Septal Deviation after Septorhinoplasty: Causes and Surgical Management

Revision rhinoplasty exists because the perfect primary rhinoplasty technique does not. The benefit of revision surgery is that it offers us the opportunity to study and identify what did not work well during previous surgery. Thoughtful approaches to technique and outcomes allow us to recognize which maneuvers are dependable and worth repeating, and which are not reliable and therefore worth avoiding. As surgeons seek safer, more predictable results to improve patient outcomes, new techniques emerge which we then apply, study, and modify again, based on what works and what does not over the short term and the long term. There is no substitute for experience or for learning from trusted surgeons' experiences. Revision rhinoplasty presents many challenges including surgically induced anatomical changes, weakened structural support, a lack of available tissue for reconstruction, tissue remodeling responses, and other iatrogenic and wound healing complications. The septum, as the primary source of structural nasal integrity, forms the foundation for functional and aesthetic rhinoplasty. Herein, we describe strategies in septorhinoplasty for patients who have undergone prior nasal septal surgery.