indication of a rib grafting in a scenario other than saddle nose deformity revision rhinoplasty and primary ethnic rhinoplasty; as a contributing factor to require rib grafting the nasal septum was totally absent, literally the patient had no nasal septum at all.

READ
Alar flaring,Alar rim retraction,Asymmetric nose,Asymmetric tip,Bifid columella,Bifid tip,Broad dorsum,Broad nose,Concave lateral cruras,Congenital nose,Crooked nose,Crooked septum,Crooked tip,Dorsum hump,Dorsum ridges,Droopy tip,Failed osteotomies,Flat dorsum,Irregular dorsum,Large alar cartilages,Large nose,Large nostrils,Large sills,Nasal fibrosis,Nasal valve collapse,Overprojected tip,Pinched middle vault,Pinched nose,Plunging tip deformity,Poorly defined tip,Poorly supported tip,Posttraumatic nose,Rhomboid dorsum,Saddle nose deformity,Short septum,Short upper lateral cartilages,Sunken columella,Sunken supratip,Thick skin nose,Tip bossae,Underprojected tip,Alar base resection alarplasty,Columella strut graft,Dorsum hump resection,Dorsum regularization,Extended columella strut graft,Intercrural columella plasty sutures,Interdomal tip plasty sutures,Lateral cruras cephalic resection,Lateral cruras plasty sutures,Lateral cruras repositioning,Lateral cruras shortening resection,Medial cruras shortening resection,Nasal bones osteotomies,Nostril sill resection,Onlay dorsum graft,Onlay supratip graft,Open approach incision,Rib cartilage graft harvesting,Septocolumella graft,Septum caudal extension graft,Septum replacement graft,Spreader graft,Temporalis fascia graft harvesting,Tip defatting,Transdomal tip plasty sutures,Triangular cartilages caudal extension graft - photo 1
#1Tip bossae due to lateral cruras congenital concavity plus posttraumatic and surgical damages. The tip is flattened and collapsed, there is no support at all, lacks definition, the columella is sunken due to the absence of the caudal septum. ...Read more
Alar flaring,Alar rim retraction,Asymmetric nose,Asymmetric tip,Bifid columella,Bifid tip,Broad dorsum,Broad nose,Concave lateral cruras,Congenital nose,Crooked nose,Crooked septum,Crooked tip,Dorsum hump,Dorsum ridges,Droopy tip,Failed osteotomies,Flat dorsum,Irregular dorsum,Large alar cartilages,Large nose,Large nostrils,Large sills,Nasal fibrosis,Nasal valve collapse,Overprojected tip,Pinched middle vault,Pinched nose,Plunging tip deformity,Poorly defined tip,Poorly supported tip,Posttraumatic nose,Rhomboid dorsum,Saddle nose deformity,Short septum,Short upper lateral cartilages,Sunken columella,Sunken supratip,Thick skin nose,Tip bossae,Underprojected tip,Alar base resection alarplasty,Columella strut graft,Dorsum hump resection,Dorsum regularization,Extended columella strut graft,Intercrural columella plasty sutures,Interdomal tip plasty sutures,Lateral cruras cephalic resection,Lateral cruras plasty sutures,Lateral cruras repositioning,Lateral cruras shortening resection,Medial cruras shortening resection,Nasal bones osteotomies,Nostril sill resection,Onlay dorsum graft,Onlay supratip graft,Open approach incision,Rib cartilage graft harvesting,Septocolumella graft,Septum caudal extension graft,Septum replacement graft,Spreader graft,Temporalis fascia graft harvesting,Tip defatting,Transdomal tip plasty sutures,Triangular cartilages caudal extension graft - photo 2
#2Left: The line shows the zigzag misalignment of the crooked nasal pyramid and tip; the arrow points to the impact area of the traumatism, not solved during the previous failed rhinoplasty. Right: The lines show the sinusoid contours of the nasal ...Read more
Alar flaring,Alar rim retraction,Asymmetric nose,Asymmetric tip,Bifid columella,Bifid tip,Broad dorsum,Broad nose,Concave lateral cruras,Congenital nose,Crooked nose,Crooked septum,Crooked tip,Dorsum hump,Dorsum ridges,Droopy tip,Failed osteotomies,Flat dorsum,Irregular dorsum,Large alar cartilages,Large nose,Large nostrils,Large sills,Nasal fibrosis,Nasal valve collapse,Overprojected tip,Pinched middle vault,Pinched nose,Plunging tip deformity,Poorly defined tip,Poorly supported tip,Posttraumatic nose,Rhomboid dorsum,Saddle nose deformity,Short septum,Short upper lateral cartilages,Sunken columella,Sunken supratip,Thick skin nose,Tip bossae,Underprojected tip,Alar base resection alarplasty,Columella strut graft,Dorsum hump resection,Dorsum regularization,Extended columella strut graft,Intercrural columella plasty sutures,Interdomal tip plasty sutures,Lateral cruras cephalic resection,Lateral cruras plasty sutures,Lateral cruras repositioning,Lateral cruras shortening resection,Medial cruras shortening resection,Nasal bones osteotomies,Nostril sill resection,Onlay dorsum graft,Onlay supratip graft,Open approach incision,Rib cartilage graft harvesting,Septocolumella graft,Septum caudal extension graft,Septum replacement graft,Spreader graft,Temporalis fascia graft harvesting,Tip defatting,Transdomal tip plasty sutures,Triangular cartilages caudal extension graft - photo 3
#3Left: The line shows the zigzag misalignment of the crooked nasal pyramid and tip; the arrow points to the impact area of the traumatism, not solved during the previous failed rhinoplasty. Right: The lines at the nasal dorsum show its sinusoid ...Read more
Alar flaring,Alar rim retraction,Asymmetric nose,Asymmetric tip,Bifid columella,Bifid tip,Broad dorsum,Broad nose,Concave lateral cruras,Congenital nose,Crooked nose,Crooked septum,Crooked tip,Dorsum hump,Dorsum ridges,Droopy tip,Failed osteotomies,Flat dorsum,Irregular dorsum,Large alar cartilages,Large nose,Large nostrils,Large sills,Nasal fibrosis,Nasal valve collapse,Overprojected tip,Pinched middle vault,Pinched nose,Plunging tip deformity,Poorly defined tip,Poorly supported tip,Posttraumatic nose,Rhomboid dorsum,Saddle nose deformity,Short septum,Short upper lateral cartilages,Sunken columella,Sunken supratip,Thick skin nose,Tip bossae,Underprojected tip,Alar base resection alarplasty,Columella strut graft,Dorsum hump resection,Dorsum regularization,Extended columella strut graft,Intercrural columella plasty sutures,Interdomal tip plasty sutures,Lateral cruras cephalic resection,Lateral cruras plasty sutures,Lateral cruras repositioning,Lateral cruras shortening resection,Medial cruras shortening resection,Nasal bones osteotomies,Nostril sill resection,Onlay dorsum graft,Onlay supratip graft,Open approach incision,Rib cartilage graft harvesting,Septocolumella graft,Septum caudal extension graft,Septum replacement graft,Spreader graft,Temporalis fascia graft harvesting,Tip defatting,Transdomal tip plasty sutures,Triangular cartilages caudal extension graft - photo 4
#4Profile view showing the hump, the sunken middle vault, the overprojected tip and the sunken columella.
Alar flaring,Alar rim retraction,Asymmetric nose,Asymmetric tip,Bifid columella,Bifid tip,Broad dorsum,Broad nose,Concave lateral cruras,Congenital nose,Crooked nose,Crooked septum,Crooked tip,Dorsum hump,Dorsum ridges,Droopy tip,Failed osteotomies,Flat dorsum,Irregular dorsum,Large alar cartilages,Large nose,Large nostrils,Large sills,Nasal fibrosis,Nasal valve collapse,Overprojected tip,Pinched middle vault,Pinched nose,Plunging tip deformity,Poorly defined tip,Poorly supported tip,Posttraumatic nose,Rhomboid dorsum,Saddle nose deformity,Short septum,Short upper lateral cartilages,Sunken columella,Sunken supratip,Thick skin nose,Tip bossae,Underprojected tip,Alar base resection alarplasty,Columella strut graft,Dorsum hump resection,Dorsum regularization,Extended columella strut graft,Intercrural columella plasty sutures,Interdomal tip plasty sutures,Lateral cruras cephalic resection,Lateral cruras plasty sutures,Lateral cruras repositioning,Lateral cruras shortening resection,Medial cruras shortening resection,Nasal bones osteotomies,Nostril sill resection,Onlay dorsum graft,Onlay supratip graft,Open approach incision,Rib cartilage graft harvesting,Septocolumella graft,Septum caudal extension graft,Septum replacement graft,Spreader graft,Temporalis fascia graft harvesting,Tip defatting,Transdomal tip plasty sutures,Triangular cartilages caudal extension graft - photo 5
#5The line contours the real skeleton underlying the nasal profile; note how at the middle vault there is a gap between the skeletal level and the skin, filled by postsurgical fibrosis; this line is the cornerstone of this rhinoplasty regarding ...Read more
Alar flaring,Alar rim retraction,Asymmetric nose,Asymmetric tip,Bifid columella,Bifid tip,Broad dorsum,Broad nose,Concave lateral cruras,Congenital nose,Crooked nose,Crooked septum,Crooked tip,Dorsum hump,Dorsum ridges,Droopy tip,Failed osteotomies,Flat dorsum,Irregular dorsum,Large alar cartilages,Large nose,Large nostrils,Large sills,Nasal fibrosis,Nasal valve collapse,Overprojected tip,Pinched middle vault,Pinched nose,Plunging tip deformity,Poorly defined tip,Poorly supported tip,Posttraumatic nose,Rhomboid dorsum,Saddle nose deformity,Short septum,Short upper lateral cartilages,Sunken columella,Sunken supratip,Thick skin nose,Tip bossae,Underprojected tip,Alar base resection alarplasty,Columella strut graft,Dorsum hump resection,Dorsum regularization,Extended columella strut graft,Intercrural columella plasty sutures,Interdomal tip plasty sutures,Lateral cruras cephalic resection,Lateral cruras plasty sutures,Lateral cruras repositioning,Lateral cruras shortening resection,Medial cruras shortening resection,Nasal bones osteotomies,Nostril sill resection,Onlay dorsum graft,Onlay supratip graft,Open approach incision,Rib cartilage graft harvesting,Septocolumella graft,Septum caudal extension graft,Septum replacement graft,Spreader graft,Temporalis fascia graft harvesting,Tip defatting,Transdomal tip plasty sutures,Triangular cartilages caudal extension graft - photo 6
#6Erroneous theoretical planning of this rhinoplasty regarding the profile view, considering the sunken supratip as the right dorsal level; this entails an aggressive osseous shaving, a powerful oblique vector of nasal expansion and a firm caudal ...Read more
Alar flaring,Alar rim retraction,Asymmetric nose,Asymmetric tip,Bifid columella,Bifid tip,Broad dorsum,Broad nose,Concave lateral cruras,Congenital nose,Crooked nose,Crooked septum,Crooked tip,Dorsum hump,Dorsum ridges,Droopy tip,Failed osteotomies,Flat dorsum,Irregular dorsum,Large alar cartilages,Large nose,Large nostrils,Large sills,Nasal fibrosis,Nasal valve collapse,Overprojected tip,Pinched middle vault,Pinched nose,Plunging tip deformity,Poorly defined tip,Poorly supported tip,Posttraumatic nose,Rhomboid dorsum,Saddle nose deformity,Short septum,Short upper lateral cartilages,Sunken columella,Sunken supratip,Thick skin nose,Tip bossae,Underprojected tip,Alar base resection alarplasty,Columella strut graft,Dorsum hump resection,Dorsum regularization,Extended columella strut graft,Intercrural columella plasty sutures,Interdomal tip plasty sutures,Lateral cruras cephalic resection,Lateral cruras plasty sutures,Lateral cruras repositioning,Lateral cruras shortening resection,Medial cruras shortening resection,Nasal bones osteotomies,Nostril sill resection,Onlay dorsum graft,Onlay supratip graft,Open approach incision,Rib cartilage graft harvesting,Septocolumella graft,Septum caudal extension graft,Septum replacement graft,Spreader graft,Temporalis fascia graft harvesting,Tip defatting,Transdomal tip plasty sutures,Triangular cartilages caudal extension graft - photo 7
#7Erroneous theoretical planning of this rhinoplasty regarding the profile view, considering the peak of the osseous hump as the right dorsal level; this entails a massive middle vault raise, a powerful oblique vector of nasal expansion and a ...Read more
Alar flaring,Alar rim retraction,Asymmetric nose,Asymmetric tip,Bifid columella,Bifid tip,Broad dorsum,Broad nose,Concave lateral cruras,Congenital nose,Crooked nose,Crooked septum,Crooked tip,Dorsum hump,Dorsum ridges,Droopy tip,Failed osteotomies,Flat dorsum,Irregular dorsum,Large alar cartilages,Large nose,Large nostrils,Large sills,Nasal fibrosis,Nasal valve collapse,Overprojected tip,Pinched middle vault,Pinched nose,Plunging tip deformity,Poorly defined tip,Poorly supported tip,Posttraumatic nose,Rhomboid dorsum,Saddle nose deformity,Short septum,Short upper lateral cartilages,Sunken columella,Sunken supratip,Thick skin nose,Tip bossae,Underprojected tip,Alar base resection alarplasty,Columella strut graft,Dorsum hump resection,Dorsum regularization,Extended columella strut graft,Intercrural columella plasty sutures,Interdomal tip plasty sutures,Lateral cruras cephalic resection,Lateral cruras plasty sutures,Lateral cruras repositioning,Lateral cruras shortening resection,Medial cruras shortening resection,Nasal bones osteotomies,Nostril sill resection,Onlay dorsum graft,Onlay supratip graft,Open approach incision,Rib cartilage graft harvesting,Septocolumella graft,Septum caudal extension graft,Septum replacement graft,Spreader graft,Temporalis fascia graft harvesting,Tip defatting,Transdomal tip plasty sutures,Triangular cartilages caudal extension graft - photo 8
#8Optimal theoretical planning of this rhinoplasty regarding the profile view, considering the right dorsal level lower than the osseous hump and higher than the sunken middle vault; this entails a moderate osseous shaving, a moderate middle vault ...Read more
Alar flaring,Alar rim retraction,Asymmetric nose,Asymmetric tip,Bifid columella,Bifid tip,Broad dorsum,Broad nose,Concave lateral cruras,Congenital nose,Crooked nose,Crooked septum,Crooked tip,Dorsum hump,Dorsum ridges,Droopy tip,Failed osteotomies,Flat dorsum,Irregular dorsum,Large alar cartilages,Large nose,Large nostrils,Large sills,Nasal fibrosis,Nasal valve collapse,Overprojected tip,Pinched middle vault,Pinched nose,Plunging tip deformity,Poorly defined tip,Poorly supported tip,Posttraumatic nose,Rhomboid dorsum,Saddle nose deformity,Short septum,Short upper lateral cartilages,Sunken columella,Sunken supratip,Thick skin nose,Tip bossae,Underprojected tip,Alar base resection alarplasty,Columella strut graft,Dorsum hump resection,Dorsum regularization,Extended columella strut graft,Intercrural columella plasty sutures,Interdomal tip plasty sutures,Lateral cruras cephalic resection,Lateral cruras plasty sutures,Lateral cruras repositioning,Lateral cruras shortening resection,Medial cruras shortening resection,Nasal bones osteotomies,Nostril sill resection,Onlay dorsum graft,Onlay supratip graft,Open approach incision,Rib cartilage graft harvesting,Septocolumella graft,Septum caudal extension graft,Septum replacement graft,Spreader graft,Temporalis fascia graft harvesting,Tip defatting,Transdomal tip plasty sutures,Triangular cartilages caudal extension graft - photo 9
#9Representation of the optimal theoretical planning of this rhinoplasty regarding the profile view, considering the right dorsal level lower than the osseous hump and higher than the sunken middle vault; this entails a moderate osseous shaving ...Read more
Alar flaring,Alar rim retraction,Asymmetric nose,Asymmetric tip,Bifid columella,Bifid tip,Broad dorsum,Broad nose,Concave lateral cruras,Congenital nose,Crooked nose,Crooked septum,Crooked tip,Dorsum hump,Dorsum ridges,Droopy tip,Failed osteotomies,Flat dorsum,Irregular dorsum,Large alar cartilages,Large nose,Large nostrils,Large sills,Nasal fibrosis,Nasal valve collapse,Overprojected tip,Pinched middle vault,Pinched nose,Plunging tip deformity,Poorly defined tip,Poorly supported tip,Posttraumatic nose,Rhomboid dorsum,Saddle nose deformity,Short septum,Short upper lateral cartilages,Sunken columella,Sunken supratip,Thick skin nose,Tip bossae,Underprojected tip,Alar base resection alarplasty,Columella strut graft,Dorsum hump resection,Dorsum regularization,Extended columella strut graft,Intercrural columella plasty sutures,Interdomal tip plasty sutures,Lateral cruras cephalic resection,Lateral cruras plasty sutures,Lateral cruras repositioning,Lateral cruras shortening resection,Medial cruras shortening resection,Nasal bones osteotomies,Nostril sill resection,Onlay dorsum graft,Onlay supratip graft,Open approach incision,Rib cartilage graft harvesting,Septocolumella graft,Septum caudal extension graft,Septum replacement graft,Spreader graft,Temporalis fascia graft harvesting,Tip defatting,Transdomal tip plasty sutures,Triangular cartilages caudal extension graft - photo 10
#10Left: Maneuver to test and show the total weakness of the tip and the absolute lack of support of the tip and the middle vault, as much as to allow contact between the tip and the upper lip. Right: The lines contour the upper osseous dorsum, ...Read more
Alar flaring,Alar rim retraction,Asymmetric nose,Asymmetric tip,Bifid columella,Bifid tip,Broad dorsum,Broad nose,Concave lateral cruras,Congenital nose,Crooked nose,Crooked septum,Crooked tip,Dorsum hump,Dorsum ridges,Droopy tip,Failed osteotomies,Flat dorsum,Irregular dorsum,Large alar cartilages,Large nose,Large nostrils,Large sills,Nasal fibrosis,Nasal valve collapse,Overprojected tip,Pinched middle vault,Pinched nose,Plunging tip deformity,Poorly defined tip,Poorly supported tip,Posttraumatic nose,Rhomboid dorsum,Saddle nose deformity,Short septum,Short upper lateral cartilages,Sunken columella,Sunken supratip,Thick skin nose,Tip bossae,Underprojected tip,Alar base resection alarplasty,Columella strut graft,Dorsum hump resection,Dorsum regularization,Extended columella strut graft,Intercrural columella plasty sutures,Interdomal tip plasty sutures,Lateral cruras cephalic resection,Lateral cruras plasty sutures,Lateral cruras repositioning,Lateral cruras shortening resection,Medial cruras shortening resection,Nasal bones osteotomies,Nostril sill resection,Onlay dorsum graft,Onlay supratip graft,Open approach incision,Rib cartilage graft harvesting,Septocolumella graft,Septum caudal extension graft,Septum replacement graft,Spreader graft,Temporalis fascia graft harvesting,Tip defatting,Transdomal tip plasty sutures,Triangular cartilages caudal extension graft - photo 11
#11Left: Maneuver to test and show the total weakness of the tip and the absolute lack of support of the tip and the middle vault, as much as to allow contact between the tip and the upper lip. Right: The lines contour the upper osseous dorsum, ...Read more
Alar flaring,Alar rim retraction,Asymmetric nose,Asymmetric tip,Bifid columella,Bifid tip,Broad dorsum,Broad nose,Concave lateral cruras,Congenital nose,Crooked nose,Crooked septum,Crooked tip,Dorsum hump,Dorsum ridges,Droopy tip,Failed osteotomies,Flat dorsum,Irregular dorsum,Large alar cartilages,Large nose,Large nostrils,Large sills,Nasal fibrosis,Nasal valve collapse,Overprojected tip,Pinched middle vault,Pinched nose,Plunging tip deformity,Poorly defined tip,Poorly supported tip,Posttraumatic nose,Rhomboid dorsum,Saddle nose deformity,Short septum,Short upper lateral cartilages,Sunken columella,Sunken supratip,Thick skin nose,Tip bossae,Underprojected tip,Alar base resection alarplasty,Columella strut graft,Dorsum hump resection,Dorsum regularization,Extended columella strut graft,Intercrural columella plasty sutures,Interdomal tip plasty sutures,Lateral cruras cephalic resection,Lateral cruras plasty sutures,Lateral cruras repositioning,Lateral cruras shortening resection,Medial cruras shortening resection,Nasal bones osteotomies,Nostril sill resection,Onlay dorsum graft,Onlay supratip graft,Open approach incision,Rib cartilage graft harvesting,Septocolumella graft,Septum caudal extension graft,Septum replacement graft,Spreader graft,Temporalis fascia graft harvesting,Tip defatting,Transdomal tip plasty sutures,Triangular cartilages caudal extension graft - photo 12
#12The total absence of the caudal septum is tested and shown in this lateral push maneuver.
Alar flaring,Alar rim retraction,Asymmetric nose,Asymmetric tip,Bifid columella,Bifid tip,Broad dorsum,Broad nose,Concave lateral cruras,Congenital nose,Crooked nose,Crooked septum,Crooked tip,Dorsum hump,Dorsum ridges,Droopy tip,Failed osteotomies,Flat dorsum,Irregular dorsum,Large alar cartilages,Large nose,Large nostrils,Large sills,Nasal fibrosis,Nasal valve collapse,Overprojected tip,Pinched middle vault,Pinched nose,Plunging tip deformity,Poorly defined tip,Poorly supported tip,Posttraumatic nose,Rhomboid dorsum,Saddle nose deformity,Short septum,Short upper lateral cartilages,Sunken columella,Sunken supratip,Thick skin nose,Tip bossae,Underprojected tip,Alar base resection alarplasty,Columella strut graft,Dorsum hump resection,Dorsum regularization,Extended columella strut graft,Intercrural columella plasty sutures,Interdomal tip plasty sutures,Lateral cruras cephalic resection,Lateral cruras plasty sutures,Lateral cruras repositioning,Lateral cruras shortening resection,Medial cruras shortening resection,Nasal bones osteotomies,Nostril sill resection,Onlay dorsum graft,Onlay supratip graft,Open approach incision,Rib cartilage graft harvesting,Septocolumella graft,Septum caudal extension graft,Septum replacement graft,Spreader graft,Temporalis fascia graft harvesting,Tip defatting,Transdomal tip plasty sutures,Triangular cartilages caudal extension graft - photo 13
#13The total absence of the caudal septum is tested and shown in this columellar push maneuver.
Alar flaring,Alar rim retraction,Asymmetric nose,Asymmetric tip,Bifid columella,Bifid tip,Broad dorsum,Broad nose,Concave lateral cruras,Congenital nose,Crooked nose,Crooked septum,Crooked tip,Dorsum hump,Dorsum ridges,Droopy tip,Failed osteotomies,Flat dorsum,Irregular dorsum,Large alar cartilages,Large nose,Large nostrils,Large sills,Nasal fibrosis,Nasal valve collapse,Overprojected tip,Pinched middle vault,Pinched nose,Plunging tip deformity,Poorly defined tip,Poorly supported tip,Posttraumatic nose,Rhomboid dorsum,Saddle nose deformity,Short septum,Short upper lateral cartilages,Sunken columella,Sunken supratip,Thick skin nose,Tip bossae,Underprojected tip,Alar base resection alarplasty,Columella strut graft,Dorsum hump resection,Dorsum regularization,Extended columella strut graft,Intercrural columella plasty sutures,Interdomal tip plasty sutures,Lateral cruras cephalic resection,Lateral cruras plasty sutures,Lateral cruras repositioning,Lateral cruras shortening resection,Medial cruras shortening resection,Nasal bones osteotomies,Nostril sill resection,Onlay dorsum graft,Onlay supratip graft,Open approach incision,Rib cartilage graft harvesting,Septocolumella graft,Septum caudal extension graft,Septum replacement graft,Spreader graft,Temporalis fascia graft harvesting,Tip defatting,Transdomal tip plasty sutures,Triangular cartilages caudal extension graft - photo 14
#14The arrows point to the massive fibrosis covering the lateral cruras of the alar cartilages and the supratip; the circle spots the sunken middle vault. This fibrosis has to be meticulously and exhaustively removed, as required and essential ...Read more
Alar flaring,Alar rim retraction,Asymmetric nose,Asymmetric tip,Bifid columella,Bifid tip,Broad dorsum,Broad nose,Concave lateral cruras,Congenital nose,Crooked nose,Crooked septum,Crooked tip,Dorsum hump,Dorsum ridges,Droopy tip,Failed osteotomies,Flat dorsum,Irregular dorsum,Large alar cartilages,Large nose,Large nostrils,Large sills,Nasal fibrosis,Nasal valve collapse,Overprojected tip,Pinched middle vault,Pinched nose,Plunging tip deformity,Poorly defined tip,Poorly supported tip,Posttraumatic nose,Rhomboid dorsum,Saddle nose deformity,Short septum,Short upper lateral cartilages,Sunken columella,Sunken supratip,Thick skin nose,Tip bossae,Underprojected tip,Alar base resection alarplasty,Columella strut graft,Dorsum hump resection,Dorsum regularization,Extended columella strut graft,Intercrural columella plasty sutures,Interdomal tip plasty sutures,Lateral cruras cephalic resection,Lateral cruras plasty sutures,Lateral cruras repositioning,Lateral cruras shortening resection,Medial cruras shortening resection,Nasal bones osteotomies,Nostril sill resection,Onlay dorsum graft,Onlay supratip graft,Open approach incision,Rib cartilage graft harvesting,Septocolumella graft,Septum caudal extension graft,Septum replacement graft,Spreader graft,Temporalis fascia graft harvesting,Tip defatting,Transdomal tip plasty sutures,Triangular cartilages caudal extension graft - photo 15
#15The arrows point to the medial cruras; note the buckling and concavities of both the lateral and medial cruras.
Alar flaring,Alar rim retraction,Asymmetric nose,Asymmetric tip,Bifid columella,Bifid tip,Broad dorsum,Broad nose,Concave lateral cruras,Congenital nose,Crooked nose,Crooked septum,Crooked tip,Dorsum hump,Dorsum ridges,Droopy tip,Failed osteotomies,Flat dorsum,Irregular dorsum,Large alar cartilages,Large nose,Large nostrils,Large sills,Nasal fibrosis,Nasal valve collapse,Overprojected tip,Pinched middle vault,Pinched nose,Plunging tip deformity,Poorly defined tip,Poorly supported tip,Posttraumatic nose,Rhomboid dorsum,Saddle nose deformity,Short septum,Short upper lateral cartilages,Sunken columella,Sunken supratip,Thick skin nose,Tip bossae,Underprojected tip,Alar base resection alarplasty,Columella strut graft,Dorsum hump resection,Dorsum regularization,Extended columella strut graft,Intercrural columella plasty sutures,Interdomal tip plasty sutures,Lateral cruras cephalic resection,Lateral cruras plasty sutures,Lateral cruras repositioning,Lateral cruras shortening resection,Medial cruras shortening resection,Nasal bones osteotomies,Nostril sill resection,Onlay dorsum graft,Onlay supratip graft,Open approach incision,Rib cartilage graft harvesting,Septocolumella graft,Septum caudal extension graft,Septum replacement graft,Spreader graft,Temporalis fascia graft harvesting,Tip defatting,Transdomal tip plasty sutures,Triangular cartilages caudal extension graft - photo 16
#16Once the meticulous and exhaustive debridement has been accomplished the actual shape of the lateral cruras and the domes can be seen; note the concavities (CC). The arrows point to the severe damage to the lateral crura during previous surgery.
Alar flaring,Alar rim retraction,Asymmetric nose,Asymmetric tip,Bifid columella,Bifid tip,Broad dorsum,Broad nose,Concave lateral cruras,Congenital nose,Crooked nose,Crooked septum,Crooked tip,Dorsum hump,Dorsum ridges,Droopy tip,Failed osteotomies,Flat dorsum,Irregular dorsum,Large alar cartilages,Large nose,Large nostrils,Large sills,Nasal fibrosis,Nasal valve collapse,Overprojected tip,Pinched middle vault,Pinched nose,Plunging tip deformity,Poorly defined tip,Poorly supported tip,Posttraumatic nose,Rhomboid dorsum,Saddle nose deformity,Short septum,Short upper lateral cartilages,Sunken columella,Sunken supratip,Thick skin nose,Tip bossae,Underprojected tip,Alar base resection alarplasty,Columella strut graft,Dorsum hump resection,Dorsum regularization,Extended columella strut graft,Intercrural columella plasty sutures,Interdomal tip plasty sutures,Lateral cruras cephalic resection,Lateral cruras plasty sutures,Lateral cruras repositioning,Lateral cruras shortening resection,Medial cruras shortening resection,Nasal bones osteotomies,Nostril sill resection,Onlay dorsum graft,Onlay supratip graft,Open approach incision,Rib cartilage graft harvesting,Septocolumella graft,Septum caudal extension graft,Septum replacement graft,Spreader graft,Temporalis fascia graft harvesting,Tip defatting,Transdomal tip plasty sutures,Triangular cartilages caudal extension graft - photo 17
#17The lines contour every and each facet of the polyhedral shape of the lateral cruras and the domes; in part due to congenital factors and largely due to posttraumatic and iatrogenic causes.
Alar flaring,Alar rim retraction,Asymmetric nose,Asymmetric tip,Bifid columella,Bifid tip,Broad dorsum,Broad nose,Concave lateral cruras,Congenital nose,Crooked nose,Crooked septum,Crooked tip,Dorsum hump,Dorsum ridges,Droopy tip,Failed osteotomies,Flat dorsum,Irregular dorsum,Large alar cartilages,Large nose,Large nostrils,Large sills,Nasal fibrosis,Nasal valve collapse,Overprojected tip,Pinched middle vault,Pinched nose,Plunging tip deformity,Poorly defined tip,Poorly supported tip,Posttraumatic nose,Rhomboid dorsum,Saddle nose deformity,Short septum,Short upper lateral cartilages,Sunken columella,Sunken supratip,Thick skin nose,Tip bossae,Underprojected tip,Alar base resection alarplasty,Columella strut graft,Dorsum hump resection,Dorsum regularization,Extended columella strut graft,Intercrural columella plasty sutures,Interdomal tip plasty sutures,Lateral cruras cephalic resection,Lateral cruras plasty sutures,Lateral cruras repositioning,Lateral cruras shortening resection,Medial cruras shortening resection,Nasal bones osteotomies,Nostril sill resection,Onlay dorsum graft,Onlay supratip graft,Open approach incision,Rib cartilage graft harvesting,Septocolumella graft,Septum caudal extension graft,Septum replacement graft,Spreader graft,Temporalis fascia graft harvesting,Tip defatting,Transdomal tip plasty sutures,Triangular cartilages caudal extension graft - photo 18
#18Concavities (CC) at the medial cruras and the domes.
Alar flaring,Alar rim retraction,Asymmetric nose,Asymmetric tip,Bifid columella,Bifid tip,Broad dorsum,Broad nose,Concave lateral cruras,Congenital nose,Crooked nose,Crooked septum,Crooked tip,Dorsum hump,Dorsum ridges,Droopy tip,Failed osteotomies,Flat dorsum,Irregular dorsum,Large alar cartilages,Large nose,Large nostrils,Large sills,Nasal fibrosis,Nasal valve collapse,Overprojected tip,Pinched middle vault,Pinched nose,Plunging tip deformity,Poorly defined tip,Poorly supported tip,Posttraumatic nose,Rhomboid dorsum,Saddle nose deformity,Short septum,Short upper lateral cartilages,Sunken columella,Sunken supratip,Thick skin nose,Tip bossae,Underprojected tip,Alar base resection alarplasty,Columella strut graft,Dorsum hump resection,Dorsum regularization,Extended columella strut graft,Intercrural columella plasty sutures,Interdomal tip plasty sutures,Lateral cruras cephalic resection,Lateral cruras plasty sutures,Lateral cruras repositioning,Lateral cruras shortening resection,Medial cruras shortening resection,Nasal bones osteotomies,Nostril sill resection,Onlay dorsum graft,Onlay supratip graft,Open approach incision,Rib cartilage graft harvesting,Septocolumella graft,Septum caudal extension graft,Septum replacement graft,Spreader graft,Temporalis fascia graft harvesting,Tip defatting,Transdomal tip plasty sutures,Triangular cartilages caudal extension graft - photo 19
#19The lines contour every and each facet of the polyhedral shape of the medial cruras and the domes; in part due to congenital factors and largely due to posttraumatic and iatrogenic causes.
Alar flaring,Alar rim retraction,Asymmetric nose,Asymmetric tip,Bifid columella,Bifid tip,Broad dorsum,Broad nose,Concave lateral cruras,Congenital nose,Crooked nose,Crooked septum,Crooked tip,Dorsum hump,Dorsum ridges,Droopy tip,Failed osteotomies,Flat dorsum,Irregular dorsum,Large alar cartilages,Large nose,Large nostrils,Large sills,Nasal fibrosis,Nasal valve collapse,Overprojected tip,Pinched middle vault,Pinched nose,Plunging tip deformity,Poorly defined tip,Poorly supported tip,Posttraumatic nose,Rhomboid dorsum,Saddle nose deformity,Short septum,Short upper lateral cartilages,Sunken columella,Sunken supratip,Thick skin nose,Tip bossae,Underprojected tip,Alar base resection alarplasty,Columella strut graft,Dorsum hump resection,Dorsum regularization,Extended columella strut graft,Intercrural columella plasty sutures,Interdomal tip plasty sutures,Lateral cruras cephalic resection,Lateral cruras plasty sutures,Lateral cruras repositioning,Lateral cruras shortening resection,Medial cruras shortening resection,Nasal bones osteotomies,Nostril sill resection,Onlay dorsum graft,Onlay supratip graft,Open approach incision,Rib cartilage graft harvesting,Septocolumella graft,Septum caudal extension graft,Septum replacement graft,Spreader graft,Temporalis fascia graft harvesting,Tip defatting,Transdomal tip plasty sutures,Triangular cartilages caudal extension graft - photo 20
#20The circle spots the joint or frontier between the osseous pyramid and the cartilaginous sunken middle vault.
Alar flaring,Alar rim retraction,Asymmetric nose,Asymmetric tip,Bifid columella,Bifid tip,Broad dorsum,Broad nose,Concave lateral cruras,Congenital nose,Crooked nose,Crooked septum,Crooked tip,Dorsum hump,Dorsum ridges,Droopy tip,Failed osteotomies,Flat dorsum,Irregular dorsum,Large alar cartilages,Large nose,Large nostrils,Large sills,Nasal fibrosis,Nasal valve collapse,Overprojected tip,Pinched middle vault,Pinched nose,Plunging tip deformity,Poorly defined tip,Poorly supported tip,Posttraumatic nose,Rhomboid dorsum,Saddle nose deformity,Short septum,Short upper lateral cartilages,Sunken columella,Sunken supratip,Thick skin nose,Tip bossae,Underprojected tip,Alar base resection alarplasty,Columella strut graft,Dorsum hump resection,Dorsum regularization,Extended columella strut graft,Intercrural columella plasty sutures,Interdomal tip plasty sutures,Lateral cruras cephalic resection,Lateral cruras plasty sutures,Lateral cruras repositioning,Lateral cruras shortening resection,Medial cruras shortening resection,Nasal bones osteotomies,Nostril sill resection,Onlay dorsum graft,Onlay supratip graft,Open approach incision,Rib cartilage graft harvesting,Septocolumella graft,Septum caudal extension graft,Septum replacement graft,Spreader graft,Temporalis fascia graft harvesting,Tip defatting,Transdomal tip plasty sutures,Triangular cartilages caudal extension graft - photo 21
#21The circle spots the joint or frontier between the osseous pyramid and the cartilaginous sunken middle vault. The arrow points to the severe damage to the lateral crura during previous surgery.
Alar flaring,Alar rim retraction,Asymmetric nose,Asymmetric tip,Bifid columella,Bifid tip,Broad dorsum,Broad nose,Concave lateral cruras,Congenital nose,Crooked nose,Crooked septum,Crooked tip,Dorsum hump,Dorsum ridges,Droopy tip,Failed osteotomies,Flat dorsum,Irregular dorsum,Large alar cartilages,Large nose,Large nostrils,Large sills,Nasal fibrosis,Nasal valve collapse,Overprojected tip,Pinched middle vault,Pinched nose,Plunging tip deformity,Poorly defined tip,Poorly supported tip,Posttraumatic nose,Rhomboid dorsum,Saddle nose deformity,Short septum,Short upper lateral cartilages,Sunken columella,Sunken supratip,Thick skin nose,Tip bossae,Underprojected tip,Alar base resection alarplasty,Columella strut graft,Dorsum hump resection,Dorsum regularization,Extended columella strut graft,Intercrural columella plasty sutures,Interdomal tip plasty sutures,Lateral cruras cephalic resection,Lateral cruras plasty sutures,Lateral cruras repositioning,Lateral cruras shortening resection,Medial cruras shortening resection,Nasal bones osteotomies,Nostril sill resection,Onlay dorsum graft,Onlay supratip graft,Open approach incision,Rib cartilage graft harvesting,Septocolumella graft,Septum caudal extension graft,Septum replacement graft,Spreader graft,Temporalis fascia graft harvesting,Tip defatting,Transdomal tip plasty sutures,Triangular cartilages caudal extension graft - photo 22
#22The lines contour the joint or frontier between the osseous pyramid and the cartilaginous sunken middle vault.
Alar flaring,Alar rim retraction,Asymmetric nose,Asymmetric tip,Bifid columella,Bifid tip,Broad dorsum,Broad nose,Concave lateral cruras,Congenital nose,Crooked nose,Crooked septum,Crooked tip,Dorsum hump,Dorsum ridges,Droopy tip,Failed osteotomies,Flat dorsum,Irregular dorsum,Large alar cartilages,Large nose,Large nostrils,Large sills,Nasal fibrosis,Nasal valve collapse,Overprojected tip,Pinched middle vault,Pinched nose,Plunging tip deformity,Poorly defined tip,Poorly supported tip,Posttraumatic nose,Rhomboid dorsum,Saddle nose deformity,Short septum,Short upper lateral cartilages,Sunken columella,Sunken supratip,Thick skin nose,Tip bossae,Underprojected tip,Alar base resection alarplasty,Columella strut graft,Dorsum hump resection,Dorsum regularization,Extended columella strut graft,Intercrural columella plasty sutures,Interdomal tip plasty sutures,Lateral cruras cephalic resection,Lateral cruras plasty sutures,Lateral cruras repositioning,Lateral cruras shortening resection,Medial cruras shortening resection,Nasal bones osteotomies,Nostril sill resection,Onlay dorsum graft,Onlay supratip graft,Open approach incision,Rib cartilage graft harvesting,Septocolumella graft,Septum caudal extension graft,Septum replacement graft,Spreader graft,Temporalis fascia graft harvesting,Tip defatting,Transdomal tip plasty sutures,Triangular cartilages caudal extension graft - photo 23
#23The arrow points to the joint or frontier between the osseous pyramid and the cartilaginous sunken middle vault.
Alar flaring,Alar rim retraction,Asymmetric nose,Asymmetric tip,Bifid columella,Bifid tip,Broad dorsum,Broad nose,Concave lateral cruras,Congenital nose,Crooked nose,Crooked septum,Crooked tip,Dorsum hump,Dorsum ridges,Droopy tip,Failed osteotomies,Flat dorsum,Irregular dorsum,Large alar cartilages,Large nose,Large nostrils,Large sills,Nasal fibrosis,Nasal valve collapse,Overprojected tip,Pinched middle vault,Pinched nose,Plunging tip deformity,Poorly defined tip,Poorly supported tip,Posttraumatic nose,Rhomboid dorsum,Saddle nose deformity,Short septum,Short upper lateral cartilages,Sunken columella,Sunken supratip,Thick skin nose,Tip bossae,Underprojected tip,Alar base resection alarplasty,Columella strut graft,Dorsum hump resection,Dorsum regularization,Extended columella strut graft,Intercrural columella plasty sutures,Interdomal tip plasty sutures,Lateral cruras cephalic resection,Lateral cruras plasty sutures,Lateral cruras repositioning,Lateral cruras shortening resection,Medial cruras shortening resection,Nasal bones osteotomies,Nostril sill resection,Onlay dorsum graft,Onlay supratip graft,Open approach incision,Rib cartilage graft harvesting,Septocolumella graft,Septum caudal extension graft,Septum replacement graft,Spreader graft,Temporalis fascia graft harvesting,Tip defatting,Transdomal tip plasty sutures,Triangular cartilages caudal extension graft - photo 24
#24The lines contour the joint or frontier between the osseous pyramid and the cartilaginous sunken middle vault. Note the downwards angle of the middle vault compared with the right level the middle vault should have, pointed by the arrow as a ...Read more
Alar flaring,Alar rim retraction,Asymmetric nose,Asymmetric tip,Bifid columella,Bifid tip,Broad dorsum,Broad nose,Concave lateral cruras,Congenital nose,Crooked nose,Crooked septum,Crooked tip,Dorsum hump,Dorsum ridges,Droopy tip,Failed osteotomies,Flat dorsum,Irregular dorsum,Large alar cartilages,Large nose,Large nostrils,Large sills,Nasal fibrosis,Nasal valve collapse,Overprojected tip,Pinched middle vault,Pinched nose,Plunging tip deformity,Poorly defined tip,Poorly supported tip,Posttraumatic nose,Rhomboid dorsum,Saddle nose deformity,Short septum,Short upper lateral cartilages,Sunken columella,Sunken supratip,Thick skin nose,Tip bossae,Underprojected tip,Alar base resection alarplasty,Columella strut graft,Dorsum hump resection,Dorsum regularization,Extended columella strut graft,Intercrural columella plasty sutures,Interdomal tip plasty sutures,Lateral cruras cephalic resection,Lateral cruras plasty sutures,Lateral cruras repositioning,Lateral cruras shortening resection,Medial cruras shortening resection,Nasal bones osteotomies,Nostril sill resection,Onlay dorsum graft,Onlay supratip graft,Open approach incision,Rib cartilage graft harvesting,Septocolumella graft,Septum caudal extension graft,Septum replacement graft,Spreader graft,Temporalis fascia graft harvesting,Tip defatting,Transdomal tip plasty sutures,Triangular cartilages caudal extension graft - photo 25
#25The arrow points to the joint or frontier between the osseous pyramid and the cartilaginous sunken middle vault.
Alar flaring,Alar rim retraction,Asymmetric nose,Asymmetric tip,Bifid columella,Bifid tip,Broad dorsum,Broad nose,Concave lateral cruras,Congenital nose,Crooked nose,Crooked septum,Crooked tip,Dorsum hump,Dorsum ridges,Droopy tip,Failed osteotomies,Flat dorsum,Irregular dorsum,Large alar cartilages,Large nose,Large nostrils,Large sills,Nasal fibrosis,Nasal valve collapse,Overprojected tip,Pinched middle vault,Pinched nose,Plunging tip deformity,Poorly defined tip,Poorly supported tip,Posttraumatic nose,Rhomboid dorsum,Saddle nose deformity,Short septum,Short upper lateral cartilages,Sunken columella,Sunken supratip,Thick skin nose,Tip bossae,Underprojected tip,Alar base resection alarplasty,Columella strut graft,Dorsum hump resection,Dorsum regularization,Extended columella strut graft,Intercrural columella plasty sutures,Interdomal tip plasty sutures,Lateral cruras cephalic resection,Lateral cruras plasty sutures,Lateral cruras repositioning,Lateral cruras shortening resection,Medial cruras shortening resection,Nasal bones osteotomies,Nostril sill resection,Onlay dorsum graft,Onlay supratip graft,Open approach incision,Rib cartilage graft harvesting,Septocolumella graft,Septum caudal extension graft,Septum replacement graft,Spreader graft,Temporalis fascia graft harvesting,Tip defatting,Transdomal tip plasty sutures,Triangular cartilages caudal extension graft - photo 26
#26The lines contour the joint or frontier between the osseous pyramid and the cartilaginous sunken middle vault. Note the downwards angle of the middle vault compared with the right level the middle vault should have, pointed by the arrow as a ...Read more
Alar flaring,Alar rim retraction,Asymmetric nose,Asymmetric tip,Bifid columella,Bifid tip,Broad dorsum,Broad nose,Concave lateral cruras,Congenital nose,Crooked nose,Crooked septum,Crooked tip,Dorsum hump,Dorsum ridges,Droopy tip,Failed osteotomies,Flat dorsum,Irregular dorsum,Large alar cartilages,Large nose,Large nostrils,Large sills,Nasal fibrosis,Nasal valve collapse,Overprojected tip,Pinched middle vault,Pinched nose,Plunging tip deformity,Poorly defined tip,Poorly supported tip,Posttraumatic nose,Rhomboid dorsum,Saddle nose deformity,Short septum,Short upper lateral cartilages,Sunken columella,Sunken supratip,Thick skin nose,Tip bossae,Underprojected tip,Alar base resection alarplasty,Columella strut graft,Dorsum hump resection,Dorsum regularization,Extended columella strut graft,Intercrural columella plasty sutures,Interdomal tip plasty sutures,Lateral cruras cephalic resection,Lateral cruras plasty sutures,Lateral cruras repositioning,Lateral cruras shortening resection,Medial cruras shortening resection,Nasal bones osteotomies,Nostril sill resection,Onlay dorsum graft,Onlay supratip graft,Open approach incision,Rib cartilage graft harvesting,Septocolumella graft,Septum caudal extension graft,Septum replacement graft,Spreader graft,Temporalis fascia graft harvesting,Tip defatting,Transdomal tip plasty sutures,Triangular cartilages caudal extension graft - photo 27
#27Close up details of the damages to the right lateral crura.
Alar flaring,Alar rim retraction,Asymmetric nose,Asymmetric tip,Bifid columella,Bifid tip,Broad dorsum,Broad nose,Concave lateral cruras,Congenital nose,Crooked nose,Crooked septum,Crooked tip,Dorsum hump,Dorsum ridges,Droopy tip,Failed osteotomies,Flat dorsum,Irregular dorsum,Large alar cartilages,Large nose,Large nostrils,Large sills,Nasal fibrosis,Nasal valve collapse,Overprojected tip,Pinched middle vault,Pinched nose,Plunging tip deformity,Poorly defined tip,Poorly supported tip,Posttraumatic nose,Rhomboid dorsum,Saddle nose deformity,Short septum,Short upper lateral cartilages,Sunken columella,Sunken supratip,Thick skin nose,Tip bossae,Underprojected tip,Alar base resection alarplasty,Columella strut graft,Dorsum hump resection,Dorsum regularization,Extended columella strut graft,Intercrural columella plasty sutures,Interdomal tip plasty sutures,Lateral cruras cephalic resection,Lateral cruras plasty sutures,Lateral cruras repositioning,Lateral cruras shortening resection,Medial cruras shortening resection,Nasal bones osteotomies,Nostril sill resection,Onlay dorsum graft,Onlay supratip graft,Open approach incision,Rib cartilage graft harvesting,Septocolumella graft,Septum caudal extension graft,Septum replacement graft,Spreader graft,Temporalis fascia graft harvesting,Tip defatting,Transdomal tip plasty sutures,Triangular cartilages caudal extension graft - photo 28
#28Close up details of the damages to the left lateral crura.
Alar flaring,Alar rim retraction,Asymmetric nose,Asymmetric tip,Bifid columella,Bifid tip,Broad dorsum,Broad nose,Concave lateral cruras,Congenital nose,Crooked nose,Crooked septum,Crooked tip,Dorsum hump,Dorsum ridges,Droopy tip,Failed osteotomies,Flat dorsum,Irregular dorsum,Large alar cartilages,Large nose,Large nostrils,Large sills,Nasal fibrosis,Nasal valve collapse,Overprojected tip,Pinched middle vault,Pinched nose,Plunging tip deformity,Poorly defined tip,Poorly supported tip,Posttraumatic nose,Rhomboid dorsum,Saddle nose deformity,Short septum,Short upper lateral cartilages,Sunken columella,Sunken supratip,Thick skin nose,Tip bossae,Underprojected tip,Alar base resection alarplasty,Columella strut graft,Dorsum hump resection,Dorsum regularization,Extended columella strut graft,Intercrural columella plasty sutures,Interdomal tip plasty sutures,Lateral cruras cephalic resection,Lateral cruras plasty sutures,Lateral cruras repositioning,Lateral cruras shortening resection,Medial cruras shortening resection,Nasal bones osteotomies,Nostril sill resection,Onlay dorsum graft,Onlay supratip graft,Open approach incision,Rib cartilage graft harvesting,Septocolumella graft,Septum caudal extension graft,Septum replacement graft,Spreader graft,Temporalis fascia graft harvesting,Tip defatting,Transdomal tip plasty sutures,Triangular cartilages caudal extension graft - photo 29
#29The medial cruras are split from each other and the lateral cruras freed from the triangular cartilages; all fibrosis has been meticulously and exhaustively removed. Note how the caudal nasal septum is absent, it should be visible in the valley ...Read more
Alar flaring,Alar rim retraction,Asymmetric nose,Asymmetric tip,Bifid columella,Bifid tip,Broad dorsum,Broad nose,Concave lateral cruras,Congenital nose,Crooked nose,Crooked septum,Crooked tip,Dorsum hump,Dorsum ridges,Droopy tip,Failed osteotomies,Flat dorsum,Irregular dorsum,Large alar cartilages,Large nose,Large nostrils,Large sills,Nasal fibrosis,Nasal valve collapse,Overprojected tip,Pinched middle vault,Pinched nose,Plunging tip deformity,Poorly defined tip,Poorly supported tip,Posttraumatic nose,Rhomboid dorsum,Saddle nose deformity,Short septum,Short upper lateral cartilages,Sunken columella,Sunken supratip,Thick skin nose,Tip bossae,Underprojected tip,Alar base resection alarplasty,Columella strut graft,Dorsum hump resection,Dorsum regularization,Extended columella strut graft,Intercrural columella plasty sutures,Interdomal tip plasty sutures,Lateral cruras cephalic resection,Lateral cruras plasty sutures,Lateral cruras repositioning,Lateral cruras shortening resection,Medial cruras shortening resection,Nasal bones osteotomies,Nostril sill resection,Onlay dorsum graft,Onlay supratip graft,Open approach incision,Rib cartilage graft harvesting,Septocolumella graft,Septum caudal extension graft,Septum replacement graft,Spreader graft,Temporalis fascia graft harvesting,Tip defatting,Transdomal tip plasty sutures,Triangular cartilages caudal extension graft - photo 30
#30Lateral cruras (L) and medial cruras (M); where is the missing septum? It should be there (S?).
Alar flaring,Alar rim retraction,Asymmetric nose,Asymmetric tip,Bifid columella,Bifid tip,Broad dorsum,Broad nose,Concave lateral cruras,Congenital nose,Crooked nose,Crooked septum,Crooked tip,Dorsum hump,Dorsum ridges,Droopy tip,Failed osteotomies,Flat dorsum,Irregular dorsum,Large alar cartilages,Large nose,Large nostrils,Large sills,Nasal fibrosis,Nasal valve collapse,Overprojected tip,Pinched middle vault,Pinched nose,Plunging tip deformity,Poorly defined tip,Poorly supported tip,Posttraumatic nose,Rhomboid dorsum,Saddle nose deformity,Short septum,Short upper lateral cartilages,Sunken columella,Sunken supratip,Thick skin nose,Tip bossae,Underprojected tip,Alar base resection alarplasty,Columella strut graft,Dorsum hump resection,Dorsum regularization,Extended columella strut graft,Intercrural columella plasty sutures,Interdomal tip plasty sutures,Lateral cruras cephalic resection,Lateral cruras plasty sutures,Lateral cruras repositioning,Lateral cruras shortening resection,Medial cruras shortening resection,Nasal bones osteotomies,Nostril sill resection,Onlay dorsum graft,Onlay supratip graft,Open approach incision,Rib cartilage graft harvesting,Septocolumella graft,Septum caudal extension graft,Septum replacement graft,Spreader graft,Temporalis fascia graft harvesting,Tip defatting,Transdomal tip plasty sutures,Triangular cartilages caudal extension graft - photo 31
#31The lines contour the joint or frontier between the osseous pyramid and the cartilaginous sunken middle vault. The nasal bones (N) stand firmly whilst the triangular cartilages (T) are sunken due to null septal support.
Alar flaring,Alar rim retraction,Asymmetric nose,Asymmetric tip,Bifid columella,Bifid tip,Broad dorsum,Broad nose,Concave lateral cruras,Congenital nose,Crooked nose,Crooked septum,Crooked tip,Dorsum hump,Dorsum ridges,Droopy tip,Failed osteotomies,Flat dorsum,Irregular dorsum,Large alar cartilages,Large nose,Large nostrils,Large sills,Nasal fibrosis,Nasal valve collapse,Overprojected tip,Pinched middle vault,Pinched nose,Plunging tip deformity,Poorly defined tip,Poorly supported tip,Posttraumatic nose,Rhomboid dorsum,Saddle nose deformity,Short septum,Short upper lateral cartilages,Sunken columella,Sunken supratip,Thick skin nose,Tip bossae,Underprojected tip,Alar base resection alarplasty,Columella strut graft,Dorsum hump resection,Dorsum regularization,Extended columella strut graft,Intercrural columella plasty sutures,Interdomal tip plasty sutures,Lateral cruras cephalic resection,Lateral cruras plasty sutures,Lateral cruras repositioning,Lateral cruras shortening resection,Medial cruras shortening resection,Nasal bones osteotomies,Nostril sill resection,Onlay dorsum graft,Onlay supratip graft,Open approach incision,Rib cartilage graft harvesting,Septocolumella graft,Septum caudal extension graft,Septum replacement graft,Spreader graft,Temporalis fascia graft harvesting,Tip defatting,Transdomal tip plasty sutures,Triangular cartilages caudal extension graft - photo 32
#32Lateral cruras and medial cruras separated to access the septum; where is the missing septum? It should be there (S?).
Alar flaring,Alar rim retraction,Asymmetric nose,Asymmetric tip,Bifid columella,Bifid tip,Broad dorsum,Broad nose,Concave lateral cruras,Congenital nose,Crooked nose,Crooked septum,Crooked tip,Dorsum hump,Dorsum ridges,Droopy tip,Failed osteotomies,Flat dorsum,Irregular dorsum,Large alar cartilages,Large nose,Large nostrils,Large sills,Nasal fibrosis,Nasal valve collapse,Overprojected tip,Pinched middle vault,Pinched nose,Plunging tip deformity,Poorly defined tip,Poorly supported tip,Posttraumatic nose,Rhomboid dorsum,Saddle nose deformity,Short septum,Short upper lateral cartilages,Sunken columella,Sunken supratip,Thick skin nose,Tip bossae,Underprojected tip,Alar base resection alarplasty,Columella strut graft,Dorsum hump resection,Dorsum regularization,Extended columella strut graft,Intercrural columella plasty sutures,Interdomal tip plasty sutures,Lateral cruras cephalic resection,Lateral cruras plasty sutures,Lateral cruras repositioning,Lateral cruras shortening resection,Medial cruras shortening resection,Nasal bones osteotomies,Nostril sill resection,Onlay dorsum graft,Onlay supratip graft,Open approach incision,Rib cartilage graft harvesting,Septocolumella graft,Septum caudal extension graft,Septum replacement graft,Spreader graft,Temporalis fascia graft harvesting,Tip defatting,Transdomal tip plasty sutures,Triangular cartilages caudal extension graft - photo 33
#33This is the right 7th rib donor site seen from the surgeon's perspective, the landmarks are patient's head below and feet above of the image, sternum on the left and armpit at the right of the image.
Alar flaring,Alar rim retraction,Asymmetric nose,Asymmetric tip,Bifid columella,Bifid tip,Broad dorsum,Broad nose,Concave lateral cruras,Congenital nose,Crooked nose,Crooked septum,Crooked tip,Dorsum hump,Dorsum ridges,Droopy tip,Failed osteotomies,Flat dorsum,Irregular dorsum,Large alar cartilages,Large nose,Large nostrils,Large sills,Nasal fibrosis,Nasal valve collapse,Overprojected tip,Pinched middle vault,Pinched nose,Plunging tip deformity,Poorly defined tip,Poorly supported tip,Posttraumatic nose,Rhomboid dorsum,Saddle nose deformity,Short septum,Short upper lateral cartilages,Sunken columella,Sunken supratip,Thick skin nose,Tip bossae,Underprojected tip,Alar base resection alarplasty,Columella strut graft,Dorsum hump resection,Dorsum regularization,Extended columella strut graft,Intercrural columella plasty sutures,Interdomal tip plasty sutures,Lateral cruras cephalic resection,Lateral cruras plasty sutures,Lateral cruras repositioning,Lateral cruras shortening resection,Medial cruras shortening resection,Nasal bones osteotomies,Nostril sill resection,Onlay dorsum graft,Onlay supratip graft,Open approach incision,Rib cartilage graft harvesting,Septocolumella graft,Septum caudal extension graft,Septum replacement graft,Spreader graft,Temporalis fascia graft harvesting,Tip defatting,Transdomal tip plasty sutures,Triangular cartilages caudal extension graft - photo 34
#34This is the right 7th rib donor site seen from the surgeon's perspective, the landmarks are patient's head below and feet above of the image, sternum on the left and armpit at the right of the image; the layers that have to be crossed to reach ...Read more
Alar flaring,Alar rim retraction,Asymmetric nose,Asymmetric tip,Bifid columella,Bifid tip,Broad dorsum,Broad nose,Concave lateral cruras,Congenital nose,Crooked nose,Crooked septum,Crooked tip,Dorsum hump,Dorsum ridges,Droopy tip,Failed osteotomies,Flat dorsum,Irregular dorsum,Large alar cartilages,Large nose,Large nostrils,Large sills,Nasal fibrosis,Nasal valve collapse,Overprojected tip,Pinched middle vault,Pinched nose,Plunging tip deformity,Poorly defined tip,Poorly supported tip,Posttraumatic nose,Rhomboid dorsum,Saddle nose deformity,Short septum,Short upper lateral cartilages,Sunken columella,Sunken supratip,Thick skin nose,Tip bossae,Underprojected tip,Alar base resection alarplasty,Columella strut graft,Dorsum hump resection,Dorsum regularization,Extended columella strut graft,Intercrural columella plasty sutures,Interdomal tip plasty sutures,Lateral cruras cephalic resection,Lateral cruras plasty sutures,Lateral cruras repositioning,Lateral cruras shortening resection,Medial cruras shortening resection,Nasal bones osteotomies,Nostril sill resection,Onlay dorsum graft,Onlay supratip graft,Open approach incision,Rib cartilage graft harvesting,Septocolumella graft,Septum caudal extension graft,Septum replacement graft,Spreader graft,Temporalis fascia graft harvesting,Tip defatting,Transdomal tip plasty sutures,Triangular cartilages caudal extension graft - photo 35
#35The outer cortex of the 7th rib has been discarded to prevent warping; the core shaft of the rib is freed from its perichondrium sheath and ready to be extracted; the ribs are spotted (6, 7 and 8).
Alar flaring,Alar rim retraction,Asymmetric nose,Asymmetric tip,Bifid columella,Bifid tip,Broad dorsum,Broad nose,Concave lateral cruras,Congenital nose,Crooked nose,Crooked septum,Crooked tip,Dorsum hump,Dorsum ridges,Droopy tip,Failed osteotomies,Flat dorsum,Irregular dorsum,Large alar cartilages,Large nose,Large nostrils,Large sills,Nasal fibrosis,Nasal valve collapse,Overprojected tip,Pinched middle vault,Pinched nose,Plunging tip deformity,Poorly defined tip,Poorly supported tip,Posttraumatic nose,Rhomboid dorsum,Saddle nose deformity,Short septum,Short upper lateral cartilages,Sunken columella,Sunken supratip,Thick skin nose,Tip bossae,Underprojected tip,Alar base resection alarplasty,Columella strut graft,Dorsum hump resection,Dorsum regularization,Extended columella strut graft,Intercrural columella plasty sutures,Interdomal tip plasty sutures,Lateral cruras cephalic resection,Lateral cruras plasty sutures,Lateral cruras repositioning,Lateral cruras shortening resection,Medial cruras shortening resection,Nasal bones osteotomies,Nostril sill resection,Onlay dorsum graft,Onlay supratip graft,Open approach incision,Rib cartilage graft harvesting,Septocolumella graft,Septum caudal extension graft,Septum replacement graft,Spreader graft,Temporalis fascia graft harvesting,Tip defatting,Transdomal tip plasty sutures,Triangular cartilages caudal extension graft - photo 36
#36The forceps grasp the cartilage segment of the 7th rib which will be used in this nasal reconstruction; note how it is form stable and warping free.
Alar flaring,Alar rim retraction,Asymmetric nose,Asymmetric tip,Bifid columella,Bifid tip,Broad dorsum,Broad nose,Concave lateral cruras,Congenital nose,Crooked nose,Crooked septum,Crooked tip,Dorsum hump,Dorsum ridges,Droopy tip,Failed osteotomies,Flat dorsum,Irregular dorsum,Large alar cartilages,Large nose,Large nostrils,Large sills,Nasal fibrosis,Nasal valve collapse,Overprojected tip,Pinched middle vault,Pinched nose,Plunging tip deformity,Poorly defined tip,Poorly supported tip,Posttraumatic nose,Rhomboid dorsum,Saddle nose deformity,Short septum,Short upper lateral cartilages,Sunken columella,Sunken supratip,Thick skin nose,Tip bossae,Underprojected tip,Alar base resection alarplasty,Columella strut graft,Dorsum hump resection,Dorsum regularization,Extended columella strut graft,Intercrural columella plasty sutures,Interdomal tip plasty sutures,Lateral cruras cephalic resection,Lateral cruras plasty sutures,Lateral cruras repositioning,Lateral cruras shortening resection,Medial cruras shortening resection,Nasal bones osteotomies,Nostril sill resection,Onlay dorsum graft,Onlay supratip graft,Open approach incision,Rib cartilage graft harvesting,Septocolumella graft,Septum caudal extension graft,Septum replacement graft,Spreader graft,Temporalis fascia graft harvesting,Tip defatting,Transdomal tip plasty sutures,Triangular cartilages caudal extension graft - photo 37
#37The forceps grasp the cartilage segment of the 7th rib which will be used in this nasal reconstruction; note how it is form stable and warping free.
Alar flaring,Alar rim retraction,Asymmetric nose,Asymmetric tip,Bifid columella,Bifid tip,Broad dorsum,Broad nose,Concave lateral cruras,Congenital nose,Crooked nose,Crooked septum,Crooked tip,Dorsum hump,Dorsum ridges,Droopy tip,Failed osteotomies,Flat dorsum,Irregular dorsum,Large alar cartilages,Large nose,Large nostrils,Large sills,Nasal fibrosis,Nasal valve collapse,Overprojected tip,Pinched middle vault,Pinched nose,Plunging tip deformity,Poorly defined tip,Poorly supported tip,Posttraumatic nose,Rhomboid dorsum,Saddle nose deformity,Short septum,Short upper lateral cartilages,Sunken columella,Sunken supratip,Thick skin nose,Tip bossae,Underprojected tip,Alar base resection alarplasty,Columella strut graft,Dorsum hump resection,Dorsum regularization,Extended columella strut graft,Intercrural columella plasty sutures,Interdomal tip plasty sutures,Lateral cruras cephalic resection,Lateral cruras plasty sutures,Lateral cruras repositioning,Lateral cruras shortening resection,Medial cruras shortening resection,Nasal bones osteotomies,Nostril sill resection,Onlay dorsum graft,Onlay supratip graft,Open approach incision,Rib cartilage graft harvesting,Septocolumella graft,Septum caudal extension graft,Septum replacement graft,Spreader graft,Temporalis fascia graft harvesting,Tip defatting,Transdomal tip plasty sutures,Triangular cartilages caudal extension graft - photo 38
#38The forceps grasp the cartilage segment of the 7th rib which will be used in this nasal reconstruction; note how it is form stable and warping free.
Alar flaring,Alar rim retraction,Asymmetric nose,Asymmetric tip,Bifid columella,Bifid tip,Broad dorsum,Broad nose,Concave lateral cruras,Congenital nose,Crooked nose,Crooked septum,Crooked tip,Dorsum hump,Dorsum ridges,Droopy tip,Failed osteotomies,Flat dorsum,Irregular dorsum,Large alar cartilages,Large nose,Large nostrils,Large sills,Nasal fibrosis,Nasal valve collapse,Overprojected tip,Pinched middle vault,Pinched nose,Plunging tip deformity,Poorly defined tip,Poorly supported tip,Posttraumatic nose,Rhomboid dorsum,Saddle nose deformity,Short septum,Short upper lateral cartilages,Sunken columella,Sunken supratip,Thick skin nose,Tip bossae,Underprojected tip,Alar base resection alarplasty,Columella strut graft,Dorsum hump resection,Dorsum regularization,Extended columella strut graft,Intercrural columella plasty sutures,Interdomal tip plasty sutures,Lateral cruras cephalic resection,Lateral cruras plasty sutures,Lateral cruras repositioning,Lateral cruras shortening resection,Medial cruras shortening resection,Nasal bones osteotomies,Nostril sill resection,Onlay dorsum graft,Onlay supratip graft,Open approach incision,Rib cartilage graft harvesting,Septocolumella graft,Septum caudal extension graft,Septum replacement graft,Spreader graft,Temporalis fascia graft harvesting,Tip defatting,Transdomal tip plasty sutures,Triangular cartilages caudal extension graft - photo 39
#39Comprehensive anatomical view after finishing the cartilage extraction showing the ribs (6, 7 and 8).
Alar flaring,Alar rim retraction,Asymmetric nose,Asymmetric tip,Bifid columella,Bifid tip,Broad dorsum,Broad nose,Concave lateral cruras,Congenital nose,Crooked nose,Crooked septum,Crooked tip,Dorsum hump,Dorsum ridges,Droopy tip,Failed osteotomies,Flat dorsum,Irregular dorsum,Large alar cartilages,Large nose,Large nostrils,Large sills,Nasal fibrosis,Nasal valve collapse,Overprojected tip,Pinched middle vault,Pinched nose,Plunging tip deformity,Poorly defined tip,Poorly supported tip,Posttraumatic nose,Rhomboid dorsum,Saddle nose deformity,Short septum,Short upper lateral cartilages,Sunken columella,Sunken supratip,Thick skin nose,Tip bossae,Underprojected tip,Alar base resection alarplasty,Columella strut graft,Dorsum hump resection,Dorsum regularization,Extended columella strut graft,Intercrural columella plasty sutures,Interdomal tip plasty sutures,Lateral cruras cephalic resection,Lateral cruras plasty sutures,Lateral cruras repositioning,Lateral cruras shortening resection,Medial cruras shortening resection,Nasal bones osteotomies,Nostril sill resection,Onlay dorsum graft,Onlay supratip graft,Open approach incision,Rib cartilage graft harvesting,Septocolumella graft,Septum caudal extension graft,Septum replacement graft,Spreader graft,Temporalis fascia graft harvesting,Tip defatting,Transdomal tip plasty sutures,Triangular cartilages caudal extension graft - photo 40
#405 cm long caudal extension graft tailored out of the rib cartilage.
Alar flaring,Alar rim retraction,Asymmetric nose,Asymmetric tip,Bifid columella,Bifid tip,Broad dorsum,Broad nose,Concave lateral cruras,Congenital nose,Crooked nose,Crooked septum,Crooked tip,Dorsum hump,Dorsum ridges,Droopy tip,Failed osteotomies,Flat dorsum,Irregular dorsum,Large alar cartilages,Large nose,Large nostrils,Large sills,Nasal fibrosis,Nasal valve collapse,Overprojected tip,Pinched middle vault,Pinched nose,Plunging tip deformity,Poorly defined tip,Poorly supported tip,Posttraumatic nose,Rhomboid dorsum,Saddle nose deformity,Short septum,Short upper lateral cartilages,Sunken columella,Sunken supratip,Thick skin nose,Tip bossae,Underprojected tip,Alar base resection alarplasty,Columella strut graft,Dorsum hump resection,Dorsum regularization,Extended columella strut graft,Intercrural columella plasty sutures,Interdomal tip plasty sutures,Lateral cruras cephalic resection,Lateral cruras plasty sutures,Lateral cruras repositioning,Lateral cruras shortening resection,Medial cruras shortening resection,Nasal bones osteotomies,Nostril sill resection,Onlay dorsum graft,Onlay supratip graft,Open approach incision,Rib cartilage graft harvesting,Septocolumella graft,Septum caudal extension graft,Septum replacement graft,Spreader graft,Temporalis fascia graft harvesting,Tip defatting,Transdomal tip plasty sutures,Triangular cartilages caudal extension graft - photo 41
#41The caudal extension graft (E) inserted and secured with sutures between the triangular cartilages (T) and also sutured to the septum replacement graft (S); the lateral cruras (L) have been shortened and secured with sutures. Due to its extraordinary ...Read more
Alar flaring,Alar rim retraction,Asymmetric nose,Asymmetric tip,Bifid columella,Bifid tip,Broad dorsum,Broad nose,Concave lateral cruras,Congenital nose,Crooked nose,Crooked septum,Crooked tip,Dorsum hump,Dorsum ridges,Droopy tip,Failed osteotomies,Flat dorsum,Irregular dorsum,Large alar cartilages,Large nose,Large nostrils,Large sills,Nasal fibrosis,Nasal valve collapse,Overprojected tip,Pinched middle vault,Pinched nose,Plunging tip deformity,Poorly defined tip,Poorly supported tip,Posttraumatic nose,Rhomboid dorsum,Saddle nose deformity,Short septum,Short upper lateral cartilages,Sunken columella,Sunken supratip,Thick skin nose,Tip bossae,Underprojected tip,Alar base resection alarplasty,Columella strut graft,Dorsum hump resection,Dorsum regularization,Extended columella strut graft,Intercrural columella plasty sutures,Interdomal tip plasty sutures,Lateral cruras cephalic resection,Lateral cruras plasty sutures,Lateral cruras repositioning,Lateral cruras shortening resection,Medial cruras shortening resection,Nasal bones osteotomies,Nostril sill resection,Onlay dorsum graft,Onlay supratip graft,Open approach incision,Rib cartilage graft harvesting,Septocolumella graft,Septum caudal extension graft,Septum replacement graft,Spreader graft,Temporalis fascia graft harvesting,Tip defatting,Transdomal tip plasty sutures,Triangular cartilages caudal extension graft - photo 42
#42The caudal extension graft (E) inserted and secured with sutures between the triangular cartilages (T) and also sutured to the septum replacement graft (S); the lateral cruras (L) and the medial cruras (M) have been shortened and secured with ...Read more
Alar flaring,Alar rim retraction,Asymmetric nose,Asymmetric tip,Bifid columella,Bifid tip,Broad dorsum,Broad nose,Concave lateral cruras,Congenital nose,Crooked nose,Crooked septum,Crooked tip,Dorsum hump,Dorsum ridges,Droopy tip,Failed osteotomies,Flat dorsum,Irregular dorsum,Large alar cartilages,Large nose,Large nostrils,Large sills,Nasal fibrosis,Nasal valve collapse,Overprojected tip,Pinched middle vault,Pinched nose,Plunging tip deformity,Poorly defined tip,Poorly supported tip,Posttraumatic nose,Rhomboid dorsum,Saddle nose deformity,Short septum,Short upper lateral cartilages,Sunken columella,Sunken supratip,Thick skin nose,Tip bossae,Underprojected tip,Alar base resection alarplasty,Columella strut graft,Dorsum hump resection,Dorsum regularization,Extended columella strut graft,Intercrural columella plasty sutures,Interdomal tip plasty sutures,Lateral cruras cephalic resection,Lateral cruras plasty sutures,Lateral cruras repositioning,Lateral cruras shortening resection,Medial cruras shortening resection,Nasal bones osteotomies,Nostril sill resection,Onlay dorsum graft,Onlay supratip graft,Open approach incision,Rib cartilage graft harvesting,Septocolumella graft,Septum caudal extension graft,Septum replacement graft,Spreader graft,Temporalis fascia graft harvesting,Tip defatting,Transdomal tip plasty sutures,Triangular cartilages caudal extension graft - photo 43
#43The caudal extension graft (E) inserted and secured with sutures between the triangular cartilages (T) and also sutured to the septum replacement graft (S); the lateral cruras (L) and the medial cruras (M) have been shortened and secured with ...Read more
Alar flaring,Alar rim retraction,Asymmetric nose,Asymmetric tip,Bifid columella,Bifid tip,Broad dorsum,Broad nose,Concave lateral cruras,Congenital nose,Crooked nose,Crooked septum,Crooked tip,Dorsum hump,Dorsum ridges,Droopy tip,Failed osteotomies,Flat dorsum,Irregular dorsum,Large alar cartilages,Large nose,Large nostrils,Large sills,Nasal fibrosis,Nasal valve collapse,Overprojected tip,Pinched middle vault,Pinched nose,Plunging tip deformity,Poorly defined tip,Poorly supported tip,Posttraumatic nose,Rhomboid dorsum,Saddle nose deformity,Short septum,Short upper lateral cartilages,Sunken columella,Sunken supratip,Thick skin nose,Tip bossae,Underprojected tip,Alar base resection alarplasty,Columella strut graft,Dorsum hump resection,Dorsum regularization,Extended columella strut graft,Intercrural columella plasty sutures,Interdomal tip plasty sutures,Lateral cruras cephalic resection,Lateral cruras plasty sutures,Lateral cruras repositioning,Lateral cruras shortening resection,Medial cruras shortening resection,Nasal bones osteotomies,Nostril sill resection,Onlay dorsum graft,Onlay supratip graft,Open approach incision,Rib cartilage graft harvesting,Septocolumella graft,Septum caudal extension graft,Septum replacement graft,Spreader graft,Temporalis fascia graft harvesting,Tip defatting,Transdomal tip plasty sutures,Triangular cartilages caudal extension graft - photo 44
#44The caudal extension graft (E) inserted and secured with sutures between the triangular cartilages (T) and also sutured to the septum replacement graft (S). Due to its extraordinary firmness only a one on one design was necessary to create the ...Read more
Alar flaring,Alar rim retraction,Asymmetric nose,Asymmetric tip,Bifid columella,Bifid tip,Broad dorsum,Broad nose,Concave lateral cruras,Congenital nose,Crooked nose,Crooked septum,Crooked tip,Dorsum hump,Dorsum ridges,Droopy tip,Failed osteotomies,Flat dorsum,Irregular dorsum,Large alar cartilages,Large nose,Large nostrils,Large sills,Nasal fibrosis,Nasal valve collapse,Overprojected tip,Pinched middle vault,Pinched nose,Plunging tip deformity,Poorly defined tip,Poorly supported tip,Posttraumatic nose,Rhomboid dorsum,Saddle nose deformity,Short septum,Short upper lateral cartilages,Sunken columella,Sunken supratip,Thick skin nose,Tip bossae,Underprojected tip,Alar base resection alarplasty,Columella strut graft,Dorsum hump resection,Dorsum regularization,Extended columella strut graft,Intercrural columella plasty sutures,Interdomal tip plasty sutures,Lateral cruras cephalic resection,Lateral cruras plasty sutures,Lateral cruras repositioning,Lateral cruras shortening resection,Medial cruras shortening resection,Nasal bones osteotomies,Nostril sill resection,Onlay dorsum graft,Onlay supratip graft,Open approach incision,Rib cartilage graft harvesting,Septocolumella graft,Septum caudal extension graft,Septum replacement graft,Spreader graft,Temporalis fascia graft harvesting,Tip defatting,Transdomal tip plasty sutures,Triangular cartilages caudal extension graft - photo 45
#45The L shaped septocolumellar graft was designed according to the preoperative plan, so that an oblique vector allows expansion of the nose forwardly and inferiorly; the slope up in the caudal extension graft intends to set the new tip level ...Read more
Alar flaring,Alar rim retraction,Asymmetric nose,Asymmetric tip,Bifid columella,Bifid tip,Broad dorsum,Broad nose,Concave lateral cruras,Congenital nose,Crooked nose,Crooked septum,Crooked tip,Dorsum hump,Dorsum ridges,Droopy tip,Failed osteotomies,Flat dorsum,Irregular dorsum,Large alar cartilages,Large nose,Large nostrils,Large sills,Nasal fibrosis,Nasal valve collapse,Overprojected tip,Pinched middle vault,Pinched nose,Plunging tip deformity,Poorly defined tip,Poorly supported tip,Posttraumatic nose,Rhomboid dorsum,Saddle nose deformity,Short septum,Short upper lateral cartilages,Sunken columella,Sunken supratip,Thick skin nose,Tip bossae,Underprojected tip,Alar base resection alarplasty,Columella strut graft,Dorsum hump resection,Dorsum regularization,Extended columella strut graft,Intercrural columella plasty sutures,Interdomal tip plasty sutures,Lateral cruras cephalic resection,Lateral cruras plasty sutures,Lateral cruras repositioning,Lateral cruras shortening resection,Medial cruras shortening resection,Nasal bones osteotomies,Nostril sill resection,Onlay dorsum graft,Onlay supratip graft,Open approach incision,Rib cartilage graft harvesting,Septocolumella graft,Septum caudal extension graft,Septum replacement graft,Spreader graft,Temporalis fascia graft harvesting,Tip defatting,Transdomal tip plasty sutures,Triangular cartilages caudal extension graft - photo 46
#46The L shaped septocolumellar graft was designed according to the preoperative plan, so that an oblique vector allows expansion of the nose forwardly and inferiorly; the slope up in the caudal extension graft intends to set the new tip level ...Read more
Alar flaring,Alar rim retraction,Asymmetric nose,Asymmetric tip,Bifid columella,Bifid tip,Broad dorsum,Broad nose,Concave lateral cruras,Congenital nose,Crooked nose,Crooked septum,Crooked tip,Dorsum hump,Dorsum ridges,Droopy tip,Failed osteotomies,Flat dorsum,Irregular dorsum,Large alar cartilages,Large nose,Large nostrils,Large sills,Nasal fibrosis,Nasal valve collapse,Overprojected tip,Pinched middle vault,Pinched nose,Plunging tip deformity,Poorly defined tip,Poorly supported tip,Posttraumatic nose,Rhomboid dorsum,Saddle nose deformity,Short septum,Short upper lateral cartilages,Sunken columella,Sunken supratip,Thick skin nose,Tip bossae,Underprojected tip,Alar base resection alarplasty,Columella strut graft,Dorsum hump resection,Dorsum regularization,Extended columella strut graft,Intercrural columella plasty sutures,Interdomal tip plasty sutures,Lateral cruras cephalic resection,Lateral cruras plasty sutures,Lateral cruras repositioning,Lateral cruras shortening resection,Medial cruras shortening resection,Nasal bones osteotomies,Nostril sill resection,Onlay dorsum graft,Onlay supratip graft,Open approach incision,Rib cartilage graft harvesting,Septocolumella graft,Septum caudal extension graft,Septum replacement graft,Spreader graft,Temporalis fascia graft harvesting,Tip defatting,Transdomal tip plasty sutures,Triangular cartilages caudal extension graft - photo 47
#47The caudal extension graft (E) inserted and secured with sutures between the triangular cartilages (T) and also sutured to the septum replacement graft (S); the lateral cruras (L) and the medial cruras (M) have been shortened and secured with ...Read more
Alar flaring,Alar rim retraction,Asymmetric nose,Asymmetric tip,Bifid columella,Bifid tip,Broad dorsum,Broad nose,Concave lateral cruras,Congenital nose,Crooked nose,Crooked septum,Crooked tip,Dorsum hump,Dorsum ridges,Droopy tip,Failed osteotomies,Flat dorsum,Irregular dorsum,Large alar cartilages,Large nose,Large nostrils,Large sills,Nasal fibrosis,Nasal valve collapse,Overprojected tip,Pinched middle vault,Pinched nose,Plunging tip deformity,Poorly defined tip,Poorly supported tip,Posttraumatic nose,Rhomboid dorsum,Saddle nose deformity,Short septum,Short upper lateral cartilages,Sunken columella,Sunken supratip,Thick skin nose,Tip bossae,Underprojected tip,Alar base resection alarplasty,Columella strut graft,Dorsum hump resection,Dorsum regularization,Extended columella strut graft,Intercrural columella plasty sutures,Interdomal tip plasty sutures,Lateral cruras cephalic resection,Lateral cruras plasty sutures,Lateral cruras repositioning,Lateral cruras shortening resection,Medial cruras shortening resection,Nasal bones osteotomies,Nostril sill resection,Onlay dorsum graft,Onlay supratip graft,Open approach incision,Rib cartilage graft harvesting,Septocolumella graft,Septum caudal extension graft,Septum replacement graft,Spreader graft,Temporalis fascia graft harvesting,Tip defatting,Transdomal tip plasty sutures,Triangular cartilages caudal extension graft - photo 48
#48As an accessory support element a powerful columellar strut is placed between the medial cruras, pointed by the arrow; note how the columella is not sunken anymore and sticks below the level of the alae, as is correct.
Alar flaring,Alar rim retraction,Asymmetric nose,Asymmetric tip,Bifid columella,Bifid tip,Broad dorsum,Broad nose,Concave lateral cruras,Congenital nose,Crooked nose,Crooked septum,Crooked tip,Dorsum hump,Dorsum ridges,Droopy tip,Failed osteotomies,Flat dorsum,Irregular dorsum,Large alar cartilages,Large nose,Large nostrils,Large sills,Nasal fibrosis,Nasal valve collapse,Overprojected tip,Pinched middle vault,Pinched nose,Plunging tip deformity,Poorly defined tip,Poorly supported tip,Posttraumatic nose,Rhomboid dorsum,Saddle nose deformity,Short septum,Short upper lateral cartilages,Sunken columella,Sunken supratip,Thick skin nose,Tip bossae,Underprojected tip,Alar base resection alarplasty,Columella strut graft,Dorsum hump resection,Dorsum regularization,Extended columella strut graft,Intercrural columella plasty sutures,Interdomal tip plasty sutures,Lateral cruras cephalic resection,Lateral cruras plasty sutures,Lateral cruras repositioning,Lateral cruras shortening resection,Medial cruras shortening resection,Nasal bones osteotomies,Nostril sill resection,Onlay dorsum graft,Onlay supratip graft,Open approach incision,Rib cartilage graft harvesting,Septocolumella graft,Septum caudal extension graft,Septum replacement graft,Spreader graft,Temporalis fascia graft harvesting,Tip defatting,Transdomal tip plasty sutures,Triangular cartilages caudal extension graft - photo 49
#49As an accessory support element a powerful columellar strut is placed between the medial cruras, pointed by the arrow; note how the columella is not sunken anymore and sticks below the level of the alae, as is correct.
Alar flaring,Alar rim retraction,Asymmetric nose,Asymmetric tip,Bifid columella,Bifid tip,Broad dorsum,Broad nose,Concave lateral cruras,Congenital nose,Crooked nose,Crooked septum,Crooked tip,Dorsum hump,Dorsum ridges,Droopy tip,Failed osteotomies,Flat dorsum,Irregular dorsum,Large alar cartilages,Large nose,Large nostrils,Large sills,Nasal fibrosis,Nasal valve collapse,Overprojected tip,Pinched middle vault,Pinched nose,Plunging tip deformity,Poorly defined tip,Poorly supported tip,Posttraumatic nose,Rhomboid dorsum,Saddle nose deformity,Short septum,Short upper lateral cartilages,Sunken columella,Sunken supratip,Thick skin nose,Tip bossae,Underprojected tip,Alar base resection alarplasty,Columella strut graft,Dorsum hump resection,Dorsum regularization,Extended columella strut graft,Intercrural columella plasty sutures,Interdomal tip plasty sutures,Lateral cruras cephalic resection,Lateral cruras plasty sutures,Lateral cruras repositioning,Lateral cruras shortening resection,Medial cruras shortening resection,Nasal bones osteotomies,Nostril sill resection,Onlay dorsum graft,Onlay supratip graft,Open approach incision,Rib cartilage graft harvesting,Septocolumella graft,Septum caudal extension graft,Septum replacement graft,Spreader graft,Temporalis fascia graft harvesting,Tip defatting,Transdomal tip plasty sutures,Triangular cartilages caudal extension graft - photo 50
#50The caudal extension graft (E) inserted and secured with sutures between the triangular cartilages (T) and also sutured to the septum replacement graft (S); the lateral cruras have been shortened and secured with sutures, pointed by the large ...Read more
Alar flaring,Alar rim retraction,Asymmetric nose,Asymmetric tip,Bifid columella,Bifid tip,Broad dorsum,Broad nose,Concave lateral cruras,Congenital nose,Crooked nose,Crooked septum,Crooked tip,Dorsum hump,Dorsum ridges,Droopy tip,Failed osteotomies,Flat dorsum,Irregular dorsum,Large alar cartilages,Large nose,Large nostrils,Large sills,Nasal fibrosis,Nasal valve collapse,Overprojected tip,Pinched middle vault,Pinched nose,Plunging tip deformity,Poorly defined tip,Poorly supported tip,Posttraumatic nose,Rhomboid dorsum,Saddle nose deformity,Short septum,Short upper lateral cartilages,Sunken columella,Sunken supratip,Thick skin nose,Tip bossae,Underprojected tip,Alar base resection alarplasty,Columella strut graft,Dorsum hump resection,Dorsum regularization,Extended columella strut graft,Intercrural columella plasty sutures,Interdomal tip plasty sutures,Lateral cruras cephalic resection,Lateral cruras plasty sutures,Lateral cruras repositioning,Lateral cruras shortening resection,Medial cruras shortening resection,Nasal bones osteotomies,Nostril sill resection,Onlay dorsum graft,Onlay supratip graft,Open approach incision,Rib cartilage graft harvesting,Septocolumella graft,Septum caudal extension graft,Septum replacement graft,Spreader graft,Temporalis fascia graft harvesting,Tip defatting,Transdomal tip plasty sutures,Triangular cartilages caudal extension graft - photo 51
#51The caudal extension graft inserted and secured with sutures between the triangular cartilages and also sutured to the septum replacement graft; the lateral cruras have been shortened and secured with sutures. Due to its extraordinary firmness ...Read more
Alar flaring,Alar rim retraction,Asymmetric nose,Asymmetric tip,Bifid columella,Bifid tip,Broad dorsum,Broad nose,Concave lateral cruras,Congenital nose,Crooked nose,Crooked septum,Crooked tip,Dorsum hump,Dorsum ridges,Droopy tip,Failed osteotomies,Flat dorsum,Irregular dorsum,Large alar cartilages,Large nose,Large nostrils,Large sills,Nasal fibrosis,Nasal valve collapse,Overprojected tip,Pinched middle vault,Pinched nose,Plunging tip deformity,Poorly defined tip,Poorly supported tip,Posttraumatic nose,Rhomboid dorsum,Saddle nose deformity,Short septum,Short upper lateral cartilages,Sunken columella,Sunken supratip,Thick skin nose,Tip bossae,Underprojected tip,Alar base resection alarplasty,Columella strut graft,Dorsum hump resection,Dorsum regularization,Extended columella strut graft,Intercrural columella plasty sutures,Interdomal tip plasty sutures,Lateral cruras cephalic resection,Lateral cruras plasty sutures,Lateral cruras repositioning,Lateral cruras shortening resection,Medial cruras shortening resection,Nasal bones osteotomies,Nostril sill resection,Onlay dorsum graft,Onlay supratip graft,Open approach incision,Rib cartilage graft harvesting,Septocolumella graft,Septum caudal extension graft,Septum replacement graft,Spreader graft,Temporalis fascia graft harvesting,Tip defatting,Transdomal tip plasty sutures,Triangular cartilages caudal extension graft - photo 52
#52The lateral cruras are sutured ahead of the septocolumellar graft in order to gain forward and inferior projection and support; the medial cruras are mounted with sutures onto the columellar strut; the sunken middle vault has been raised with ...Read more
Alar flaring,Alar rim retraction,Asymmetric nose,Asymmetric tip,Bifid columella,Bifid tip,Broad dorsum,Broad nose,Concave lateral cruras,Congenital nose,Crooked nose,Crooked septum,Crooked tip,Dorsum hump,Dorsum ridges,Droopy tip,Failed osteotomies,Flat dorsum,Irregular dorsum,Large alar cartilages,Large nose,Large nostrils,Large sills,Nasal fibrosis,Nasal valve collapse,Overprojected tip,Pinched middle vault,Pinched nose,Plunging tip deformity,Poorly defined tip,Poorly supported tip,Posttraumatic nose,Rhomboid dorsum,Saddle nose deformity,Short septum,Short upper lateral cartilages,Sunken columella,Sunken supratip,Thick skin nose,Tip bossae,Underprojected tip,Alar base resection alarplasty,Columella strut graft,Dorsum hump resection,Dorsum regularization,Extended columella strut graft,Intercrural columella plasty sutures,Interdomal tip plasty sutures,Lateral cruras cephalic resection,Lateral cruras plasty sutures,Lateral cruras repositioning,Lateral cruras shortening resection,Medial cruras shortening resection,Nasal bones osteotomies,Nostril sill resection,Onlay dorsum graft,Onlay supratip graft,Open approach incision,Rib cartilage graft harvesting,Septocolumella graft,Septum caudal extension graft,Septum replacement graft,Spreader graft,Temporalis fascia graft harvesting,Tip defatting,Transdomal tip plasty sutures,Triangular cartilages caudal extension graft - photo 53
#53The circle spots the middle vault onlay graft; the arrows point to the confluent support, projection and expansion vectors achieved with this strong and complex structural scaffold.
Alar flaring,Alar rim retraction,Asymmetric nose,Asymmetric tip,Bifid columella,Bifid tip,Broad dorsum,Broad nose,Concave lateral cruras,Congenital nose,Crooked nose,Crooked septum,Crooked tip,Dorsum hump,Dorsum ridges,Droopy tip,Failed osteotomies,Flat dorsum,Irregular dorsum,Large alar cartilages,Large nose,Large nostrils,Large sills,Nasal fibrosis,Nasal valve collapse,Overprojected tip,Pinched middle vault,Pinched nose,Plunging tip deformity,Poorly defined tip,Poorly supported tip,Posttraumatic nose,Rhomboid dorsum,Saddle nose deformity,Short septum,Short upper lateral cartilages,Sunken columella,Sunken supratip,Thick skin nose,Tip bossae,Underprojected tip,Alar base resection alarplasty,Columella strut graft,Dorsum hump resection,Dorsum regularization,Extended columella strut graft,Intercrural columella plasty sutures,Interdomal tip plasty sutures,Lateral cruras cephalic resection,Lateral cruras plasty sutures,Lateral cruras repositioning,Lateral cruras shortening resection,Medial cruras shortening resection,Nasal bones osteotomies,Nostril sill resection,Onlay dorsum graft,Onlay supratip graft,Open approach incision,Rib cartilage graft harvesting,Septocolumella graft,Septum caudal extension graft,Septum replacement graft,Spreader graft,Temporalis fascia graft harvesting,Tip defatting,Transdomal tip plasty sutures,Triangular cartilages caudal extension graft - photo 54
#54The lateral cruras are sutured ahead of the septocolumellar graft in order to gain forward and inferior projection and support; the medial cruras are mounted with sutures onto the columellar strut; the sunken middle vault has been raised with ...Read more
Alar flaring,Alar rim retraction,Asymmetric nose,Asymmetric tip,Bifid columella,Bifid tip,Broad dorsum,Broad nose,Concave lateral cruras,Congenital nose,Crooked nose,Crooked septum,Crooked tip,Dorsum hump,Dorsum ridges,Droopy tip,Failed osteotomies,Flat dorsum,Irregular dorsum,Large alar cartilages,Large nose,Large nostrils,Large sills,Nasal fibrosis,Nasal valve collapse,Overprojected tip,Pinched middle vault,Pinched nose,Plunging tip deformity,Poorly defined tip,Poorly supported tip,Posttraumatic nose,Rhomboid dorsum,Saddle nose deformity,Short septum,Short upper lateral cartilages,Sunken columella,Sunken supratip,Thick skin nose,Tip bossae,Underprojected tip,Alar base resection alarplasty,Columella strut graft,Dorsum hump resection,Dorsum regularization,Extended columella strut graft,Intercrural columella plasty sutures,Interdomal tip plasty sutures,Lateral cruras cephalic resection,Lateral cruras plasty sutures,Lateral cruras repositioning,Lateral cruras shortening resection,Medial cruras shortening resection,Nasal bones osteotomies,Nostril sill resection,Onlay dorsum graft,Onlay supratip graft,Open approach incision,Rib cartilage graft harvesting,Septocolumella graft,Septum caudal extension graft,Septum replacement graft,Spreader graft,Temporalis fascia graft harvesting,Tip defatting,Transdomal tip plasty sutures,Triangular cartilages caudal extension graft - photo 55
#55The thin lines contour the joint or frontier between the osseous pyramid and the cartilaginous sunken middle vault; the thick line contours the onlay graft at the sunken middle vault.
Alar flaring,Alar rim retraction,Asymmetric nose,Asymmetric tip,Bifid columella,Bifid tip,Broad dorsum,Broad nose,Concave lateral cruras,Congenital nose,Crooked nose,Crooked septum,Crooked tip,Dorsum hump,Dorsum ridges,Droopy tip,Failed osteotomies,Flat dorsum,Irregular dorsum,Large alar cartilages,Large nose,Large nostrils,Large sills,Nasal fibrosis,Nasal valve collapse,Overprojected tip,Pinched middle vault,Pinched nose,Plunging tip deformity,Poorly defined tip,Poorly supported tip,Posttraumatic nose,Rhomboid dorsum,Saddle nose deformity,Short septum,Short upper lateral cartilages,Sunken columella,Sunken supratip,Thick skin nose,Tip bossae,Underprojected tip,Alar base resection alarplasty,Columella strut graft,Dorsum hump resection,Dorsum regularization,Extended columella strut graft,Intercrural columella plasty sutures,Interdomal tip plasty sutures,Lateral cruras cephalic resection,Lateral cruras plasty sutures,Lateral cruras repositioning,Lateral cruras shortening resection,Medial cruras shortening resection,Nasal bones osteotomies,Nostril sill resection,Onlay dorsum graft,Onlay supratip graft,Open approach incision,Rib cartilage graft harvesting,Septocolumella graft,Septum caudal extension graft,Septum replacement graft,Spreader graft,Temporalis fascia graft harvesting,Tip defatting,Transdomal tip plasty sutures,Triangular cartilages caudal extension graft - photo 56
#56Right temple; donor site of the superficial temporalis fascia graft; the fascia has been freed from the overlying subcutaneous tissue of the scalp and from the underlying temporalis muscle fascia or deep temporal fascia.
Alar flaring,Alar rim retraction,Asymmetric nose,Asymmetric tip,Bifid columella,Bifid tip,Broad dorsum,Broad nose,Concave lateral cruras,Congenital nose,Crooked nose,Crooked septum,Crooked tip,Dorsum hump,Dorsum ridges,Droopy tip,Failed osteotomies,Flat dorsum,Irregular dorsum,Large alar cartilages,Large nose,Large nostrils,Large sills,Nasal fibrosis,Nasal valve collapse,Overprojected tip,Pinched middle vault,Pinched nose,Plunging tip deformity,Poorly defined tip,Poorly supported tip,Posttraumatic nose,Rhomboid dorsum,Saddle nose deformity,Short septum,Short upper lateral cartilages,Sunken columella,Sunken supratip,Thick skin nose,Tip bossae,Underprojected tip,Alar base resection alarplasty,Columella strut graft,Dorsum hump resection,Dorsum regularization,Extended columella strut graft,Intercrural columella plasty sutures,Interdomal tip plasty sutures,Lateral cruras cephalic resection,Lateral cruras plasty sutures,Lateral cruras repositioning,Lateral cruras shortening resection,Medial cruras shortening resection,Nasal bones osteotomies,Nostril sill resection,Onlay dorsum graft,Onlay supratip graft,Open approach incision,Rib cartilage graft harvesting,Septocolumella graft,Septum caudal extension graft,Septum replacement graft,Spreader graft,Temporalis fascia graft harvesting,Tip defatting,Transdomal tip plasty sutures,Triangular cartilages caudal extension graft - photo 57
#57The superficial temporalis fascia graft extracted; note how once trimmed out the tissue shrinks with vigor.
Alar flaring,Alar rim retraction,Asymmetric nose,Asymmetric tip,Bifid columella,Bifid tip,Broad dorsum,Broad nose,Concave lateral cruras,Congenital nose,Crooked nose,Crooked septum,Crooked tip,Dorsum hump,Dorsum ridges,Droopy tip,Failed osteotomies,Flat dorsum,Irregular dorsum,Large alar cartilages,Large nose,Large nostrils,Large sills,Nasal fibrosis,Nasal valve collapse,Overprojected tip,Pinched middle vault,Pinched nose,Plunging tip deformity,Poorly defined tip,Poorly supported tip,Posttraumatic nose,Rhomboid dorsum,Saddle nose deformity,Short septum,Short upper lateral cartilages,Sunken columella,Sunken supratip,Thick skin nose,Tip bossae,Underprojected tip,Alar base resection alarplasty,Columella strut graft,Dorsum hump resection,Dorsum regularization,Extended columella strut graft,Intercrural columella plasty sutures,Interdomal tip plasty sutures,Lateral cruras cephalic resection,Lateral cruras plasty sutures,Lateral cruras repositioning,Lateral cruras shortening resection,Medial cruras shortening resection,Nasal bones osteotomies,Nostril sill resection,Onlay dorsum graft,Onlay supratip graft,Open approach incision,Rib cartilage graft harvesting,Septocolumella graft,Septum caudal extension graft,Septum replacement graft,Spreader graft,Temporalis fascia graft harvesting,Tip defatting,Transdomal tip plasty sutures,Triangular cartilages caudal extension graft - photo 58
#58The forceps stretch the superficial temporalis fascia graft to show its real dimensions without shrinkage.
Alar flaring,Alar rim retraction,Asymmetric nose,Asymmetric tip,Bifid columella,Bifid tip,Broad dorsum,Broad nose,Concave lateral cruras,Congenital nose,Crooked nose,Crooked septum,Crooked tip,Dorsum hump,Dorsum ridges,Droopy tip,Failed osteotomies,Flat dorsum,Irregular dorsum,Large alar cartilages,Large nose,Large nostrils,Large sills,Nasal fibrosis,Nasal valve collapse,Overprojected tip,Pinched middle vault,Pinched nose,Plunging tip deformity,Poorly defined tip,Poorly supported tip,Posttraumatic nose,Rhomboid dorsum,Saddle nose deformity,Short septum,Short upper lateral cartilages,Sunken columella,Sunken supratip,Thick skin nose,Tip bossae,Underprojected tip,Alar base resection alarplasty,Columella strut graft,Dorsum hump resection,Dorsum regularization,Extended columella strut graft,Intercrural columella plasty sutures,Interdomal tip plasty sutures,Lateral cruras cephalic resection,Lateral cruras plasty sutures,Lateral cruras repositioning,Lateral cruras shortening resection,Medial cruras shortening resection,Nasal bones osteotomies,Nostril sill resection,Onlay dorsum graft,Onlay supratip graft,Open approach incision,Rib cartilage graft harvesting,Septocolumella graft,Septum caudal extension graft,Septum replacement graft,Spreader graft,Temporalis fascia graft harvesting,Tip defatting,Transdomal tip plasty sutures,Triangular cartilages caudal extension graft - photo 59
#59The forceps stretch the superficial temporalis fascia graft to show its real dimensions without shrinkage.
Alar flaring,Alar rim retraction,Asymmetric nose,Asymmetric tip,Bifid columella,Bifid tip,Broad dorsum,Broad nose,Concave lateral cruras,Congenital nose,Crooked nose,Crooked septum,Crooked tip,Dorsum hump,Dorsum ridges,Droopy tip,Failed osteotomies,Flat dorsum,Irregular dorsum,Large alar cartilages,Large nose,Large nostrils,Large sills,Nasal fibrosis,Nasal valve collapse,Overprojected tip,Pinched middle vault,Pinched nose,Plunging tip deformity,Poorly defined tip,Poorly supported tip,Posttraumatic nose,Rhomboid dorsum,Saddle nose deformity,Short septum,Short upper lateral cartilages,Sunken columella,Sunken supratip,Thick skin nose,Tip bossae,Underprojected tip,Alar base resection alarplasty,Columella strut graft,Dorsum hump resection,Dorsum regularization,Extended columella strut graft,Intercrural columella plasty sutures,Interdomal tip plasty sutures,Lateral cruras cephalic resection,Lateral cruras plasty sutures,Lateral cruras repositioning,Lateral cruras shortening resection,Medial cruras shortening resection,Nasal bones osteotomies,Nostril sill resection,Onlay dorsum graft,Onlay supratip graft,Open approach incision,Rib cartilage graft harvesting,Septocolumella graft,Septum caudal extension graft,Septum replacement graft,Spreader graft,Temporalis fascia graft harvesting,Tip defatting,Transdomal tip plasty sutures,Triangular cartilages caudal extension graft - photo 60
#60The superficial temporalis fascia graft placed over the nasal dorsum; note how it has shrunk and seems undersized to cover and hide all the dorsal irregularities, which is not true at all given its actual size can be twice it is seen in the ...Read more
Alar flaring,Alar rim retraction,Asymmetric nose,Asymmetric tip,Bifid columella,Bifid tip,Broad dorsum,Broad nose,Concave lateral cruras,Congenital nose,Crooked nose,Crooked septum,Crooked tip,Dorsum hump,Dorsum ridges,Droopy tip,Failed osteotomies,Flat dorsum,Irregular dorsum,Large alar cartilages,Large nose,Large nostrils,Large sills,Nasal fibrosis,Nasal valve collapse,Overprojected tip,Pinched middle vault,Pinched nose,Plunging tip deformity,Poorly defined tip,Poorly supported tip,Posttraumatic nose,Rhomboid dorsum,Saddle nose deformity,Short septum,Short upper lateral cartilages,Sunken columella,Sunken supratip,Thick skin nose,Tip bossae,Underprojected tip,Alar base resection alarplasty,Columella strut graft,Dorsum hump resection,Dorsum regularization,Extended columella strut graft,Intercrural columella plasty sutures,Interdomal tip plasty sutures,Lateral cruras cephalic resection,Lateral cruras plasty sutures,Lateral cruras repositioning,Lateral cruras shortening resection,Medial cruras shortening resection,Nasal bones osteotomies,Nostril sill resection,Onlay dorsum graft,Onlay supratip graft,Open approach incision,Rib cartilage graft harvesting,Septocolumella graft,Septum caudal extension graft,Septum replacement graft,Spreader graft,Temporalis fascia graft harvesting,Tip defatting,Transdomal tip plasty sutures,Triangular cartilages caudal extension graft - photo 61
#61The superficial temporalis fascia graft placed over the nasal dorsum; note how it has shrunk and seems undersized to cover and hide all the dorsal irregularities, which is not true at all given its actual size can be twice it is seen in the ...Read more
Alar flaring,Alar rim retraction,Asymmetric nose,Asymmetric tip,Bifid columella,Bifid tip,Broad dorsum,Broad nose,Concave lateral cruras,Congenital nose,Crooked nose,Crooked septum,Crooked tip,Dorsum hump,Dorsum ridges,Droopy tip,Failed osteotomies,Flat dorsum,Irregular dorsum,Large alar cartilages,Large nose,Large nostrils,Large sills,Nasal fibrosis,Nasal valve collapse,Overprojected tip,Pinched middle vault,Pinched nose,Plunging tip deformity,Poorly defined tip,Poorly supported tip,Posttraumatic nose,Rhomboid dorsum,Saddle nose deformity,Short septum,Short upper lateral cartilages,Sunken columella,Sunken supratip,Thick skin nose,Tip bossae,Underprojected tip,Alar base resection alarplasty,Columella strut graft,Dorsum hump resection,Dorsum regularization,Extended columella strut graft,Intercrural columella plasty sutures,Interdomal tip plasty sutures,Lateral cruras cephalic resection,Lateral cruras plasty sutures,Lateral cruras repositioning,Lateral cruras shortening resection,Medial cruras shortening resection,Nasal bones osteotomies,Nostril sill resection,Onlay dorsum graft,Onlay supratip graft,Open approach incision,Rib cartilage graft harvesting,Septocolumella graft,Septum caudal extension graft,Septum replacement graft,Spreader graft,Temporalis fascia graft harvesting,Tip defatting,Transdomal tip plasty sutures,Triangular cartilages caudal extension graft - photo 62
#62The superficial temporalis fascia graft placed over the nasal dorsum; note how it has shrunk and seems undersized to cover and hide all the dorsal irregularities, which is not true at all given its actual size can be twice it is seen in the ...Read more
Alar flaring,Alar rim retraction,Asymmetric nose,Asymmetric tip,Bifid columella,Bifid tip,Broad dorsum,Broad nose,Concave lateral cruras,Congenital nose,Crooked nose,Crooked septum,Crooked tip,Dorsum hump,Dorsum ridges,Droopy tip,Failed osteotomies,Flat dorsum,Irregular dorsum,Large alar cartilages,Large nose,Large nostrils,Large sills,Nasal fibrosis,Nasal valve collapse,Overprojected tip,Pinched middle vault,Pinched nose,Plunging tip deformity,Poorly defined tip,Poorly supported tip,Posttraumatic nose,Rhomboid dorsum,Saddle nose deformity,Short septum,Short upper lateral cartilages,Sunken columella,Sunken supratip,Thick skin nose,Tip bossae,Underprojected tip,Alar base resection alarplasty,Columella strut graft,Dorsum hump resection,Dorsum regularization,Extended columella strut graft,Intercrural columella plasty sutures,Interdomal tip plasty sutures,Lateral cruras cephalic resection,Lateral cruras plasty sutures,Lateral cruras repositioning,Lateral cruras shortening resection,Medial cruras shortening resection,Nasal bones osteotomies,Nostril sill resection,Onlay dorsum graft,Onlay supratip graft,Open approach incision,Rib cartilage graft harvesting,Septocolumella graft,Septum caudal extension graft,Septum replacement graft,Spreader graft,Temporalis fascia graft harvesting,Tip defatting,Transdomal tip plasty sutures,Triangular cartilages caudal extension graft - photo 63
#63The actual dimensions of the superficial temporalis fascia graft are well calculated to cover the whole nasal pyramid; it needs pinning to achieve extension; this is easy to achieve at the lower end of the nose since it is of easy access, however ...Read more
Alar flaring,Alar rim retraction,Asymmetric nose,Asymmetric tip,Bifid columella,Bifid tip,Broad dorsum,Broad nose,Concave lateral cruras,Congenital nose,Crooked nose,Crooked septum,Crooked tip,Dorsum hump,Dorsum ridges,Droopy tip,Failed osteotomies,Flat dorsum,Irregular dorsum,Large alar cartilages,Large nose,Large nostrils,Large sills,Nasal fibrosis,Nasal valve collapse,Overprojected tip,Pinched middle vault,Pinched nose,Plunging tip deformity,Poorly defined tip,Poorly supported tip,Posttraumatic nose,Rhomboid dorsum,Saddle nose deformity,Short septum,Short upper lateral cartilages,Sunken columella,Sunken supratip,Thick skin nose,Tip bossae,Underprojected tip,Alar base resection alarplasty,Columella strut graft,Dorsum hump resection,Dorsum regularization,Extended columella strut graft,Intercrural columella plasty sutures,Interdomal tip plasty sutures,Lateral cruras cephalic resection,Lateral cruras plasty sutures,Lateral cruras repositioning,Lateral cruras shortening resection,Medial cruras shortening resection,Nasal bones osteotomies,Nostril sill resection,Onlay dorsum graft,Onlay supratip graft,Open approach incision,Rib cartilage graft harvesting,Septocolumella graft,Septum caudal extension graft,Septum replacement graft,Spreader graft,Temporalis fascia graft harvesting,Tip defatting,Transdomal tip plasty sutures,Triangular cartilages caudal extension graft - photo 64
#64The actual dimensions of the superficial temporalis fascia graft are well calculated to cover the whole nasal pyramid; it needs pinning to achieve extension; this is easy to achieve at the lower end of the nose since it is of easy access, however ...Read more
Alar flaring,Alar rim retraction,Asymmetric nose,Asymmetric tip,Bifid columella,Bifid tip,Broad dorsum,Broad nose,Concave lateral cruras,Congenital nose,Crooked nose,Crooked septum,Crooked tip,Dorsum hump,Dorsum ridges,Droopy tip,Failed osteotomies,Flat dorsum,Irregular dorsum,Large alar cartilages,Large nose,Large nostrils,Large sills,Nasal fibrosis,Nasal valve collapse,Overprojected tip,Pinched middle vault,Pinched nose,Plunging tip deformity,Poorly defined tip,Poorly supported tip,Posttraumatic nose,Rhomboid dorsum,Saddle nose deformity,Short septum,Short upper lateral cartilages,Sunken columella,Sunken supratip,Thick skin nose,Tip bossae,Underprojected tip,Alar base resection alarplasty,Columella strut graft,Dorsum hump resection,Dorsum regularization,Extended columella strut graft,Intercrural columella plasty sutures,Interdomal tip plasty sutures,Lateral cruras cephalic resection,Lateral cruras plasty sutures,Lateral cruras repositioning,Lateral cruras shortening resection,Medial cruras shortening resection,Nasal bones osteotomies,Nostril sill resection,Onlay dorsum graft,Onlay supratip graft,Open approach incision,Rib cartilage graft harvesting,Septocolumella graft,Septum caudal extension graft,Septum replacement graft,Spreader graft,Temporalis fascia graft harvesting,Tip defatting,Transdomal tip plasty sutures,Triangular cartilages caudal extension graft - photo 65
#65One of the main properties of the superficial temporalis fascia graft is the millefeuille layer of abundant collagen attached to its undersurface which is of essential preservation during its extraction; the forceps grasp the collagen to show ...Read more
Alar flaring,Alar rim retraction,Asymmetric nose,Asymmetric tip,Bifid columella,Bifid tip,Broad dorsum,Broad nose,Concave lateral cruras,Congenital nose,Crooked nose,Crooked septum,Crooked tip,Dorsum hump,Dorsum ridges,Droopy tip,Failed osteotomies,Flat dorsum,Irregular dorsum,Large alar cartilages,Large nose,Large nostrils,Large sills,Nasal fibrosis,Nasal valve collapse,Overprojected tip,Pinched middle vault,Pinched nose,Plunging tip deformity,Poorly defined tip,Poorly supported tip,Posttraumatic nose,Rhomboid dorsum,Saddle nose deformity,Short septum,Short upper lateral cartilages,Sunken columella,Sunken supratip,Thick skin nose,Tip bossae,Underprojected tip,Alar base resection alarplasty,Columella strut graft,Dorsum hump resection,Dorsum regularization,Extended columella strut graft,Intercrural columella plasty sutures,Interdomal tip plasty sutures,Lateral cruras cephalic resection,Lateral cruras plasty sutures,Lateral cruras repositioning,Lateral cruras shortening resection,Medial cruras shortening resection,Nasal bones osteotomies,Nostril sill resection,Onlay dorsum graft,Onlay supratip graft,Open approach incision,Rib cartilage graft harvesting,Septocolumella graft,Septum caudal extension graft,Septum replacement graft,Spreader graft,Temporalis fascia graft harvesting,Tip defatting,Transdomal tip plasty sutures,Triangular cartilages caudal extension graft - photo 66
#66The superficial temporalis fascia graft is planned to be located and pinned in that position covering the middle vault onlay graft and all the dorsal irregularities.
Alar flaring,Alar rim retraction,Asymmetric nose,Asymmetric tip,Bifid columella,Bifid tip,Broad dorsum,Broad nose,Concave lateral cruras,Congenital nose,Crooked nose,Crooked septum,Crooked tip,Dorsum hump,Dorsum ridges,Droopy tip,Failed osteotomies,Flat dorsum,Irregular dorsum,Large alar cartilages,Large nose,Large nostrils,Large sills,Nasal fibrosis,Nasal valve collapse,Overprojected tip,Pinched middle vault,Pinched nose,Plunging tip deformity,Poorly defined tip,Poorly supported tip,Posttraumatic nose,Rhomboid dorsum,Saddle nose deformity,Short septum,Short upper lateral cartilages,Sunken columella,Sunken supratip,Thick skin nose,Tip bossae,Underprojected tip,Alar base resection alarplasty,Columella strut graft,Dorsum hump resection,Dorsum regularization,Extended columella strut graft,Intercrural columella plasty sutures,Interdomal tip plasty sutures,Lateral cruras cephalic resection,Lateral cruras plasty sutures,Lateral cruras repositioning,Lateral cruras shortening resection,Medial cruras shortening resection,Nasal bones osteotomies,Nostril sill resection,Onlay dorsum graft,Onlay supratip graft,Open approach incision,Rib cartilage graft harvesting,Septocolumella graft,Septum caudal extension graft,Septum replacement graft,Spreader graft,Temporalis fascia graft harvesting,Tip defatting,Transdomal tip plasty sutures,Triangular cartilages caudal extension graft - photo 67
#67The superficial temporalis fascia graft is planned to be located and pinned in that position covering the middle vault onlay graft and all the dorsal irregularities. The thin lines contour the joint or frontier between the osseous pyramid and ...Read more
Alar flaring,Alar rim retraction,Asymmetric nose,Asymmetric tip,Bifid columella,Bifid tip,Broad dorsum,Broad nose,Concave lateral cruras,Congenital nose,Crooked nose,Crooked septum,Crooked tip,Dorsum hump,Dorsum ridges,Droopy tip,Failed osteotomies,Flat dorsum,Irregular dorsum,Large alar cartilages,Large nose,Large nostrils,Large sills,Nasal fibrosis,Nasal valve collapse,Overprojected tip,Pinched middle vault,Pinched nose,Plunging tip deformity,Poorly defined tip,Poorly supported tip,Posttraumatic nose,Rhomboid dorsum,Saddle nose deformity,Short septum,Short upper lateral cartilages,Sunken columella,Sunken supratip,Thick skin nose,Tip bossae,Underprojected tip,Alar base resection alarplasty,Columella strut graft,Dorsum hump resection,Dorsum regularization,Extended columella strut graft,Intercrural columella plasty sutures,Interdomal tip plasty sutures,Lateral cruras cephalic resection,Lateral cruras plasty sutures,Lateral cruras repositioning,Lateral cruras shortening resection,Medial cruras shortening resection,Nasal bones osteotomies,Nostril sill resection,Onlay dorsum graft,Onlay supratip graft,Open approach incision,Rib cartilage graft harvesting,Septocolumella graft,Septum caudal extension graft,Septum replacement graft,Spreader graft,Temporalis fascia graft harvesting,Tip defatting,Transdomal tip plasty sutures,Triangular cartilages caudal extension graft - photo 68
#68Insertion, extension and fixation method of the superficial temporalis fascia graft inside the nose to cover all the dorsum and the entire nasal walls. The circle spots the massive irregularities visible at the dorsum which are deemed irreparable ...Read more
Alar flaring,Alar rim retraction,Asymmetric nose,Asymmetric tip,Bifid columella,Bifid tip,Broad dorsum,Broad nose,Concave lateral cruras,Congenital nose,Crooked nose,Crooked septum,Crooked tip,Dorsum hump,Dorsum ridges,Droopy tip,Failed osteotomies,Flat dorsum,Irregular dorsum,Large alar cartilages,Large nose,Large nostrils,Large sills,Nasal fibrosis,Nasal valve collapse,Overprojected tip,Pinched middle vault,Pinched nose,Plunging tip deformity,Poorly defined tip,Poorly supported tip,Posttraumatic nose,Rhomboid dorsum,Saddle nose deformity,Short septum,Short upper lateral cartilages,Sunken columella,Sunken supratip,Thick skin nose,Tip bossae,Underprojected tip,Alar base resection alarplasty,Columella strut graft,Dorsum hump resection,Dorsum regularization,Extended columella strut graft,Intercrural columella plasty sutures,Interdomal tip plasty sutures,Lateral cruras cephalic resection,Lateral cruras plasty sutures,Lateral cruras repositioning,Lateral cruras shortening resection,Medial cruras shortening resection,Nasal bones osteotomies,Nostril sill resection,Onlay dorsum graft,Onlay supratip graft,Open approach incision,Rib cartilage graft harvesting,Septocolumella graft,Septum caudal extension graft,Septum replacement graft,Spreader graft,Temporalis fascia graft harvesting,Tip defatting,Transdomal tip plasty sutures,Triangular cartilages caudal extension graft - photo 69
#69The arrows point to entry and exit points of the threads for the 5 inaccessible to the surgeon fixation sutures of the temporalis fascia graft (F). In this case full extension of the superficial temporalis fascia graft needs 8 fixation points; ...Read more
Alar flaring,Alar rim retraction,Asymmetric nose,Asymmetric tip,Bifid columella,Bifid tip,Broad dorsum,Broad nose,Concave lateral cruras,Congenital nose,Crooked nose,Crooked septum,Crooked tip,Dorsum hump,Dorsum ridges,Droopy tip,Failed osteotomies,Flat dorsum,Irregular dorsum,Large alar cartilages,Large nose,Large nostrils,Large sills,Nasal fibrosis,Nasal valve collapse,Overprojected tip,Pinched middle vault,Pinched nose,Plunging tip deformity,Poorly defined tip,Poorly supported tip,Posttraumatic nose,Rhomboid dorsum,Saddle nose deformity,Short septum,Short upper lateral cartilages,Sunken columella,Sunken supratip,Thick skin nose,Tip bossae,Underprojected tip,Alar base resection alarplasty,Columella strut graft,Dorsum hump resection,Dorsum regularization,Extended columella strut graft,Intercrural columella plasty sutures,Interdomal tip plasty sutures,Lateral cruras cephalic resection,Lateral cruras plasty sutures,Lateral cruras repositioning,Lateral cruras shortening resection,Medial cruras shortening resection,Nasal bones osteotomies,Nostril sill resection,Onlay dorsum graft,Onlay supratip graft,Open approach incision,Rib cartilage graft harvesting,Septocolumella graft,Septum caudal extension graft,Septum replacement graft,Spreader graft,Temporalis fascia graft harvesting,Tip defatting,Transdomal tip plasty sutures,Triangular cartilages caudal extension graft - photo 70
#70The arrows point to the traction vector from the thread for the clock position 12 fixation suture. Note how 5 U form threads pierce the skin from out to in, then grasp the superficial temporalis fascia graft, which is lying on patient's cheek, ...Read more
Alar flaring,Alar rim retraction,Asymmetric nose,Asymmetric tip,Bifid columella,Bifid tip,Broad dorsum,Broad nose,Concave lateral cruras,Congenital nose,Crooked nose,Crooked septum,Crooked tip,Dorsum hump,Dorsum ridges,Droopy tip,Failed osteotomies,Flat dorsum,Irregular dorsum,Large alar cartilages,Large nose,Large nostrils,Large sills,Nasal fibrosis,Nasal valve collapse,Overprojected tip,Pinched middle vault,Pinched nose,Plunging tip deformity,Poorly defined tip,Poorly supported tip,Posttraumatic nose,Rhomboid dorsum,Saddle nose deformity,Short septum,Short upper lateral cartilages,Sunken columella,Sunken supratip,Thick skin nose,Tip bossae,Underprojected tip,Alar base resection alarplasty,Columella strut graft,Dorsum hump resection,Dorsum regularization,Extended columella strut graft,Intercrural columella plasty sutures,Interdomal tip plasty sutures,Lateral cruras cephalic resection,Lateral cruras plasty sutures,Lateral cruras repositioning,Lateral cruras shortening resection,Medial cruras shortening resection,Nasal bones osteotomies,Nostril sill resection,Onlay dorsum graft,Onlay supratip graft,Open approach incision,Rib cartilage graft harvesting,Septocolumella graft,Septum caudal extension graft,Septum replacement graft,Spreader graft,Temporalis fascia graft harvesting,Tip defatting,Transdomal tip plasty sutures,Triangular cartilages caudal extension graft - photo 71
#71The arrows point to the traction vector from the thread for the clock position 2 fixation suture. Note how 5 U form threads pierce the skin from out to in, then grasp the superficial temporalis fascia graft, which is lying on patient's cheek, ...Read more
Alar flaring,Alar rim retraction,Asymmetric nose,Asymmetric tip,Bifid columella,Bifid tip,Broad dorsum,Broad nose,Concave lateral cruras,Congenital nose,Crooked nose,Crooked septum,Crooked tip,Dorsum hump,Dorsum ridges,Droopy tip,Failed osteotomies,Flat dorsum,Irregular dorsum,Large alar cartilages,Large nose,Large nostrils,Large sills,Nasal fibrosis,Nasal valve collapse,Overprojected tip,Pinched middle vault,Pinched nose,Plunging tip deformity,Poorly defined tip,Poorly supported tip,Posttraumatic nose,Rhomboid dorsum,Saddle nose deformity,Short septum,Short upper lateral cartilages,Sunken columella,Sunken supratip,Thick skin nose,Tip bossae,Underprojected tip,Alar base resection alarplasty,Columella strut graft,Dorsum hump resection,Dorsum regularization,Extended columella strut graft,Intercrural columella plasty sutures,Interdomal tip plasty sutures,Lateral cruras cephalic resection,Lateral cruras plasty sutures,Lateral cruras repositioning,Lateral cruras shortening resection,Medial cruras shortening resection,Nasal bones osteotomies,Nostril sill resection,Onlay dorsum graft,Onlay supratip graft,Open approach incision,Rib cartilage graft harvesting,Septocolumella graft,Septum caudal extension graft,Septum replacement graft,Spreader graft,Temporalis fascia graft harvesting,Tip defatting,Transdomal tip plasty sutures,Triangular cartilages caudal extension graft - photo 72
#72The arrows point to the traction vector from the thread for the clock position 3 fixation suture. Note how 5 U form threads pierce the skin from out to in, then grasp the superficial temporalis fascia graft, which is lying on patient's cheek, ...Read more
Alar flaring,Alar rim retraction,Asymmetric nose,Asymmetric tip,Bifid columella,Bifid tip,Broad dorsum,Broad nose,Concave lateral cruras,Congenital nose,Crooked nose,Crooked septum,Crooked tip,Dorsum hump,Dorsum ridges,Droopy tip,Failed osteotomies,Flat dorsum,Irregular dorsum,Large alar cartilages,Large nose,Large nostrils,Large sills,Nasal fibrosis,Nasal valve collapse,Overprojected tip,Pinched middle vault,Pinched nose,Plunging tip deformity,Poorly defined tip,Poorly supported tip,Posttraumatic nose,Rhomboid dorsum,Saddle nose deformity,Short septum,Short upper lateral cartilages,Sunken columella,Sunken supratip,Thick skin nose,Tip bossae,Underprojected tip,Alar base resection alarplasty,Columella strut graft,Dorsum hump resection,Dorsum regularization,Extended columella strut graft,Intercrural columella plasty sutures,Interdomal tip plasty sutures,Lateral cruras cephalic resection,Lateral cruras plasty sutures,Lateral cruras repositioning,Lateral cruras shortening resection,Medial cruras shortening resection,Nasal bones osteotomies,Nostril sill resection,Onlay dorsum graft,Onlay supratip graft,Open approach incision,Rib cartilage graft harvesting,Septocolumella graft,Septum caudal extension graft,Septum replacement graft,Spreader graft,Temporalis fascia graft harvesting,Tip defatting,Transdomal tip plasty sutures,Triangular cartilages caudal extension graft - photo 73
#73The arrows point to the traction vector from the thread for the clock position 9 fixation suture. Note how 5 U form threads pierce the skin from out to in, then grasp the superficial temporalis fascia graft, which is lying on patient's cheek, ...Read more
Alar flaring,Alar rim retraction,Asymmetric nose,Asymmetric tip,Bifid columella,Bifid tip,Broad dorsum,Broad nose,Concave lateral cruras,Congenital nose,Crooked nose,Crooked septum,Crooked tip,Dorsum hump,Dorsum ridges,Droopy tip,Failed osteotomies,Flat dorsum,Irregular dorsum,Large alar cartilages,Large nose,Large nostrils,Large sills,Nasal fibrosis,Nasal valve collapse,Overprojected tip,Pinched middle vault,Pinched nose,Plunging tip deformity,Poorly defined tip,Poorly supported tip,Posttraumatic nose,Rhomboid dorsum,Saddle nose deformity,Short septum,Short upper lateral cartilages,Sunken columella,Sunken supratip,Thick skin nose,Tip bossae,Underprojected tip,Alar base resection alarplasty,Columella strut graft,Dorsum hump resection,Dorsum regularization,Extended columella strut graft,Intercrural columella plasty sutures,Interdomal tip plasty sutures,Lateral cruras cephalic resection,Lateral cruras plasty sutures,Lateral cruras repositioning,Lateral cruras shortening resection,Medial cruras shortening resection,Nasal bones osteotomies,Nostril sill resection,Onlay dorsum graft,Onlay supratip graft,Open approach incision,Rib cartilage graft harvesting,Septocolumella graft,Septum caudal extension graft,Septum replacement graft,Spreader graft,Temporalis fascia graft harvesting,Tip defatting,Transdomal tip plasty sutures,Triangular cartilages caudal extension graft - photo 74
#74The arrows point to the traction vector from the thread for the clock position 10 fixation suture. Note how 5 U form threads pierce the skin from out to in, then grasp the superficial temporalis fascia graft, which is lying on patient's cheek, ...Read more
Alar flaring,Alar rim retraction,Asymmetric nose,Asymmetric tip,Bifid columella,Bifid tip,Broad dorsum,Broad nose,Concave lateral cruras,Congenital nose,Crooked nose,Crooked septum,Crooked tip,Dorsum hump,Dorsum ridges,Droopy tip,Failed osteotomies,Flat dorsum,Irregular dorsum,Large alar cartilages,Large nose,Large nostrils,Large sills,Nasal fibrosis,Nasal valve collapse,Overprojected tip,Pinched middle vault,Pinched nose,Plunging tip deformity,Poorly defined tip,Poorly supported tip,Posttraumatic nose,Rhomboid dorsum,Saddle nose deformity,Short septum,Short upper lateral cartilages,Sunken columella,Sunken supratip,Thick skin nose,Tip bossae,Underprojected tip,Alar base resection alarplasty,Columella strut graft,Dorsum hump resection,Dorsum regularization,Extended columella strut graft,Intercrural columella plasty sutures,Interdomal tip plasty sutures,Lateral cruras cephalic resection,Lateral cruras plasty sutures,Lateral cruras repositioning,Lateral cruras shortening resection,Medial cruras shortening resection,Nasal bones osteotomies,Nostril sill resection,Onlay dorsum graft,Onlay supratip graft,Open approach incision,Rib cartilage graft harvesting,Septocolumella graft,Septum caudal extension graft,Septum replacement graft,Spreader graft,Temporalis fascia graft harvesting,Tip defatting,Transdomal tip plasty sutures,Triangular cartilages caudal extension graft - photo 75
#75Note how 5 U form threads pierce the skin from out to in, then grasp the superficial temporalis fascia graft, which is lying on patient's cheek, for what they exit the nose through the surgical cavity, and then return piercing again the skin ...Read more
Alar flaring,Alar rim retraction,Asymmetric nose,Asymmetric tip,Bifid columella,Bifid tip,Broad dorsum,Broad nose,Concave lateral cruras,Congenital nose,Crooked nose,Crooked septum,Crooked tip,Dorsum hump,Dorsum ridges,Droopy tip,Failed osteotomies,Flat dorsum,Irregular dorsum,Large alar cartilages,Large nose,Large nostrils,Large sills,Nasal fibrosis,Nasal valve collapse,Overprojected tip,Pinched middle vault,Pinched nose,Plunging tip deformity,Poorly defined tip,Poorly supported tip,Posttraumatic nose,Rhomboid dorsum,Saddle nose deformity,Short septum,Short upper lateral cartilages,Sunken columella,Sunken supratip,Thick skin nose,Tip bossae,Underprojected tip,Alar base resection alarplasty,Columella strut graft,Dorsum hump resection,Dorsum regularization,Extended columella strut graft,Intercrural columella plasty sutures,Interdomal tip plasty sutures,Lateral cruras cephalic resection,Lateral cruras plasty sutures,Lateral cruras repositioning,Lateral cruras shortening resection,Medial cruras shortening resection,Nasal bones osteotomies,Nostril sill resection,Onlay dorsum graft,Onlay supratip graft,Open approach incision,Rib cartilage graft harvesting,Septocolumella graft,Septum caudal extension graft,Septum replacement graft,Spreader graft,Temporalis fascia graft harvesting,Tip defatting,Transdomal tip plasty sutures,Triangular cartilages caudal extension graft - photo 76
#76The arrows point to the traction vector from the thread for the clock position 12 fixation suture, whilst the forceps grasps the temporalis fascia graft to achieve extension that eases its introduction into the nose and guides it.
Alar flaring,Alar rim retraction,Asymmetric nose,Asymmetric tip,Bifid columella,Bifid tip,Broad dorsum,Broad nose,Concave lateral cruras,Congenital nose,Crooked nose,Crooked septum,Crooked tip,Dorsum hump,Dorsum ridges,Droopy tip,Failed osteotomies,Flat dorsum,Irregular dorsum,Large alar cartilages,Large nose,Large nostrils,Large sills,Nasal fibrosis,Nasal valve collapse,Overprojected tip,Pinched middle vault,Pinched nose,Plunging tip deformity,Poorly defined tip,Poorly supported tip,Posttraumatic nose,Rhomboid dorsum,Saddle nose deformity,Short septum,Short upper lateral cartilages,Sunken columella,Sunken supratip,Thick skin nose,Tip bossae,Underprojected tip,Alar base resection alarplasty,Columella strut graft,Dorsum hump resection,Dorsum regularization,Extended columella strut graft,Intercrural columella plasty sutures,Interdomal tip plasty sutures,Lateral cruras cephalic resection,Lateral cruras plasty sutures,Lateral cruras repositioning,Lateral cruras shortening resection,Medial cruras shortening resection,Nasal bones osteotomies,Nostril sill resection,Onlay dorsum graft,Onlay supratip graft,Open approach incision,Rib cartilage graft harvesting,Septocolumella graft,Septum caudal extension graft,Septum replacement graft,Spreader graft,Temporalis fascia graft harvesting,Tip defatting,Transdomal tip plasty sutures,Triangular cartilages caudal extension graft - photo 77
#77The arrows point to the traction vector from the thread for the clock position 12 fixation suture, whilst the forceps grasps the temporalis fascia graft to achieve extension that eases its introduction into the nose and guides it.
Alar flaring,Alar rim retraction,Asymmetric nose,Asymmetric tip,Bifid columella,Bifid tip,Broad dorsum,Broad nose,Concave lateral cruras,Congenital nose,Crooked nose,Crooked septum,Crooked tip,Dorsum hump,Dorsum ridges,Droopy tip,Failed osteotomies,Flat dorsum,Irregular dorsum,Large alar cartilages,Large nose,Large nostrils,Large sills,Nasal fibrosis,Nasal valve collapse,Overprojected tip,Pinched middle vault,Pinched nose,Plunging tip deformity,Poorly defined tip,Poorly supported tip,Posttraumatic nose,Rhomboid dorsum,Saddle nose deformity,Short septum,Short upper lateral cartilages,Sunken columella,Sunken supratip,Thick skin nose,Tip bossae,Underprojected tip,Alar base resection alarplasty,Columella strut graft,Dorsum hump resection,Dorsum regularization,Extended columella strut graft,Intercrural columella plasty sutures,Interdomal tip plasty sutures,Lateral cruras cephalic resection,Lateral cruras plasty sutures,Lateral cruras repositioning,Lateral cruras shortening resection,Medial cruras shortening resection,Nasal bones osteotomies,Nostril sill resection,Onlay dorsum graft,Onlay supratip graft,Open approach incision,Rib cartilage graft harvesting,Septocolumella graft,Septum caudal extension graft,Septum replacement graft,Spreader graft,Temporalis fascia graft harvesting,Tip defatting,Transdomal tip plasty sutures,Triangular cartilages caudal extension graft - photo 78
#78The arrows point to the traction vector from the thread for the clock position 12 fixation suture, whilst the forceps grasps the temporalis fascia graft to achieve extension that eases its introduction into the nose and guides it.
Alar flaring,Alar rim retraction,Asymmetric nose,Asymmetric tip,Bifid columella,Bifid tip,Broad dorsum,Broad nose,Concave lateral cruras,Congenital nose,Crooked nose,Crooked septum,Crooked tip,Dorsum hump,Dorsum ridges,Droopy tip,Failed osteotomies,Flat dorsum,Irregular dorsum,Large alar cartilages,Large nose,Large nostrils,Large sills,Nasal fibrosis,Nasal valve collapse,Overprojected tip,Pinched middle vault,Pinched nose,Plunging tip deformity,Poorly defined tip,Poorly supported tip,Posttraumatic nose,Rhomboid dorsum,Saddle nose deformity,Short septum,Short upper lateral cartilages,Sunken columella,Sunken supratip,Thick skin nose,Tip bossae,Underprojected tip,Alar base resection alarplasty,Columella strut graft,Dorsum hump resection,Dorsum regularization,Extended columella strut graft,Intercrural columella plasty sutures,Interdomal tip plasty sutures,Lateral cruras cephalic resection,Lateral cruras plasty sutures,Lateral cruras repositioning,Lateral cruras shortening resection,Medial cruras shortening resection,Nasal bones osteotomies,Nostril sill resection,Onlay dorsum graft,Onlay supratip graft,Open approach incision,Rib cartilage graft harvesting,Septocolumella graft,Septum caudal extension graft,Septum replacement graft,Spreader graft,Temporalis fascia graft harvesting,Tip defatting,Transdomal tip plasty sutures,Triangular cartilages caudal extension graft - photo 79
#79After inserting in full the temporalis fascia graft its extension is achieved by means of pulling tight the 5 U form threads, which are fixed to the skin with adhesive to maintain the tension, and suturing to the new nasal skeleton the 3 lower ...Read more
Alar flaring,Alar rim retraction,Asymmetric nose,Asymmetric tip,Bifid columella,Bifid tip,Broad dorsum,Broad nose,Concave lateral cruras,Congenital nose,Crooked nose,Crooked septum,Crooked tip,Dorsum hump,Dorsum ridges,Droopy tip,Failed osteotomies,Flat dorsum,Irregular dorsum,Large alar cartilages,Large nose,Large nostrils,Large sills,Nasal fibrosis,Nasal valve collapse,Overprojected tip,Pinched middle vault,Pinched nose,Plunging tip deformity,Poorly defined tip,Poorly supported tip,Posttraumatic nose,Rhomboid dorsum,Saddle nose deformity,Short septum,Short upper lateral cartilages,Sunken columella,Sunken supratip,Thick skin nose,Tip bossae,Underprojected tip,Alar base resection alarplasty,Columella strut graft,Dorsum hump resection,Dorsum regularization,Extended columella strut graft,Intercrural columella plasty sutures,Interdomal tip plasty sutures,Lateral cruras cephalic resection,Lateral cruras plasty sutures,Lateral cruras repositioning,Lateral cruras shortening resection,Medial cruras shortening resection,Nasal bones osteotomies,Nostril sill resection,Onlay dorsum graft,Onlay supratip graft,Open approach incision,Rib cartilage graft harvesting,Septocolumella graft,Septum caudal extension graft,Septum replacement graft,Spreader graft,Temporalis fascia graft harvesting,Tip defatting,Transdomal tip plasty sutures,Triangular cartilages caudal extension graft - photo 80
#80The line shows the contour of the fully extended and pinned temporalis fascia graft; the arrows point to the traction vectors of the threads for its 5 inaccessible to the surgeon pull through fixation sutures; the 3 accessible direct sutures ...Read more
Alar flaring,Alar rim retraction,Asymmetric nose,Asymmetric tip,Bifid columella,Bifid tip,Broad dorsum,Broad nose,Concave lateral cruras,Congenital nose,Crooked nose,Crooked septum,Crooked tip,Dorsum hump,Dorsum ridges,Droopy tip,Failed osteotomies,Flat dorsum,Irregular dorsum,Large alar cartilages,Large nose,Large nostrils,Large sills,Nasal fibrosis,Nasal valve collapse,Overprojected tip,Pinched middle vault,Pinched nose,Plunging tip deformity,Poorly defined tip,Poorly supported tip,Posttraumatic nose,Rhomboid dorsum,Saddle nose deformity,Short septum,Short upper lateral cartilages,Sunken columella,Sunken supratip,Thick skin nose,Tip bossae,Underprojected tip,Alar base resection alarplasty,Columella strut graft,Dorsum hump resection,Dorsum regularization,Extended columella strut graft,Intercrural columella plasty sutures,Interdomal tip plasty sutures,Lateral cruras cephalic resection,Lateral cruras plasty sutures,Lateral cruras repositioning,Lateral cruras shortening resection,Medial cruras shortening resection,Nasal bones osteotomies,Nostril sill resection,Onlay dorsum graft,Onlay supratip graft,Open approach incision,Rib cartilage graft harvesting,Septocolumella graft,Septum caudal extension graft,Septum replacement graft,Spreader graft,Temporalis fascia graft harvesting,Tip defatting,Transdomal tip plasty sutures,Triangular cartilages caudal extension graft - photo 81
#81After inserting in full the temporalis fascia graft its extension is achieved by means of pulling tight the 5 U form threads, which are fixed to the skin with adhesive to maintain the tension, and suturing to the new nasal skeleton the 3 lower ...Read more
Alar flaring,Alar rim retraction,Asymmetric nose,Asymmetric tip,Bifid columella,Bifid tip,Broad dorsum,Broad nose,Concave lateral cruras,Congenital nose,Crooked nose,Crooked septum,Crooked tip,Dorsum hump,Dorsum ridges,Droopy tip,Failed osteotomies,Flat dorsum,Irregular dorsum,Large alar cartilages,Large nose,Large nostrils,Large sills,Nasal fibrosis,Nasal valve collapse,Overprojected tip,Pinched middle vault,Pinched nose,Plunging tip deformity,Poorly defined tip,Poorly supported tip,Posttraumatic nose,Rhomboid dorsum,Saddle nose deformity,Short septum,Short upper lateral cartilages,Sunken columella,Sunken supratip,Thick skin nose,Tip bossae,Underprojected tip,Alar base resection alarplasty,Columella strut graft,Dorsum hump resection,Dorsum regularization,Extended columella strut graft,Intercrural columella plasty sutures,Interdomal tip plasty sutures,Lateral cruras cephalic resection,Lateral cruras plasty sutures,Lateral cruras repositioning,Lateral cruras shortening resection,Medial cruras shortening resection,Nasal bones osteotomies,Nostril sill resection,Onlay dorsum graft,Onlay supratip graft,Open approach incision,Rib cartilage graft harvesting,Septocolumella graft,Septum caudal extension graft,Septum replacement graft,Spreader graft,Temporalis fascia graft harvesting,Tip defatting,Transdomal tip plasty sutures,Triangular cartilages caudal extension graft - photo 82
#82The line shows the contour of the fully extended and pinned temporalis fascia graft; the arrows point to the traction vectors of the threads for its 5 inaccessible to the surgeon pull through fixation sutures; the 3 accessible direct sutures ...Read more
Alar flaring,Alar rim retraction,Asymmetric nose,Asymmetric tip,Bifid columella,Bifid tip,Broad dorsum,Broad nose,Concave lateral cruras,Congenital nose,Crooked nose,Crooked septum,Crooked tip,Dorsum hump,Dorsum ridges,Droopy tip,Failed osteotomies,Flat dorsum,Irregular dorsum,Large alar cartilages,Large nose,Large nostrils,Large sills,Nasal fibrosis,Nasal valve collapse,Overprojected tip,Pinched middle vault,Pinched nose,Plunging tip deformity,Poorly defined tip,Poorly supported tip,Posttraumatic nose,Rhomboid dorsum,Saddle nose deformity,Short septum,Short upper lateral cartilages,Sunken columella,Sunken supratip,Thick skin nose,Tip bossae,Underprojected tip,Alar base resection alarplasty,Columella strut graft,Dorsum hump resection,Dorsum regularization,Extended columella strut graft,Intercrural columella plasty sutures,Interdomal tip plasty sutures,Lateral cruras cephalic resection,Lateral cruras plasty sutures,Lateral cruras repositioning,Lateral cruras shortening resection,Medial cruras shortening resection,Nasal bones osteotomies,Nostril sill resection,Onlay dorsum graft,Onlay supratip graft,Open approach incision,Rib cartilage graft harvesting,Septocolumella graft,Septum caudal extension graft,Septum replacement graft,Spreader graft,Temporalis fascia graft harvesting,Tip defatting,Transdomal tip plasty sutures,Triangular cartilages caudal extension graft - photo 83
#83Perfect tip support and definition, eradication of tip bossae and firm alar support; the columella is supported and pushed out the alae. The alar flare and the nostril sill have already been trimmed away.
Alar flaring,Alar rim retraction,Asymmetric nose,Asymmetric tip,Bifid columella,Bifid tip,Broad dorsum,Broad nose,Concave lateral cruras,Congenital nose,Crooked nose,Crooked septum,Crooked tip,Dorsum hump,Dorsum ridges,Droopy tip,Failed osteotomies,Flat dorsum,Irregular dorsum,Large alar cartilages,Large nose,Large nostrils,Large sills,Nasal fibrosis,Nasal valve collapse,Overprojected tip,Pinched middle vault,Pinched nose,Plunging tip deformity,Poorly defined tip,Poorly supported tip,Posttraumatic nose,Rhomboid dorsum,Saddle nose deformity,Short septum,Short upper lateral cartilages,Sunken columella,Sunken supratip,Thick skin nose,Tip bossae,Underprojected tip,Alar base resection alarplasty,Columella strut graft,Dorsum hump resection,Dorsum regularization,Extended columella strut graft,Intercrural columella plasty sutures,Interdomal tip plasty sutures,Lateral cruras cephalic resection,Lateral cruras plasty sutures,Lateral cruras repositioning,Lateral cruras shortening resection,Medial cruras shortening resection,Nasal bones osteotomies,Nostril sill resection,Onlay dorsum graft,Onlay supratip graft,Open approach incision,Rib cartilage graft harvesting,Septocolumella graft,Septum caudal extension graft,Septum replacement graft,Spreader graft,Temporalis fascia graft harvesting,Tip defatting,Transdomal tip plasty sutures,Triangular cartilages caudal extension graft - photo 84
#84Before and after comparison. Perfect tip support and definition, eradication of tip bossae and firm alar support; the columella is supported and pushed out the alae. The alar flare and the nostril sill have already been trimmed away.
Alar flaring,Alar rim retraction,Asymmetric nose,Asymmetric tip,Bifid columella,Bifid tip,Broad dorsum,Broad nose,Concave lateral cruras,Congenital nose,Crooked nose,Crooked septum,Crooked tip,Dorsum hump,Dorsum ridges,Droopy tip,Failed osteotomies,Flat dorsum,Irregular dorsum,Large alar cartilages,Large nose,Large nostrils,Large sills,Nasal fibrosis,Nasal valve collapse,Overprojected tip,Pinched middle vault,Pinched nose,Plunging tip deformity,Poorly defined tip,Poorly supported tip,Posttraumatic nose,Rhomboid dorsum,Saddle nose deformity,Short septum,Short upper lateral cartilages,Sunken columella,Sunken supratip,Thick skin nose,Tip bossae,Underprojected tip,Alar base resection alarplasty,Columella strut graft,Dorsum hump resection,Dorsum regularization,Extended columella strut graft,Intercrural columella plasty sutures,Interdomal tip plasty sutures,Lateral cruras cephalic resection,Lateral cruras plasty sutures,Lateral cruras repositioning,Lateral cruras shortening resection,Medial cruras shortening resection,Nasal bones osteotomies,Nostril sill resection,Onlay dorsum graft,Onlay supratip graft,Open approach incision,Rib cartilage graft harvesting,Septocolumella graft,Septum caudal extension graft,Septum replacement graft,Spreader graft,Temporalis fascia graft harvesting,Tip defatting,Transdomal tip plasty sutures,Triangular cartilages caudal extension graft - photo 85
#85Before and after comparison. Excellent alignment of the preoperative nasal pyramid and nasal tip crookedness.
Alar flaring,Alar rim retraction,Asymmetric nose,Asymmetric tip,Bifid columella,Bifid tip,Broad dorsum,Broad nose,Concave lateral cruras,Congenital nose,Crooked nose,Crooked septum,Crooked tip,Dorsum hump,Dorsum ridges,Droopy tip,Failed osteotomies,Flat dorsum,Irregular dorsum,Large alar cartilages,Large nose,Large nostrils,Large sills,Nasal fibrosis,Nasal valve collapse,Overprojected tip,Pinched middle vault,Pinched nose,Plunging tip deformity,Poorly defined tip,Poorly supported tip,Posttraumatic nose,Rhomboid dorsum,Saddle nose deformity,Short septum,Short upper lateral cartilages,Sunken columella,Sunken supratip,Thick skin nose,Tip bossae,Underprojected tip,Alar base resection alarplasty,Columella strut graft,Dorsum hump resection,Dorsum regularization,Extended columella strut graft,Intercrural columella plasty sutures,Interdomal tip plasty sutures,Lateral cruras cephalic resection,Lateral cruras plasty sutures,Lateral cruras repositioning,Lateral cruras shortening resection,Medial cruras shortening resection,Nasal bones osteotomies,Nostril sill resection,Onlay dorsum graft,Onlay supratip graft,Open approach incision,Rib cartilage graft harvesting,Septocolumella graft,Septum caudal extension graft,Septum replacement graft,Spreader graft,Temporalis fascia graft harvesting,Tip defatting,Transdomal tip plasty sutures,Triangular cartilages caudal extension graft - photo 86
#86Before and after comparison. The lines at the dorsum show the correction of the preoperative dorsal zigzag and lack of definition. The line at the nasal base shows the columella is not sunken anymore and the nasal base has the anatomically canonical ...Read more
Alar flaring,Alar rim retraction,Asymmetric nose,Asymmetric tip,Bifid columella,Bifid tip,Broad dorsum,Broad nose,Concave lateral cruras,Congenital nose,Crooked nose,Crooked septum,Crooked tip,Dorsum hump,Dorsum ridges,Droopy tip,Failed osteotomies,Flat dorsum,Irregular dorsum,Large alar cartilages,Large nose,Large nostrils,Large sills,Nasal fibrosis,Nasal valve collapse,Overprojected tip,Pinched middle vault,Pinched nose,Plunging tip deformity,Poorly defined tip,Poorly supported tip,Posttraumatic nose,Rhomboid dorsum,Saddle nose deformity,Short septum,Short upper lateral cartilages,Sunken columella,Sunken supratip,Thick skin nose,Tip bossae,Underprojected tip,Alar base resection alarplasty,Columella strut graft,Dorsum hump resection,Dorsum regularization,Extended columella strut graft,Intercrural columella plasty sutures,Interdomal tip plasty sutures,Lateral cruras cephalic resection,Lateral cruras plasty sutures,Lateral cruras repositioning,Lateral cruras shortening resection,Medial cruras shortening resection,Nasal bones osteotomies,Nostril sill resection,Onlay dorsum graft,Onlay supratip graft,Open approach incision,Rib cartilage graft harvesting,Septocolumella graft,Septum caudal extension graft,Septum replacement graft,Spreader graft,Temporalis fascia graft harvesting,Tip defatting,Transdomal tip plasty sutures,Triangular cartilages caudal extension graft - photo 87
#87Before and after comparison. Comprehensive correction of deformities: crookedness, sunken areas, irregularities, bossae, concavities, flattening, lack of definition, broadness, alar flare, etc.
Alar flaring,Alar rim retraction,Asymmetric nose,Asymmetric tip,Bifid columella,Bifid tip,Broad dorsum,Broad nose,Concave lateral cruras,Congenital nose,Crooked nose,Crooked septum,Crooked tip,Dorsum hump,Dorsum ridges,Droopy tip,Failed osteotomies,Flat dorsum,Irregular dorsum,Large alar cartilages,Large nose,Large nostrils,Large sills,Nasal fibrosis,Nasal valve collapse,Overprojected tip,Pinched middle vault,Pinched nose,Plunging tip deformity,Poorly defined tip,Poorly supported tip,Posttraumatic nose,Rhomboid dorsum,Saddle nose deformity,Short septum,Short upper lateral cartilages,Sunken columella,Sunken supratip,Thick skin nose,Tip bossae,Underprojected tip,Alar base resection alarplasty,Columella strut graft,Dorsum hump resection,Dorsum regularization,Extended columella strut graft,Intercrural columella plasty sutures,Interdomal tip plasty sutures,Lateral cruras cephalic resection,Lateral cruras plasty sutures,Lateral cruras repositioning,Lateral cruras shortening resection,Medial cruras shortening resection,Nasal bones osteotomies,Nostril sill resection,Onlay dorsum graft,Onlay supratip graft,Open approach incision,Rib cartilage graft harvesting,Septocolumella graft,Septum caudal extension graft,Septum replacement graft,Spreader graft,Temporalis fascia graft harvesting,Tip defatting,Transdomal tip plasty sutures,Triangular cartilages caudal extension graft - photo 88
#88Before and after comparison. Excellent alignment of the preoperative nasal pyramid and nasal tip crookedness.
Alar flaring,Alar rim retraction,Asymmetric nose,Asymmetric tip,Bifid columella,Bifid tip,Broad dorsum,Broad nose,Concave lateral cruras,Congenital nose,Crooked nose,Crooked septum,Crooked tip,Dorsum hump,Dorsum ridges,Droopy tip,Failed osteotomies,Flat dorsum,Irregular dorsum,Large alar cartilages,Large nose,Large nostrils,Large sills,Nasal fibrosis,Nasal valve collapse,Overprojected tip,Pinched middle vault,Pinched nose,Plunging tip deformity,Poorly defined tip,Poorly supported tip,Posttraumatic nose,Rhomboid dorsum,Saddle nose deformity,Short septum,Short upper lateral cartilages,Sunken columella,Sunken supratip,Thick skin nose,Tip bossae,Underprojected tip,Alar base resection alarplasty,Columella strut graft,Dorsum hump resection,Dorsum regularization,Extended columella strut graft,Intercrural columella plasty sutures,Interdomal tip plasty sutures,Lateral cruras cephalic resection,Lateral cruras plasty sutures,Lateral cruras repositioning,Lateral cruras shortening resection,Medial cruras shortening resection,Nasal bones osteotomies,Nostril sill resection,Onlay dorsum graft,Onlay supratip graft,Open approach incision,Rib cartilage graft harvesting,Septocolumella graft,Septum caudal extension graft,Septum replacement graft,Spreader graft,Temporalis fascia graft harvesting,Tip defatting,Transdomal tip plasty sutures,Triangular cartilages caudal extension graft - photo 89
#89Before and after comparison. The lines at the nasal dorsum (inner) and nasal base (outer) show the correction of the preoperative crookedness, zigzag and lack of definition. The lines at the tip and alae show how the preoperative deformities ...Read more
Alar flaring,Alar rim retraction,Asymmetric nose,Asymmetric tip,Bifid columella,Bifid tip,Broad dorsum,Broad nose,Concave lateral cruras,Congenital nose,Crooked nose,Crooked septum,Crooked tip,Dorsum hump,Dorsum ridges,Droopy tip,Failed osteotomies,Flat dorsum,Irregular dorsum,Large alar cartilages,Large nose,Large nostrils,Large sills,Nasal fibrosis,Nasal valve collapse,Overprojected tip,Pinched middle vault,Pinched nose,Plunging tip deformity,Poorly defined tip,Poorly supported tip,Posttraumatic nose,Rhomboid dorsum,Saddle nose deformity,Short septum,Short upper lateral cartilages,Sunken columella,Sunken supratip,Thick skin nose,Tip bossae,Underprojected tip,Alar base resection alarplasty,Columella strut graft,Dorsum hump resection,Dorsum regularization,Extended columella strut graft,Intercrural columella plasty sutures,Interdomal tip plasty sutures,Lateral cruras cephalic resection,Lateral cruras plasty sutures,Lateral cruras repositioning,Lateral cruras shortening resection,Medial cruras shortening resection,Nasal bones osteotomies,Nostril sill resection,Onlay dorsum graft,Onlay supratip graft,Open approach incision,Rib cartilage graft harvesting,Septocolumella graft,Septum caudal extension graft,Septum replacement graft,Spreader graft,Temporalis fascia graft harvesting,Tip defatting,Transdomal tip plasty sutures,Triangular cartilages caudal extension graft - photo 90
#90Before and after comparison. Comprehensive correction of deformities: crookedness, sunken areas, irregularities, bossae, concavities, flattening, lack of definition, broadness alar flare, etc.
Alar flaring,Alar rim retraction,Asymmetric nose,Asymmetric tip,Bifid columella,Bifid tip,Broad dorsum,Broad nose,Concave lateral cruras,Congenital nose,Crooked nose,Crooked septum,Crooked tip,Dorsum hump,Dorsum ridges,Droopy tip,Failed osteotomies,Flat dorsum,Irregular dorsum,Large alar cartilages,Large nose,Large nostrils,Large sills,Nasal fibrosis,Nasal valve collapse,Overprojected tip,Pinched middle vault,Pinched nose,Plunging tip deformity,Poorly defined tip,Poorly supported tip,Posttraumatic nose,Rhomboid dorsum,Saddle nose deformity,Short septum,Short upper lateral cartilages,Sunken columella,Sunken supratip,Thick skin nose,Tip bossae,Underprojected tip,Alar base resection alarplasty,Columella strut graft,Dorsum hump resection,Dorsum regularization,Extended columella strut graft,Intercrural columella plasty sutures,Interdomal tip plasty sutures,Lateral cruras cephalic resection,Lateral cruras plasty sutures,Lateral cruras repositioning,Lateral cruras shortening resection,Medial cruras shortening resection,Nasal bones osteotomies,Nostril sill resection,Onlay dorsum graft,Onlay supratip graft,Open approach incision,Rib cartilage graft harvesting,Septocolumella graft,Septum caudal extension graft,Septum replacement graft,Spreader graft,Temporalis fascia graft harvesting,Tip defatting,Transdomal tip plasty sutures,Triangular cartilages caudal extension graft - photo 91
#91Before and after comparison. The lines contour the nasal dorsum, the tip and the lateral cruras to show the correction of the preoperative deformities and lack of support which have turned into perfectly supported and shaped elements.
Alar flaring,Alar rim retraction,Asymmetric nose,Asymmetric tip,Bifid columella,Bifid tip,Broad dorsum,Broad nose,Concave lateral cruras,Congenital nose,Crooked nose,Crooked septum,Crooked tip,Dorsum hump,Dorsum ridges,Droopy tip,Failed osteotomies,Flat dorsum,Irregular dorsum,Large alar cartilages,Large nose,Large nostrils,Large sills,Nasal fibrosis,Nasal valve collapse,Overprojected tip,Pinched middle vault,Pinched nose,Plunging tip deformity,Poorly defined tip,Poorly supported tip,Posttraumatic nose,Rhomboid dorsum,Saddle nose deformity,Short septum,Short upper lateral cartilages,Sunken columella,Sunken supratip,Thick skin nose,Tip bossae,Underprojected tip,Alar base resection alarplasty,Columella strut graft,Dorsum hump resection,Dorsum regularization,Extended columella strut graft,Intercrural columella plasty sutures,Interdomal tip plasty sutures,Lateral cruras cephalic resection,Lateral cruras plasty sutures,Lateral cruras repositioning,Lateral cruras shortening resection,Medial cruras shortening resection,Nasal bones osteotomies,Nostril sill resection,Onlay dorsum graft,Onlay supratip graft,Open approach incision,Rib cartilage graft harvesting,Septocolumella graft,Septum caudal extension graft,Septum replacement graft,Spreader graft,Temporalis fascia graft harvesting,Tip defatting,Transdomal tip plasty sutures,Triangular cartilages caudal extension graft - photo 92
#92After inserting in full the superficial temporalis fascia graft its extension is achieved by means of pulling tight the 5 U form threads, which are fixed to the skin with adhesive to maintain the tension, and suturing to the new nasal skeleton ...Read more
Alar flaring,Alar rim retraction,Asymmetric nose,Asymmetric tip,Bifid columella,Bifid tip,Broad dorsum,Broad nose,Concave lateral cruras,Congenital nose,Crooked nose,Crooked septum,Crooked tip,Dorsum hump,Dorsum ridges,Droopy tip,Failed osteotomies,Flat dorsum,Irregular dorsum,Large alar cartilages,Large nose,Large nostrils,Large sills,Nasal fibrosis,Nasal valve collapse,Overprojected tip,Pinched middle vault,Pinched nose,Plunging tip deformity,Poorly defined tip,Poorly supported tip,Posttraumatic nose,Rhomboid dorsum,Saddle nose deformity,Short septum,Short upper lateral cartilages,Sunken columella,Sunken supratip,Thick skin nose,Tip bossae,Underprojected tip,Alar base resection alarplasty,Columella strut graft,Dorsum hump resection,Dorsum regularization,Extended columella strut graft,Intercrural columella plasty sutures,Interdomal tip plasty sutures,Lateral cruras cephalic resection,Lateral cruras plasty sutures,Lateral cruras repositioning,Lateral cruras shortening resection,Medial cruras shortening resection,Nasal bones osteotomies,Nostril sill resection,Onlay dorsum graft,Onlay supratip graft,Open approach incision,Rib cartilage graft harvesting,Septocolumella graft,Septum caudal extension graft,Septum replacement graft,Spreader graft,Temporalis fascia graft harvesting,Tip defatting,Transdomal tip plasty sutures,Triangular cartilages caudal extension graft - photo 93
#93Before and after comparison. The new dorsum profile level is set lower than the preoperative hump and higher than the preoperative sunken middle vault.
Alar flaring,Alar rim retraction,Asymmetric nose,Asymmetric tip,Bifid columella,Bifid tip,Broad dorsum,Broad nose,Concave lateral cruras,Congenital nose,Crooked nose,Crooked septum,Crooked tip,Dorsum hump,Dorsum ridges,Droopy tip,Failed osteotomies,Flat dorsum,Irregular dorsum,Large alar cartilages,Large nose,Large nostrils,Large sills,Nasal fibrosis,Nasal valve collapse,Overprojected tip,Pinched middle vault,Pinched nose,Plunging tip deformity,Poorly defined tip,Poorly supported tip,Posttraumatic nose,Rhomboid dorsum,Saddle nose deformity,Short septum,Short upper lateral cartilages,Sunken columella,Sunken supratip,Thick skin nose,Tip bossae,Underprojected tip,Alar base resection alarplasty,Columella strut graft,Dorsum hump resection,Dorsum regularization,Extended columella strut graft,Intercrural columella plasty sutures,Interdomal tip plasty sutures,Lateral cruras cephalic resection,Lateral cruras plasty sutures,Lateral cruras repositioning,Lateral cruras shortening resection,Medial cruras shortening resection,Nasal bones osteotomies,Nostril sill resection,Onlay dorsum graft,Onlay supratip graft,Open approach incision,Rib cartilage graft harvesting,Septocolumella graft,Septum caudal extension graft,Septum replacement graft,Spreader graft,Temporalis fascia graft harvesting,Tip defatting,Transdomal tip plasty sutures,Triangular cartilages caudal extension graft - photo 94
#94Before and after comparison. The new dorsum profile level is set lower than the preoperative hump and higher than the preoperative sunken middle vault. The final result sticks with accuracy to the planned one in terms of nasal expansion, lengthening ...Read more
Alar flaring,Alar rim retraction,Asymmetric nose,Asymmetric tip,Bifid columella,Bifid tip,Broad dorsum,Broad nose,Concave lateral cruras,Congenital nose,Crooked nose,Crooked septum,Crooked tip,Dorsum hump,Dorsum ridges,Droopy tip,Failed osteotomies,Flat dorsum,Irregular dorsum,Large alar cartilages,Large nose,Large nostrils,Large sills,Nasal fibrosis,Nasal valve collapse,Overprojected tip,Pinched middle vault,Pinched nose,Plunging tip deformity,Poorly defined tip,Poorly supported tip,Posttraumatic nose,Rhomboid dorsum,Saddle nose deformity,Short septum,Short upper lateral cartilages,Sunken columella,Sunken supratip,Thick skin nose,Tip bossae,Underprojected tip,Alar base resection alarplasty,Columella strut graft,Dorsum hump resection,Dorsum regularization,Extended columella strut graft,Intercrural columella plasty sutures,Interdomal tip plasty sutures,Lateral cruras cephalic resection,Lateral cruras plasty sutures,Lateral cruras repositioning,Lateral cruras shortening resection,Medial cruras shortening resection,Nasal bones osteotomies,Nostril sill resection,Onlay dorsum graft,Onlay supratip graft,Open approach incision,Rib cartilage graft harvesting,Septocolumella graft,Septum caudal extension graft,Septum replacement graft,Spreader graft,Temporalis fascia graft harvesting,Tip defatting,Transdomal tip plasty sutures,Triangular cartilages caudal extension graft - photo 95
#95Before and after comparison. The new dorsum profile level is set lower than the preoperative hump and higher than the preoperative sunken middle vault. The final result sticks with accuracy to the planned one in terms of nasal expansion, lengthening ...Read more

  RATE THIS CASE FOR THE COMMUNITY

How much did you like the case?
How much has been useful to you?
Ranking
Usefulness
Popularity

  TECHNICALITIES

  • AREAS

  • TREATMENTS

    Reconstruction Rhinoplasty
    Revision Rhinoplasty
    Septoplasty
  • DIAGNOSES APPLICABLE

    Alar flaring
    Alar rim retraction
    Asymmetric nose
    Asymmetric tip
    Bifid columella
    Bifid tip
    Broad dorsum
    Broad nose
    Concave lateral cruras
    Congenital nose
    Crooked nose
    Crooked septum
    Crooked tip
    Dorsum hump
    Dorsum ridges
    Droopy tip
    Failed osteotomies
    Flat dorsum
    Irregular dorsum
    Large alar cartilages
    Large nose
    Large nostrils
    Large sills
    Nasal fibrosis
    Nasal valve collapse
    Overprojected tip
    Pinched middle vault
    Pinched nose
    Plunging tip deformity
    Poorly defined tip
    Poorly supported tip
    Posttraumatic nose
    Rhomboid dorsum
    Saddle nose deformity
    Short septum
    Short upper lateral cartilages
    Sunken columella
    Sunken supratip
    Thick skin nose
    Tip bossae
    Underprojected tip
  • TECHNIQUES EMPLOYED

    Alar base resection alarplasty
    Columella strut graft
    Dorsum hump resection
    Dorsum regularization
    Extended columella strut graft
    Intercrural columella plasty sutures
    Interdomal tip plasty sutures
    Lateral cruras cephalic resection
    Lateral cruras plasty sutures
    Lateral cruras repositioning
    Lateral cruras shortening resection
    Medial cruras shortening resection
    Nasal bones osteotomies
    Nostril sill resection
    Onlay dorsum graft
    Onlay supratip graft
    Open approach incision
    Rib cartilage graft harvesting
    Septocolumella graft
    Septum caudal extension graft
    Septum replacement graft
    Spreader graft
    Temporalis fascia graft harvesting
    Tip defatting
    Transdomal tip plasty sutures
    Triangular cartilages caudal extension graft

  DR. ALEJANDRO NOGUEIRA'S SIMILAR CASES PHOTO GALLERY *

  CONTACT US

  DISCLAIMER

  • This information is indicative only and does not represent an obligation with patients or a prediction of forthcoming events, since is based on statistical means for large groups of patients, with the variability that implies, and the biased experience of medical professionals.
  • Medicine and Surgery are not exact sciences, therefore it is not possible to foretell the most likely evolution neither establish the most suitable management for each individual case until the moment the physicians can preoperatively evaluate the patient and receive feedback about the postoperative.
  • One surgical process can't be fully predictable or be rigidly scheduled on a previous protocol, so the management plan may be modified at any time based on the requirements that could be considered as necessary or most suitable.
  • Healing is an imprecise and always unpredictable process due to the uniqueness nature of each patient; even with your physician prioritising post-op patient care excellence and scar minimisation techniques and treatments your evolution and results may be likely different to the information contained on this website, therefore your physician cannot guarantee any specific scenario and outcome commitment regarding your procedures.
  • Remember that all surgery is likely to produce lasting swelling and a lifetime permanent scar, which is likely to partially evolve over approximately 12 to 18 months or longer because this is an issue of unpredictable kind; some patients may be prone to permanent swelling and bad scarring.
  • Information on our website is not a substitute for a personalised, individual consultation that includes a physical examination, history taking, a discussion of the potential risks including potential common complications, pros and cons of various procedural options, and the likely outcome expectations of your surgical procedure. Only an in-person consultation and examination can help your physician to provide you with information about what you, personally, as a unique individual, can expect.
  • Dr. Alejandro Nogueira's opinions, indications, procedures, techniques and methods of diagnosis, treatment and management change frequently as new information is available due to scientific knowledge and state-of-the-art medical practice progress; we aim to keep information updated, but it is possible that some information may have been superseded and is in process of being added to our website, therefore it may not represent Dr. Alejandro Nogueira's most current methods or protocols.
  • All images are genuine, trustworthy and real standard views of the "before" situation and the long term settled "after" actual results of Dr. Alejandro Nogueira’s work, as well as true intraoperative surgical views and authentic technical or clinical scenarios depicting real practice hands-on cases belonging to Dr. Alejandro Nogueira's skills and expertise.
  • No other professional but Dr. Alejandro Nogueira himself as leading and executing surgeon has carried out the techniques, procedures and surgeries shown in the galleries.
  • No images were staged, digitally edited or modified in any way, except for cropping, adjusting and resizing to fit gallery format, removing identifiable elements and blanking with anonymity purposes.
  • The images of results, treatments, techniques and clinical situations are mere guidance examples aiming to help the patients in their decision-making process, providing an average overview of Dr. Alejandro Nogueira's work; no one of them can be considered as an obligation of any particular results nor a commitment for the application of any specific techniques, therefore you should not base your results expectations on them.
  • Every patient has to be assessed individually in order to establish a customized prognosis of results and design an individual surgical plan, being somehow unpredictable the real final outcome of any procedure as well the surgical gestures applied during the intervention, since they will depend on multiple particular, frequently unpredictable and sometimes uncontrollable factors.
  • Even when you feel that you look very similar to another patient in their images, your results will likely vary significantly, because you are a unique person and every individual has not only a completely unique physique, but also uniquely individualistic body healing capacities, scarring tendencies and recovery processes, some of which are unpredictable even in very-healthy patients who rest adequately and do all the other right and prescribed things before and after their procedure.
  • Previous successful results of a physician do not guarantee future successful procedures and patient's satisfaction.
  • The images may display content that is graphic in nature showing explicit surgery, clinical events and that may depict partial or total nudity; if you find such material offensive or you are sensitive to it you should not use this feature and should exercise caution before accessing other explicit features of the website.
  • The images are appropriate for a mature-only audience; if you are under the age of 18 you should not view the content of this website.
  • All the prices and quotations visible on our website belong to or are calculated out of the reduced price list and do already enjoy by default a -20% discount from the standard price list for our treatments as compensating remuneration for the release and transfer of the intellectual property, the rights of image, the medical records and the personal data of our patients for scientific dissemination, medical teaching, public communication, commercial promotion, advertising marketing, commercial exploitation and disclosure in general, unless they express the opposite at their surgery day booking by opting for the standard prices. External Link READ MORE ABOUT BENEFITS OF THE COLLABORATIVE MODEL
  • Our prices are quotations valid for the majority of cases operated on; notwithstanding a few cases are non standard, atypical, requiring exceptional resources and, therefore, needing customized quote calculation; do seek the advice of our Medical and Sales Teams to find out whether your case lies within the standard protocol of management, which actually is the most likely scenario.
  • Standard quotations do cover the planned protocol of management, including preoperative consultation with the surgeon, preanesthesia examination, basic preoperative tests, surgeon, anesthetist and assistant fees, planned operating room, rental time, regular intraoperative surgical supplies (materials, drugs, etc.), agreed implants (breast, etc.), one recommended postoperative garment (brassiere, corset, etc.), 1 hour recovery unit stay, individual ward room, regular hospital supplies (materials, drugs, etc.) and postoperative office-based care.
  • Not included in standard quotations are, among others, non basic preoperative tests, pre and postoperative consultant referrals for assessment, additional garments, non hospital supplies (materials, drugs, etc.), postoperative tests and any kind of postoperative re-interventions, postoperative medical or surgical emergencies and costs exceeding the planned protocol of management like unplanned, unforeseeable and unavoidable extended surgical time rental of the operating room, extended hospital stay in standard ward or Intensive Care Unit (ICU) room and all the associated costs with any hospital-based assistance of complications, medicalized repatriation, hostelry accommodation, maintenance and travel costs; we do not take account of any costs not within the scheduled treatment pre and postoperative planned and agreed management.
  • We do not offer trip packages; the patient is bound to organize and pay for any trip, accommodation, food, transport, etc.
  • Prices do include the V.A.T.
  • Prices do not include any kind of travel or revision insurance; do read about the Surgery Shield for revision surgery here should you wish to be covered in such a case.
  • Treatments are payable in Euros only; we do not accept other currencies as payment of the treatments.
  • Any currency conversion is non accurate and has indicative purposes only.
  • Combo Specials discounts are percentages of reduction applied on the retail price of the standard quotations for the treatments of the price list; these discounts are not applicable on non standard cases, customized quotations and charges not included in the standard quotations.
  • The treatments Breast implants custom XL or Breast reconstruction autologous and the Surgery Shield for any body area treament is expressly excluded from any price reduction, discount and promotion, among them the Combo Specials.
  • Combo Specials are applied and calculated for each purchase of treatments to be performed simultaneously; Combo Specials are not allowed on treatments to be performed in different anesthetic procedures or different surgical episodes; any given purchase of treatments to be performed simultaneously may include more than one Combo Special.
  • One given treatment cannot be affected by more than one discount, be it Combo Specials or other discounts; in the event of a conflict due to the coincidence of more than one Combo Specials discount affecting a given treatment, the discount that produces the greatest gross discount in favor of the patient calculated at the given treatment in conflict level will be applied.
  • The marbellia's General Combo Special only applies to treatments other than those affected by treatment-specific Combo Specials at any given purchase of treatments to be performed simultaneously; for the calculation of the marbellia's General Combo Special all the treatments affected by treatment-specific Combo Specials are considered a single treatment.
  • Any urgent matter of medical or commercial kind must be addressed through our Telephone Assistance which is operative 24/7/365 to contact with the Medical Team or through our Telephone Support which is available in office hours to contact with the Sales Team.
  • Priority but non urgent medical or commercial assistance is available by selecting priority option in the corresponding Online Consultation or Customer Support form.
  • Non urgent and non priority medical consultations may be carried out using the regular Online Consultation or Customer Support form without priority selection.
  • To apply for a face-to-face medical meeting use the In Person Consultation form.
  • If you wish to apply for treatment dates use the Surgery Day Booking form.