Q: Dr. Eppley, I am interested in a revision rhinoplasty. My ENT performed a septoplasty in March of this year. He added cartilage from my septum to make my nose shorter and wider for breathing purposes. While my breathing has never been better, my appearance has changed, and I’m not a big fan of how my nose looks now. I would love to see if this is something that could be corrected.
A: By your description, you likely had spreader grafts placed in the middle vault and perhaps even alar batten grafts. These do successfully open up the internal valves and improve nasal breathing but can make the nose in some patients potentially wider.
The question is now how make your nose look better without recreating your breathing issues. This is most likely an augmentation approach for your revision rhinoplasty but I would need to see some pictures of your nose now to see what potentially could be done if anything. Given your improvement in breathing I would not recommend removing your spreading or batten grafts. Rather I would look at building up the bridge and tip of the nose somewhat to overcome the shorter and wider nose.
Dr. Barry Eppley