#S09 Secondary Rhinoplasty: Asymmetrical Alar Base
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By Jack H. Sheen, M.D. Dr. Sheen discusses the rationale for this surgical procedure, basing the selection on years of personal experience in the specialty. This CD demonstrates secondary rhinoplasty on a nose that illustrates nasal imbalance and an asymmetric base. This case is especially interesting inasmuch as intraoperatively there is a radical change from the preoperative surgical plan. Resection of portions of the medial crura exposed a rather striking difference in nostril size, which was handled by changing the type of resection on the right nostril. The patient requested a softly rounded tip, which was the goal with specially formed cartilage grafts to the tip. The Following Techniques are Demonstrated: Resection of the medial crura for improved nostril symmetry Reduction of the dorsal height Widening of the middle third of the nose (no osteotomy) Septoplasty Lobule-only resection on the right nostril, lobular-vestibular resection on the left nostril Tip graft to achieve a softly rounded tip About the Author: Jack H. Sheen, M.D., Clinical Professor of Surgery, Department of Surgery, Section of Plastic and Reconstructive Surgery, University of Southern California; Associate Clinical Professor, Department of Surgery, Division of Plastic Surgery, UCLA School of Medicine, Los Angeles, California 1990. 60 minutes