Procedure: Rhinoplasty

Surgeon: Dr. Batniji

Location: Newport Beach, South Of Santa Ana Ca

Procedure Detail: This 16 year old male presented to Dr. Batniji in consultation for evaluation of severe nasal deformity and near-total nasal obstruction.  Dr. Batniji noted a severe septal deviation resulting in a crooked appearance to the nose on frontal view; indeed, the nasal tip falls off to the right side.  As well, the patient, who is of Hispanic ethnicity, wanted a result that would be appropriate for his ethnicity and complement his facial features.  Dr. Batniji performed the following:

• Septoplasty via an external approach; Dr. Batniji chose an external approach to the septum because the caudal septum was severely deviated.  During the septoplasty, Dr. Batniji harvested septal cartilage for future use in the rhinoplasty.
• Rhinoplasty via an external approach.
• Dorsal hump reduction (profileplasty) with a rasp for subtle refinement of the bony nasal dorsum.  Cartilaginous dorsal hump was removed conservatively.  The upper lateral cartilages were preserved to further maintain the integrity of the middle nasal vault and internal nasal valve.
• Caudal extension graft to reconstruct the severely deviated native caudal septum and provide nasal tip support as well as rotation and projection.
• The internal nasal valves were reconstructed to not only maintain the nasal airway, but also to improve upon its function.  Bilateral spreader grafts were fashioned from previously harvested septal cartilage to reconstruct the internal nasal valves.
• Lateral osteotomy of the left nasal bone to provide a more symmetric nasal bony pyramid.
• Interdomal and transdomal sutures were placed to refine the nasal tip shape.  An infratip lobule graft and horizontally-oriented tip graft were placed to further refine the nasal tip.  Crushed cartilage was placed along the tip grafts to provide camouflaging of the tip grafts.