Eastern Indian male complaining of nasal obstruction and an external nasal deformity following rhinoplasty performed twice.

PROCEDURE: Tertiary revision rhinoplasty with rib harvest, osteotomies, radix graft, Repair of nasal vestibular stenosis with reconstruction of tip support with placement of columellar strut , Repair of nasal vestibular stenosis with reconstruction of left internal valve collapse with placement of left double spreader grafts, Left and right deep temporalis fascia harvest, Repair of nasal vestibular stenosis with reconstruction of retracted subnasale and nasal tip ptosis with placement of a septal extension graft, Septal perforation repair, Revision septoplasty, Submucous resection and partial resection of right and left inferior turbinates and platelet gel application.

FINDINGS: Native LLC (lower lateral cartilage) 8 mm; right wide dome, 3+ narrow left middle vault; septum deviated caudally to left; large 3 cm horizontal perforation; dorsal irregularities (hump); deep radix; retraced nasolabial angle.

COMMENTS: The 5 month post-op photos reveal a healing, improved nose. The swelling will take approximately 1 year to resolve.