Summary
Secondary rhinoplasty on a patient with a middle vault deformity is one of the most
challenging procedures for a plastic surgeon. In order to achieve proper nasal aesthetics
and airway function, a surgeon most commonly chooses to engraft the nose with a spreader,
dorsal onlay, or columellar graft. This paper examines the aforementioned techniques
in the management of 25 patients who presented with a severe middle nasal vault deformity.
Methods
During the last 5 years, 25 patients received secondary rhinoplasty using triple cartilage
grafts to repair severe middle vault deformities. Patients were then questioned at
least 3 months postoperatively about both airway problems and cosmetic satisfaction.
Results
All the 25 patients indicated cosmetic satisfaction with 23 of the patients also achieving
complete nasal airway function. Only two patients persisted to have an insufficient
nasal airway. An endonasal examination revealed a slight nasal synechiae in one patient,
while no anatomic problem was identified in the second patient. From a cosmetic standpoint,
a straight dorsum with improved dorsal aesthetic lines and nasal profile, along with
nasal–facial balance were achieved.
When indicated, secondary rhinoplasty to repair a middle vault deformity using the
combination of spreader, dorsal onlay, and columellar grafts to augment the nose has
shown to have both functional and cosmetic benefits.
Keywords
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Article info
Publication history
Published online: July 11, 2006
Accepted:
April 4,
2006
Received:
December 5,
2005
Identification
Copyright
© 2006 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Inc. All rights reserved.
