Skip to main content

Nose

Revision Rhinoplasty Before and After

Written by on . No Comments on Revision Rhinoplasty Before and After

The patient presented with complaints of an inability to breathe after a reduction rhinoplasty many years ago. She underwent a revision rhinoplasty to improve her breathing.

She had complete blockage of her nasal breathing from prior surgeries that left her nose weak and collapsed. In the past, rhinoplasty was performed by removing and weakening nasal cartilages and bones that was designed to give an aesthetically pleasing result, but over time would cause collapse and nasal obstruction. The patient presented here was overall pleased with her external nasal appearance but could not breathe. This is a challenging case as the internal structure of the nose needs to be reconstructed without drastically altering the external appearance, especially in a young female patient. .

In order to make the nose stronger and open up the breathing passages, grafts need to be placed. Typically in primary rhinoplasty septal cartilage is used. However, this patient was missing the majority of her septum. Instead, through a 1.2 cm minimally invasive incision, the patient’s own rib cartilage was used to reconstruct the vital structures of the nose. I employ a very special technique that is low risk, and adds nothing to the recovery post operarively.

The patient subsequently underwent major nasal reconstruction with an enhanced look to an already aesthetically pleasing nose, and breathing better in the process.

Female Ethnic Revision Rhinoplasty Before and After

Written by on . No Comments on Female Ethnic Revision Rhinoplasty Before and After

Thrilled to share before and after results of my patient after a revision rhinoplasty. The patient is a very pleasant 39 year old woman that came to me complaining of a long standing infection for a year. She had a rhinoplasty 17 years ago, in which the original surgeon placed a synthetic implant. This became infected about 1 year ago!

In her preoperative photos, you can see that she has swelling, redness, and drainage from her nasal bridge. She also has what we call “saddling” of her nose. This refers to collapse of the nasal bridge. The goals of treatment were to eliminate the infection, correct the nasal deformity, and maintain the integrity of her breathing. She underwent a rhinoplasty with me with rib reconstruction through a minimally invasive 1.2 cm incision.

It is important for patients to recognize that placing foreign and synthetic implants in the nose carries a serious risk of infection, not only at the time of surgery, but many years later. This patient developed an infection after 17 years! In my practice I see infections that arise on average 11 years after the original surgery! These are extremely complicated problems as antibiotics typically cannot resolve the infection, and the implant usually is a major supportive structure. This patient was on antibiotics for almost a year, that failed to clear the infection. She sought treatment from multiple surgeons who recommended removing the infected implant and allowing her to heal for 1 more year followed by a second surgery for definitive reconstruction. Looking at the intraoperative photos after implant removal you can appreciate the gravity of this approach. She would essentially have no nose for a whole year! I offered her implant removal with reconstruction during the same surgery.

Many times, patient’s are worried that implant removal will alter the shape of their nose. This patient was particularly worried because she liked her overall nasal appearance (minus the infection!). Fortunately, using the rib made her nose look even better, and I am pleased to say that she extremely satisfied with her results. Feel very fortunate and blessed to be trusted with a patient’s face.

Male Deviated Septum / Rhinoplasty Before and After

Written by on . No Comments on Male Deviated Septum / Rhinoplasty Before and After

Very pleased to post before and after photos of my patient who had a rhinoplasty. The patient is a pleasant and wonderful 40 year old Male that came to me looking to fix the appearance of his nose.

The photos on the left show the before, where he had a droopy tip, dorsal hump and bony deviation to his left. Important considerations are to address all these areas without compromising the patient’s masculinity and keeping his nose in harmony with the remainder of his other facial features. He underwent rib reconstruction through a minimally invasive 1.2 cm incision, due to an absence of septal cartilage.

He is currently 3 weeks out and still has mild swelling but still looks great! He should continue to heal well and look good!

Closed Rhinoplasty

Written by on . No Comments on Closed Rhinoplasty

Intra op photo of a closed rhinoplasty. This rhinoplasty techniques uses no visible incisions, minimizes post operative pain and swelling, and reduces recovery time- so you can get back to life sooner and breathing better!

Male Ethnic Rhinoplasty Before and After

Written by on . No Comments on Male Ethnic Rhinoplasty Before and After

Do you ever feel like your nose is weak and collapsing? Like you have an inability to pass air? The nasal cartilages and bones can weaken over time, collapsing, causing feelings of congestion and inability to breathe. Sometimes the collapse is so severe it is present at baseline. This can be detrimental to your overall health and well being.

The patient pictured here couldn’t breathe because of collapse of his right nostril. Through an ethnic rhinoplasty this patient’s crooked nose and breathing could be fixed without any external incisions, minimizing pain and post operative swelling.

Teenage Rhinoplasty Before and After

Written by on . No Comments on Teenage Rhinoplasty Before and After

The patient is a 16-year-old female patient presented to Dr. Mourad for concerns with nasal breathing obstruction. She also complained of the appearance of her nose. The photo on the left demonstrates her preoperative view. She stated she did not like that her “tip was so big”, in addition to complaining of her tip “drooping.” The evaluation revealed the patient to have a bulbous tip. Dr. Mourad met with the girl and her family many times to help understand her complaints and understand her and her families expectations. After careful discussions with the family, she decided to undergo a closed rhinoplasty. This minimally invasive rhinoplasty, allowed for the patient to undergo the necessary modifications that maximized her outcome without compromising her future development. The photo on the right demonstrates a more refined and narrower tip, that is straight, without the “bulbous appearance” seen in the left photo. Her tip is also at a higher position, more elevated, and less droopy then seen in the preoperative photo. Her breathing is also improved after Dr. Mourad corrected her nasal airway obstruction internally.

Revision Rhinoplasty Before and After

Written by on . No Comments on Revision Rhinoplasty Before and After

This is a 41-year-old female who presented 1 year after rhinoplasty with complaints of 100% nasal blockage and unnaturally appearing nose.

Left Photographs: This photo shows her at presentation to Dr. Mourad’s office 1 year after her initial surgery. The black arrows show that she had an excessive amount of her nose removed externally, causing significant scarring and contracture. This scarring narrowed her nostrils and contributed to her inability to breathe. The blue arrows show that her nose has incomplete breaks in her nasal bones causing nasal valve collapse, further making her breathing worse. In the lower picture, the purple curved arrow also shows that she has a “droopy” tip that hangs low. The deformity is also from excessive resection of the internal structures of the nose. The blue star in the photo on the profile view also shows that the previous surgeon had left a bony hump, that also was made to appear worse by the droopy tip.

Right Photographs: This is a patient 1 year after surgery once the final healing has settled in. The purpose of the surgery was to restore her ability to breathe. The patient underwent a complete nasal reconstruction using her own rib. The orange arrow shows that her nasal tip was restored to a more natural, “higher”, position, no longer with a deforming “droopy” look. Her nasal tip has smoother contour. Her ability to breathe has been completely restored with improvement in her nasal valve structures.

Repaired Septal Perforation Before and After

Written by on . No Comments on Repaired Septal Perforation Before and After

This case demonstrates a 57-year-old woman that presented to Dr. Mourad after septal perforation secondary to a nasal surgery with a different surgeon many years before. Her complaints were nasal crusting, frequent infections, and bleeding. She attempted to use humidifying measures including ointments, humidified air, and nasal saline, which did not resolve her symptoms. The perforation is larger. The photo on the left demonstrates the 1.5 cm perforation as seen through the left nostril. Her repair required the use of a regional flap, using a right-sided Pedicled Inferior Turbinate Flap. The photo on the right demonstrates the immediate repair of the perforation intraoperatively.

Septal Perforation Repair Before and After

Written by on . No Comments on Septal Perforation Repair Before and After

The above case demonstrates a 45-year-old woman that came to see Dr. Mourad who developed a hole in her septum secondary to cocaine use. The photo on the left is a photo into the left nostril that demonstrates the 1.2 cm perforation which is located in the front portion of the septum. Her symptoms included noisy breathing, frequent nasal crusting, and bleeding. She also suffered from frequent sinus infections. The picture on the right demonstrates an intraoperative view of the repaired perforation, immediately after the repair. This perforation was repaired using a left-sided local flap (link to local flap). The technique used was an Anterior Ethmoid Artery Pedicled Flap. This technique uses rearrangement of tissue within the nasal cavity to close the hole in the septum. She has mild swelling in the area that will resolve with time.