Download PDF
Facial Plast Surg 2012; 28(04): 380-389
DOI: 10.1055/s-0032-1319842
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Common Technical Causes of the Failed Rhinoplasty

Richard E. Davis
1   Director, The Center for Facial Restoration, Miramar, Florida
2   Clinical Professor, Division of Facial Plastic Surgery, Department of Otolaryngology, The University of Miami, Miller School of Medicine, Miami, Florida
,
Michael Bublik
3   Instructor, Division of Facial Plastic and Reconstructive Surgery, The Miller School of Medicine, University of Miami, Miami, Florida
› Author Affiliations
Further Information

Publication History

Publication Date:
07 August 2012 (online)

    Permissions and Reprints

Abstract

The adverse rhinoplasty outcome may result from a wide variety of dissimilar causes. Although these causes include psychiatric patient disturbances and severely aberrant wound-healing responses, by far the most common etiology of the failed rhinoplasty is technical failure on behalf of the surgeon. Moreover, a disproportionate number of technical shortcomings stem from errors in basic rhinoplasty technique. Hence, mastery of rhinoplasty fundamentals will prevent a large number of novice errors that often taint the cosmetic outcome. Because many of the remaining technical errors stem from overaggressive tissue removal, tissue-sparing rhinoplasty techniques will also prevent many common causes of technical failure. This article identifies some of the more common technical errors associated with the unsuccessful cosmetic rhinoplasty and also provides insights as to their avoidance.

Keywords

open roof deformity - cephalic trim technique - inverted-V deformity - overresection
 

  • References

  • 1 Davis RE. Rhinoplasty and concepts of facial beauty. Facial Plast Surg 2006; 22: 198-203
    Article in Thieme ConnectPubMedGoogle Scholar
  • 2 Davis RE. Septoplasty and rhinoplasty. In: Snow J, Wackym A, eds. Ballenger's Otorhinolaryngology Head and Neck Surgery, 17th edition. Shelton, CT: BC Decker, Inc.—People's Medical Publishing House; 2009: 633-659
    Google Scholar
  • 3 Mehta U, Mazhar K, Frankel AS. Accuracy of preoperative computer imaging in rhinoplasty. Arch Facial Plast Surg 2010; 12: 394-398
    CrossrefPubMedGoogle Scholar
  • 4 Adelson RT, DeFatta RJ, Bassischis BA. Objective assessment of the accuracy of computer-simulated imaging in rhinoplasty. Am J Otolaryngol 2008; 29: 151-155
    CrossrefPubMedGoogle Scholar
  • 5 Davis RE, Raval J. Powered instrumentation for nasal bone reduction: advantages and indications. Arch Facial Plast Surg 2003; 5: 384-391
    CrossrefPubMedGoogle Scholar
  • 6 Holt GR, Garner ET, McLarey D. Postoperative sequelae and complications of rhinoplasty. Otolaryngol Clin North Am 1987; 20: 853-876
    PubMedGoogle Scholar
  • 7 Hanasono MM, Kridel RW, Pastorek NJ, Glasgold MJ, Koch RJ. Correction of the soft tissue pollybeak using triamcinolone injection. Arch Facial Plast Surg 2002; 4: 26-30 ; discussion 31
    CrossrefPubMedGoogle Scholar
  • 8 Daniel RK. Diced cartilage grafts in rhinoplasty surgery: current techniques and applications. Plast Reconstr Surg 2008; 122: 1883-1891
    CrossrefPubMedGoogle Scholar
  • 9 Daniel RK, Calvert JW. Diced cartilage grafts in rhinoplasty surgery. Plast Reconstr Surg 2004; 113: 2156-2171
    CrossrefPubMedGoogle Scholar
  • 10 Gillman GS, Simons RL, Lee DJ. Nasal tip bossae in rhinoplasty. Etiology, predisposing factors, and management techniques. [published correction appears in Arch Facial Plast Surg 1999; 1:170] Arch Facial Plast Surg 1999; 1: 83-89
    CrossrefPubMedGoogle Scholar
  • 11 Yu K, Kim A, Pearlman SJ. Functional and aesthetic concerns of patients seeking revision rhinoplasty. Arch Facial Plast Surg 2010; 12: 291-297
    CrossrefPubMedGoogle Scholar
  • 12 Gubisch W, Eichhorn-Sens J. Overresection of the lower lateral cartilages: a common conceptual mistake with functional and aesthetic consequences. Aesthetic Plast Surg 2009; 33: 6-13
    CrossrefPubMedGoogle Scholar
  • 13 Adams Jr WP, Rohrich RJ, Hollier LH, Minoli J, Thornton LK, Gyimesi I. Anatomic basis and clinical implications for nasal tip support in open versus closed rhinoplasty. Plast Reconstr Surg 1999; 103: 255-261 ; discussion 262–264
    CrossrefPubMedGoogle Scholar
  • 14 Parkes ML, Kanodia R, Machida BK. Revision rhinoplasty. An analysis of aesthetic deformities. Arch Otolaryngol Head Neck Surg 1992; 118: 695-701
    CrossrefPubMedGoogle Scholar
  • 15 Adamson PA, Morrow TA. The nasal hinge. Otolaryngol Head Neck Surg 1994; 111 (3 Pt 1) 219-231
    CrossrefPubMedGoogle Scholar
  • 16 Constantinides M, Liu ES, Miller PJ, Adamson PA. Vertical lobule division in rhinoplasty: maintaining an intact strip. Arch Facial Plast Surg 2001; 3: 258-263
    CrossrefPubMedGoogle Scholar
  • 17 Davis RE. Diagnosis and surgical management of the caudal excess nasal deformity. Arch Facial Plast Surg 2005; 7: 124-134
    CrossrefPubMedGoogle Scholar
  • 18 Kridel RW, Scott BA, Foda HM. The tongue-in-groove technique in septorhinoplasty. A 10-year experience. Arch Facial Plast Surg 1999; 1: 246-256 ; discussion 257–258
    CrossrefPubMedGoogle Scholar
  • 19 Toriumi DM. Caudal septal extension graft for correction of the retracted columella. Oper Tech Otolaryngol–Head Neck Surg 1995; 6: 311-318
    PubMedGoogle Scholar
  • 20 Byrd HS, Andochick S, Copit S, Walton KG. Septal extension grafts: a method of controlling tip projection shape. Plast Reconstr Surg 1997; 100: 999-1010
    CrossrefPubMedGoogle Scholar
  • 21 Toriumi DM. New concepts in nasal tip contouring. Arch Facial Plast Surg 2006; 8: 156-185
    CrossrefPubMedGoogle Scholar
  • 22 Guyuron B, Varghai A. Lengthening the nose with a tongue-and-groove technique. Plast Reconstr Surg 2003; 111: 1533-1539 ; discussion 1540–1541
    CrossrefPubMedGoogle Scholar
  • 23 Naficy S, Baker SR. Lengthening the short nose. Arch Otolaryngol Head Neck Surg 1998; 124: 809-813
    CrossrefPubMedGoogle Scholar
  • 24 Sheen JH, Sheen AP. Adjunctive techniques—alar resection. In: Sheen J, Sheen A, eds. Aesthetic Rhinoplasty, 2nd ed. St. Louis, MO: CV Mosby; 1987: 252-282
    Google Scholar
  • 25 Gilbert SE. Alar reductions in rhinoplasty. Arch Otolaryngol Head Neck Surg 1996; 122: 781-784
    CrossrefPubMedGoogle Scholar
  • 26 Kridel RW, Castellano RD. A simplified approach to alar base reduction: a review of 124 patients over 20 years. Arch Facial Plast Surg 2005; 7: 81-93
    CrossrefPubMedGoogle Scholar