fig18

Figure 18. Correction of the short nose due to contracture after multiple rhinoplasties. A short and contracted nose, developed after infected dorsal silicone implant removal is evident from the preop photos (A, B, C); The surgical diagram shows septal extension graft, dorsal onlay graft, bilateral extended spreader grafts, lateral crural onlay grafts, shield graft and cap graft were placed using irradiated homologous costal cartilage (D); After wide release of the skin envelope, a septal extension graft is placed and reinforced with extended spreader grafts. The released lower lateral cartilages and reinforced with extended lateral crural strut grafts. Perichondrium is added for camouflage (E, F). One year after revision surgery using rib cartilage, the nose looks much better than before. His dorsum is well elevated and the tip is caudally rotated (G, H, I)