Q: Eight years ago I had a rhinoplasty that was overdone resulting in a more feminine look than I was looking for. Specifically the bridge is curved rather than straight and the bridge is lower on my face than I would like. The surgeon tried twice unsuccessfully to correct it. I’m not sure if correcting my nose could be done by straightening the cartilage and moving up the bridge bone or if it would require an implant of some kind. Can this be determined from an online consultation? Also if I do decide to go with an online consultation rather than an in person consultation will it be possible to conduct an image prediction of the results?
A: It appears that you have had an over-resected rhinoplasty with resultant dorsal line collapse, otherwise known as a saddle nose deformity. Rather than a straight dorsal line, yours is now curved inward. Correction of the saddle nose always require augmentation. This can be done by a variety of materials from synthetic implants to using your own cartilage. There are advocates for either approach. For a small saddle nose problem, using an allogeneic dermal graft (such as Dermacell) will work just fine. If it is a bigger saddle nose, then a cartilage graft is better. This often requires a rib graft for the donor site. I am not a fan of synthetic materials in the nose as they often come back to haunt one as future complications.
There is no such thing as computer imaging in a live online video consultation on Skype. But you send me some pictures of your face beforehand, computer imaging can be done and sent to you in preparation for an online consultation.
Dr. Barry Eppley