Male revision rhinoplasty: pearls and surgical techniques

Male revision rhinoplasty surgery is the most difficult and challenging procedure that facial plastic surgeons perform because males usually have thick nasal skin, which is more difficult to re-support and project the nasal tip, and often have high or unrealistic expectations. The primary etiology for the need for male revision rhinoplasty is a primary rhinoplasty with aggressive lower lateral cartilage reduction that causes tip ptosis and loss of projection. The goal to an aesthetically pleasing revision rhinoplasty is to re-create adequate tip projection and an intact strong tripod complex. Following tip reconstruction, the height and width of the dorsum should be set. For male revision nasal surgery, a clear and thorough knowledge of nasal anatomy, function, and surgical techniques is paramount. Having an extensive preoperative discussion including expectations, outcomes, and a detailed list of potential complications with the patient can prevent physician-patient mis-communication. Prior to surgery, review the examination, previous operative summary, photographs, nasal analysis sheet, problem list, and plan and then proceed with the surgical treatment.