Extracorporeal rhinoseptoplasty in severely deviated septum: before and after at six years
Case fact sheet
- Patient: Female, 40 years old
- Reason: a very marked deviation of the nose
- Starting nose: septum frankly deviated; in profile there was almost no need to reduce the hump and the tip and the columella only needed some rotation and projection
- Technique: Extracorporeal septoplasty within a structural rhinoplasty with ultrasonic instrumentation: the septum was removed whole, reconstructed on the operating table by assembling a new "L" that includes spacer grafts (spreader grafts) and everything was placed back inside the nose; minor adjustment of the dorsum and rotation and projection of the tip and columella
- Septum and turbinates: septum reconstructed outside the nose and turbinates in the same surgery
- Approach: Correct the internal axis of the nose without further altering a profile that was already suitable.
- Result: six years after the operation
- Entry: 1 night
- Anesthesia: general type TIVA
- Duration: 3 hours long.
A very marked deviation of the septum in a nose whose profile was, in general, adequate. Extracorporeal septoplasty within a structural rhinoplasty: the septum was reconstructed outside the nose using the patient's own cartilage, with follow-up at six years.
Photos taken six years after the operation
The "after" photos are from his February 2020 check-up, six years after the operation: the longest follow-up in this record. From the front, the nose's axis is centered; from the side, the bridge is almost the same as before, with the tip slightly more rotated and projected, which was what the case called for.
Her testimony six years after rhinoplasty
She recorded it at the clinic on the day of her check-up in February 2020: she herself explains why she decided to do it and how it has gone for her.
Comment by Dr. Gustavo Sordo
Reason for consultation
He consulted about a very marked deviation of the nose, the predominant feature of his case above any other aesthetic consideration.
What I observed when evaluating it
It's an interesting case because, if you analyze the profile, there was practically no need to reduce the hump: the dorsum only required minimal reduction, and the tip and columella, some rotation and projection. The truly relevant factor was that the septum was significantly deviated.
What was important to preserve
The profile, which was generally adequate. There was no point in altering the bridge excessively: the real challenge lay in the internal axis of the nose, not its external silhouette.
My surgical approach
To correct a deviation of this magnitude, I proposed an extracorporeal septoplasty within an ultrasonic rhinoplasty : an exceptional measure that is reserved for very severe deviations of the septum.
Why I chose this technique
When the deviation of the septum is so significant that it cannot be corrected by leaving the cartilage in place, extracorporeal septoplasty allows the internal support of the nose to be rebuilt from scratch, instead of trying to straighten a septum that is no longer the correct shape.
What I did during surgery
I removed the entire septum, reconstructed it on the operating table by assembling a new "L" shape that includes spreader grafts , making the most of the patient's own cartilage, and then repositioned it all inside the nose. In addition, I made the minor adjustments to the bridge and the necessary rotation and projection of the tip and columella.
What is observed in the result
Six years later, the deviation is corrected and the profile remains natural and respectful of her original anatomy.
More cases of deviated septums are included in this collection; the technique and the remaining cases can be found on the rhinoplasty page in Madrid. I explain what structural rhinoplasty is and how it works on the blog.
Case operated on by Dr. Gustavo Sordo
Specialist in Plastic, Aesthetic and Reconstructive Surgery. Member No. 282858125.
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Dr. Gustavo Sordo · Member No. 282858125 · Plastic, Aesthetic and Reconstructive Surgery · Madrid