This gentleman had multiple rhinoplasties before. He has a Gore-Tex implant on the dorsum, pinched and upturned tip, narrow middle vault, and nasal obstruction. Surgery included replacing Gore-Tex with rib cartilage, septum and middle vault reconstruction, tip lengthening with new septal extension grafts, and medial and lateral reinforcement with cartilages. After surgery, his nose looks normal and he can breath much better. I used special technique called "grated cartilage paste" on the tip area. Grated rib cartilage was made as paste using patient's own blood and used as tip onlay graft. This gives volume not only on the tip but also on the lateral margins of the tip, which makes a more natural tip apprearance.
My blog will explain easily the concept, techniques, result, complication, and considering points of rhinoplasty, Asian rhinoplasty, revision rhinoplasty, fucional rhinoplasty, and nasal reconstruction. As a rhinoplasty surgeon with more than 20 years of experience, I will try to help people who want useful and frank information on rhinoplasty.