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This 60-year-old woman from Northern Virginia had a rhinoplasty in 1992 by another surgeon.  Since then, she has been crippled with collapse, disfigurement and difficulty breathing.  Because of the complexity of her revision rhinoplasty, we met several times prior to surgery to discuss each item of concern and how best to address each one.  Clearly, a rib graft would be necessary to control shape and the two nasal bones would need to be treated differently.  The middle of the bridge collapse would require support and the lower third of the nose collapse would have to be corrected.  Her nose was over projected and under rotated and these dimensions would be changed during surgery using carefully controlled calipher measurements from reference point on her forehead.  Taking a rib graft resulted in a scar on her lower chest which she could have chosen to conceal in her inframammary breast fold.  The scar tradeoff was worthwhile to give her improved breathing and a nose that is much more straight and normal in appearance. Although it took many hours to make these changes, they were performed with modern, reliable grafting and measurement techniques.  She will then enjoy a much more normal appearance and greatly improved breathing for the rest of her life.  Her nose is a little swollen still at four months after surgery and swelling will continue to go down for the first year to year and a half.  She is already extremely excited with the results.

Surgeon: Dr. Thomas Hubbard
Patient Age: 60

Case Number: 418

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