When reductive rhinoplasty goes wrong & how to make it right.

Abstract

To be addedAims and Backgrounds Over-resection leads to many complications in rhinoplasty. Here, we detail the most common of these pitfalls, and strategies to both avoid and repair them. Anatomy The nose is frequently divided into thirds. The nasal bones represent the upper third. The middle third is composed of the dorsal septum and upper lateral cartilages. The lower third is comprised of the lower lateral cartilages and tip-supporting structures. Techniques The commonly seen sequelae of over-resection include a deep radix, saddle nose deformity, inverted-V deformity, pollybeak deformity, alar retraction, a pinched nasal tip, bossae, deep alar grooves and external nasal valve collapse. The major mechanism to avoid these issues is avoidance, however several grafting techniques are described here to correct overly aggressive reduction. Conclusions and Clinical Relevance It is critical to avoid the complications as described in this manuscript. Just as important, it is necessary to know how to correct these deformities when patients present for revision rhinoplasty.