Treatment of Persistent Nasal Hump
Patients who have previously undergone primary rhinoplasty oftentimes would present with persistent nasal hump that was not adequately removed. The most common area that the nasal hump presents is in the cartilaginous portion, which is just above the nasal tip. This area is often called polybeak deformity. Polybeak deformity is probably the most common reason that patients undergo secondary rhinoplasty, as it is an area that is often overlooked by surgeons who do not perform rhinoplasty procedures on a routine basis. The treatment for polybeak deformity is fairly simple, yet needs exact understanding of the anatomy, function and aesthetics. If the polybeak deformity or persistent nasal bump is overly reduced during the revision or secondary rhinoplasty, the patient can develop saddle nose deformity. As a result careful intraoperative measurements and preoperative analysis is required to obtain a perfect outcome. Furthermore, Dr. Azizzadeh believes that this area and the middle portion of the nose where polybeak deformities present is an area that needs to be not only reduced aesthetically, but reconstructed functionally in order to avoid long-term problems with internal nasal valve collapse. As a result, Dr. Azizzadeh almost always reconstructs the middle nasal vaults, which is the junction between the septum and the cartilages that make up the polybeak deformity with grafts called “spreader grafts.” Spreader grafts are thin pieces of cartilage that are harvested from the septum and placed in the area where the hump is taken down and corrected. As a result, the valvular function of the nose is maintained, breathing is not compromised and the aesthetics are perfected. During the revision rhinoplasty consultation, Dr. Azizzadeh will utilize digital morphing to show how the polybeak deformity and the persistent nasal hump will be corrected aesthetically. Furthermore, the functions of the nose will be outlined as well as the anatomic basis of the correction. Again, the treatment for polybeak deformity needs to address both the aesthetics of the deformity as well as the function of the area.
Dr. Babak Azizzadeh is the Director of the Institute for Rhinoplasty & Nasal Reconstruction in Beverly Hills, California (Greater Los Angeles area) serving patients from entire country.