Procedure: Secondary Septorhinoplasty with ear (conchal) cartilage and deep temporalis fascia harvest, Harvest of bilateral composite grafts from ears and platelet gel application.

Other procedures: Chin Implant

FINDINGS: Concave 6 mm lower lateral crura (LLC) with intermediate and medial crura present on right and thin partial strip on left, Scar tissue with tedious dissection between nasal tip skin and skin; over-rotated infralobular tip with over-resected caudal septum; domal onlay graft identified, removed and reused later, bilateral composite grafts (right = 6 mm, left = 3 mm); Ear cartilage used for infralobular/domal onlay grafts. Complete alar and rim collapse with right greater than left. Right alar retraction more than left. Narrow middle vault. Left spur on floor and mid bony septum with caudal deviation to right.   

A septal extension graft, bilateral composite grafts, lateral crural strut grafts, spreader grafts, columellar strut and infratip lobular graft were placed.

Comment: The close-up photos of the ear demonstrate a normal appearing ear following ear cartilage and composite graft harvest. The close-up base view of the nose reveals healed composite grafts which help lower the retracted nostrils.

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