Richard E. Davis, MD FACS - The Center for Facial Restoration in Miramar, Florida

Before & After Photo Gallery: Revision Rhinoplasty

This photo gallery represents a cross-section of my rhinoplasty practice and includes patients of different age, gender, nasal shape, and ethnic background. This gallery is not a collection of my best rhinoplasty outcomes, but rather a representative sampling of my typical cosmetic result. In addition, a majority of these patients also had simultaneous correction of severe nasal breathing difficulties, which cannot be appreciated in photographs.

Although reviewing before and after photographs is an important element in selecting the right rhinoplasty surgeon, choosing your surgeon solely on the basis of website photos is ill-advised. Indeed, countless disappointed rhinoplasty patients can attest to the deceptive and misleading nature of many rhinoplasty websites. Moreover, viewing online photos is no substitute for the consultation visit, where I can share numerous other before and after photos, many with noses similar in appearance to your own – a far more meaningful comparison. Although I have been slow to incorporate internet marketing into my rhinoplasty practice, the growing number of individuals who look to the internet as their sole source of medical information cannot be overlooked. Consequently, I offer this website as a source of candid information to equip the prospective rhinoplasty patient with accurate information and honest advice.

I am indebted to the generous patients who kindly authorized use of their rhinoplasty photographs.

Richard E. Davis, MD, FACS

 

Revision Rhinoplasty: Patient 1

Clinical History: Healthy female underwent two previous surgeries elsewhere; residual hump, wide middle vault, pinched tip (from collapsed/retracted tip cartilages), and flared nostrils
Procedures: External (open) nasoseptal reconstruction with hump reduction (full osteotomies), middle vault reconstruction, and tip-plasty with vertical dome division and multiple cartilage grafts
Graft Types: Right side spreader graft, extension graft, and tip (shield and cap) grafts (all from septal cartilage), left alar rim graft (conchal cartilage), soft tissue (SMAS) tip onlay grafts
After Photos Taken: 13 months post-op
Richard Davis, MD Revision Rhinoplasty: Patient 1, Front View, Pre-Op Richard Davis, MD Revision Rhinoplasty: Patient 1, Front View, Post-Op
Richard Davis, MD Revision Rhinoplasty: Patient 1, Profile View, Pre-Op Richard Davis, MD Revision Rhinoplasty: Patient 1, Profile View, Post-Op
Richard Davis, MD Revision Rhinoplasty: Patient 1, Oblique View, Pre-Op Richard Davis, MD Revision Rhinoplasty: Patient 1, Oblique View, Post-Op
Richard Davis, MD Revision Rhinoplasty: Patient 1, Basal View, Pre-Op Richard Davis, MD Revision Rhinoplasty: Patient 1, Basal View, Post-Op

Revision Rhinoplasty: Patient 2

Clinical History: Healthy young female with history of successful cosmetic rhinoplasty at age 11, followed by a severe nasal fracture (untreated) at age 15. Presented with crooked nose, inverted-V and boxy tip, complaining of severe nasal obstruction (secondary to septal deviation, nasal valve collapse, and turbinate enlargement), recurrent sinusitis, and sinus headaches.
Procedures: External (open) nasoseptal reconstruction with middle vault augmentation graft, tongue-in-groove nasal shortening, tip-plasty, left alar cartilage reconstruction, septoplasty, and sub-mucous (partial) turbinate reduction.
Graft Types: Dorsal onlay graft, septal extension graft, shield (tip) graft, left alar rim graft, and left crural onlay (batten) graft, all from septal cartilage.
After Photos Taken: 8 months post-op
Comments: Breathing was restored and rhinogenic headaches resolved.
Richard Davis, MD Revision Rhinoplasty: Patient 2, Front View, Pre-Op Richard Davis, MD Revision Rhinoplasty: Patient 2, Front View, Post-Op
Richard Davis, MD Revision Rhinoplasty: Patient 2, Profile View, Pre-Op Richard Davis, MD Revision Rhinoplasty: Patient 2, Profile View, Post-Op
Richard Davis, MD Revision Rhinoplasty: Patient 2, Oblique View, Pre-Op Richard Davis, MD Revision Rhinoplasty: Patient 2, Oblique View, Post-Op
Richard Davis, MD Revision Rhinoplasty: Patient 2, Basal View, Pre-Op Richard Davis, MD Revision Rhinoplasty: Patient 2, Basal View, Post-Op

Revision Rhinoplasty: Patient 3

Clinical History: Healthy female underwent previous rhinoplasty in 1990’s; over-resected bridge, left alar collapse, and severe nasal obstruction (nasal valve collapse, septal deviation, and turbinate enlargement)
Procedures: External (open) nasoseptal reconstruction with rib cartilage augmentation grafts, septoplasty, and turbinate reduction
Graft Types: Two-layer dorsal onlay graft, septal extension graft, tip (shield) graft, columellar batten graft (all from rib cartilage), perichondrial graft to left sidewall
After Photos Taken: 13 months post-op
Richard Davis, MD Revision Rhinoplasty: Patient 3, Front View, Pre-Op Richard Davis, MD Revision Rhinoplasty: Patient 3, Front View, Post-Op
Richard Davis, MD Revision Rhinoplasty: Patient 3, Profile View, Pre-Op Richard Davis, MD Revision Rhinoplasty: Patient 3, Profile View, Post-Op
Richard Davis, MD Revision Rhinoplasty: Patient 3, Basal View, Pre-Op Richard Davis, MD Revision Rhinoplasty: Patient 3, Basal View, Post-Op

Revision Rhinoplasty: Patient 4

Clinical History: Healthy female underwent two previous surgeries elsewhere; collapsed middle vault, crooked/pinched tip, small residual hump, and caudal excess deformity
Procedures: External (open) nasoseptal reconstruction with hump reduction (rasp and lateral osteotomies), middle vault augmentation grafts, septal replacement graft, "tongue-in-groove" setback, and tip-plasty using vertical dome division and onlay grafting
Graft Types: Right side spreader graft, tip (shield) graft, columellar batten graft (all from conchal cartilage), dorsal onlay graft, septal replacement graft (both from septal cartilage)
After Photos Taken: 5 months post-op
Richard Davis, MD Revision Rhinoplasty: Patient 4, Front View, Pre-Op Richard Davis, MD Revision Rhinoplasty: Patient 4, Front View, Post-Op
Richard Davis, MD Revision Rhinoplasty: Patient 4, Profile View, Pre-Op Richard Davis, MD Revision Rhinoplasty: Patient 4, Profile View, Post-Op
Richard Davis, MD Revision Rhinoplasty: Patient 4, Oblique View, Pre-Op Richard Davis, MD Revision Rhinoplasty: Patient 4, Oblique View, Post-Op
Richard Davis, MD Revision Rhinoplasty: Patient 4, Basal View, Pre-Op Richard Davis, MD Revision Rhinoplasty: Patient 4, Basal View, Post-Op

Revision Rhinoplasty: Patient 5

Clinical History: Healthy male underwent multiple surgeries elsewhere (including nasal implant and ear cartilage graft); twisted bridge, saddle nose deformity, and tip asymmetry
Procedures: External (open) nasal reconstruction with removal of synthetic nasal bridge implant, rib cartilage augmentation grafts, and partial turbinectomies
Graft Types: Dorsal onlay graft, columellar strut graft (both from rib cartilage)
After Photos Taken: 12 months post-op
Richard Davis, MD Revision Rhinoplasty: Patient 5, Front View, Pre-Op Richard Davis, MD Revision Rhinoplasty: Patient 5, Front View, Post-Op
Richard Davis, MD Revision Rhinoplasty: Patient 5, Profile View, Pre-Op Richard Davis, MD Revision Rhinoplasty: Patient 5, Profile View, Post-Op
Richard Davis, MD Revision Rhinoplasty: Patient 5, Oblique View, Pre-Op Richard Davis, MD Revision Rhinoplasty: Patient 5, Oblique View, Post-Op
Richard Davis, MD Revision Rhinoplasty: Patient 5, Basal View, Pre-Op Richard Davis, MD Revision Rhinoplasty: Patient 5, Basal View, Post-Op

Revision Rhinoplasty: Patient 6

Clinical History: Healthy female underwent one prior surgery elsewhere; wide, asymmetric nose
Procedures: External (open) nasal reconstruction with lateral osteotomies and revision (partial excision and/or repositioning) of existing cartilage grafts
Graft Types: None
After Photos Taken: 18 months post-op
Richard Davis, MD Revision Rhinoplasty: Patient 6, Front View, Pre-Op Richard Davis, MD Revision Rhinoplasty: Patient 6, Front View, Post-Op
Richard Davis, MD Revision Rhinoplasty: Patient 6, Profile View, Pre-Op Richard Davis, MD Revision Rhinoplasty: Patient 6, Profile View, Post-Op
Richard Davis, MD Revision Rhinoplasty: Patient 6, Oblique View, Pre-Op Richard Davis, MD Revision Rhinoplasty: Patient 6, Oblique View, Post-Op
Richard Davis, MD Revision Rhinoplasty: Patient 6, Basal View, Pre-Op Richard Davis, MD Revision Rhinoplasty: Patient 6, Basal View, Post-Op

Revision Rhinoplasty: Patient 7

Clinical History: Healthy female underwent two previous rhinoplasty surgeries elsewhere; presented complaining of nasal airway obstruction (from septal deviation and turbinate hypertrophy), and cosmetic deformity (from residual hump deformity, mild inverted-V deformity, wide, overprojected nasal tip, large infra-tip lobule and retracted nostril rims)
Procedures: External (open) nasoseptal reconstruction with hump reduction (full osteotomies), tip deprojection with "tongue-in-groove" setback, suture tip refinement with minimal cartilage excision, and columellar batten graft placement; synthetic chin implant placement via extra-oral skin incision
Graft Types: Columellar batten graft (septal cartilage)
After Photos Taken: 14 months post-op (2 months after minor touch-up)
Richard Davis, MD Revision Rhinoplasty: Patient 7, Front View, Pre-Op Richard Davis, MD Revision Rhinoplasty: Patient 7, Front View, Post-Op
Richard Davis, MD Revision Rhinoplasty: Patient 7, Profile View, Pre-Op Richard Davis, MD Revision Rhinoplasty: Patient 7, Profile View, Post-Op
Richard Davis, MD Revision Rhinoplasty: Patient 7, Oblique View, Pre-Op Richard Davis, MD Revision Rhinoplasty: Patient 7, Oblique View, Post-Op
Richard Davis, MD Revision Rhinoplasty: Patient 7, Basal View, Pre-Op Richard Davis, MD Revision Rhinoplasty: Patient 7, Basal View, Post-Op