Correction of dorsal abnormalities in revision rhinoplasty

Revision rhinoplasty is probably one of the most difficult procedures performed in facial plastic surgery. Many of these postsurgical deformities are found in the nasal dorsum. These changes are usually the result of inadequate or overzealous resections as well as inadequate healing. A review of the most common dorsal abnormalities encountered and how they can be corrected is presented. Most of these patients are operated on through the open approach, and treatment is multifactorial. Osteotomy and rasp techniques are used to realign; cartilage grafts are used to fill in, camouflage, and smooth out; and in severe cases implants are used to fill in large defects. Finally, a discussion on the different alternatives for the correction of subtle dorsal defects is presented.