Rhinoplasty

Photos

Procedure: Rhinoplasty

Surgeon: Dr. Batniji

Location: Newport Beach, South Of Santa Ana Ca

Procedure Detail: This 37 year old female presented with an interest in improving the shape of the nose. Specifically, she desired removal of a dorsal hump (bump on the top of the nose) and correction of a droopy tip. Dr. Batniji performed the following:

Septoplasty to straighten the nasal septum, thus improving her ability to breathe through the nose.
Rhinoplasty via an external approach.
Bilateral auto-spreader grafts to maintain the integrity of the middle nasal vault and internal nasal valve.
Dorsal hump reduction (profileplasty) with osteotome to address the bony dorsal hump; a rasp was then used 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 increase tip projection, tip rotation, and tip support.
Tip suture technique to provide subtle refinement to the nasal tip.

Procedure: Rhinoplasty

Surgeon: Dr. Batniji

Location: Orange County California

Procedure Detail: This 62 year old female presented with an interest in changing the shape of her nose.  Specifically, she desired removal of a dorsal hump (bump on the top of the nose) and more definition of the nasal tip.  During the consultation and review of her photographs, Dr. Batniji noted a prominence at the right aspect of the nose above the tip, a depression on the opposite side, a very weak nasal tip and a prominent dorsal hump  The patient wished to achieve the aforementioned goals while maintaining her ethnicity.  Dr. Batniji performed the following:

Septoplasty to straighten the nasal septum, thus improving her ability to breathe through the nose.
Rhinoplasty via an external approach.
Bilateral spreader grafts to maintain the integrity of the middle nasal vault on both sides and, thus, preserve both internal nasal valves.
Dorsal hump reduction (profileplasty) with osteotome to address the bony dorsal hump; a rasp was then used 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 slightly increase projection of the nasal tip, maintain tip rotation, and provide tip support.
Suturing techniques to improve definition of the tip cartilages (lower lateral cartilages).
Tip graft with septal cartilage to provide subtle refinement to the nasal tip; Dr. Batniji utilized morselized cartilage as the tip graft to soften the appearance and provide a natural result.
Bilateral lateral crural grafts to strengthen the alar sidewalls and provide natural contours to the nasal tip.

Procedure: Rhinoplasty

Surgeon: Dr. Batniji

Location: Newport Beach, Ca

Procedure Detail: This 23 year old female presented in consultation with an interest in changing the shape of her nose. Specifically, she desired a straighter nose and refinement of a bump on the top of the nose. Dr Batniji performed the following:

Septo-rhinoplasty via an endonasal (closed) approach to straighten the appearance of the nose, correct a deviated septum, and perform profileplasty to reduce the dorsal hump. The dorsal hump was due to both cartilage and bone. The bony hump was removed with rasping technique and the cartilaginous hump was removed via the endonasal (closed) technique while maintaining the integrity of the internal nasal valve on both sides.

Procedure: Rhinoplasty

Surgeon: Dr. Batniji

Location: Newport Beach, Ca

Procedure Detail: This 32 year old male presented for revision rhinoplasty. Following his original surgery by another surgeon, the patient was concerned with the appearance of the nose. Specifically, he wished to address the upturned nasal tip (over-rotation), fullness of the area above the nasal tip on profile (supratip fullness; also known as a “pollybeak deformity”), a scooped-out appearance of the profile (saddle nose deformity), and excessive nostril show. As well, the patient reported nasal obstruction. During consultation, Dr. Batniji recommended a revision rhinoplasty and performed the following:

Revision rhinoplasty via an external (open) approach.
Bilateral spreader grafts to address bilateral internal nasal valve collapse. During the initial rhinoplasty, a dorsal hump was removed and the nasal bones were then mobilized with osteotomies to provide refinement of the bony pyramid. However, one potential result of such a maneuver is narrowing of the internal nasal valve, resulting in excessive narrowing of the middle part of the nose (inverted “V” deformity) and nasal obstruction. Therefore, Dr. Batniji usually reinforces the middle part of the nose with spreader grafts to prevent this from happening at the time of primary rhinoplasty surgeries that he performs. In this patient’s case, he had primary rhinoplasty by another surgeon and the middle part of the nose was not reinforced. As such, Dr. Batniji performed bilateral spreader grafts in this case to improve both the appearance and function of the nose.
Dorsal augmentation to address the scooped-out appearance of the profile. Dr. Batniji uses cartilage from the patient to perform this augmentation. While he prefers to use cartilage obtained from the septum for this augmentation, in revision cases such as this one, previous septoplasty may result in a lack of septal cartilage available for grafting. Therefore, Dr. Batniji may use cartilage from the patient’s ear to augment the dorsum and/or tip of the nose as well as use that cartilage for grafting specific areas of the nose. Dr. Batniji obtains the ear cartilage from a small incision behind the ear; removal of ear cartilage does not change the appearance of the ear. Ear cartilage was used to graft the nasal dorsum in this case.
Sculpting of the supratip region to address the supratip fullness (“pollybeak deformity”).
Nasal tip refinement with suture techniques and augmentation with cartilage grafting; these maneuvers enabled Dr. Batniji to correct the upturned appearance of the nose and correct the excessive nostril appearance.