PREOPERATIVE DIAGNOSIS:

1. Nasal obstruction secondary to deviated septum, hypertrophic turbinates, and external/internal valve collapse, s/p rhinoplasty.

PROCEDURE:

1. Revision septal reconstruction for correction of deviated nasal septum and harvest of septal graft
2. Repair of nasal vestibular stenosis with reconstruction of external valve collapse with placement of bilateral alar rim grafts.
3. Repair of nasal vestibular stenosis with reconstruction of internal valv e collapse with placement of bilateral spreader grafts.
4. Graft, right ear cartilage.
5. Bilateral Turbinoplasty
6. Repair of nasal vestibular stenosis with reconstruction of external valve collapse with placement of bilateral alar batten grafts.

FINDINGS: Over-resected lateral crura bilaterally left greater than right (intermediate, dome and medial crural present), narrow middle vault, collapsed left greater than right external valve coll apse, polly beak primarily of scar and some cartilage, retracted rims left greater than right and inverted V deformity.

COMMENT: This patient was having trouble breathing, and desired an improvement in her nasal appearance. 3 month post-operative photos reveal an improved nose. Nose is still swollen, will continue to improve.