الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Secondary rhinoplasty is basically a constant challenge to the nasal surgeon. Secondary rhinoplasty is by definition a reoperation of a nose was previously operated. Secondary rhinoplasty also includes the post traumatic rhinoplasty.
Secondary problems can be classified as minor or major defects. Minor defects are often accepted by patients like minor dorsal irregularities or slight asymmetry of the nasal tip. Major defects may result from excessive and asymmetrical resections.
As a result of the excessive fibrosis and decreased vascularity, the skin soft-tissue envelope of the nose becomes less contractile and redrapes poorly over the modified bony cartilaginous framework, thus showing less details of any modifications performed.
Apart from the technical problems encountered, these patients usually suffer from psychological implications and need more reassurance than they did prior to their first surgery. The aim is to improve both preoperative functional and aesthetic features.
Evaluation included periodic clinical examination, analysis of preoperative and postoperative photographs, and the degree of patients’ satisfaction with both their aesthetic as well as functional outcome.
The external rhinoplasty approach was used in all the cases to provide a wide exposure and allow a more accurate assessment and correction of the underlying problems, and, whenever indicated, simultaneous septal surgery was performed to correct residual septal deviations or to harvest septal cartilage for nasal grafting.
Out of the 20 patients included in this study, 11 were women and 9 men; their mean age was 26.6 years. 10 patients were due to previous rhinoplasty operation and most of them were females (80%) while other 10 patients were due to post nasal trauma and most of them were males (70%).
According to each problem, different corrective techniques were used including nasal grafting, suturing and/or osteotomies to finally obtain better results functionally and aesthetically. Also, NOSE and ROE scores were used to measure degree of patients’ satisfaction. On evaluating the degree of patient satisfaction, functionally, 87.5% of the cases with preoperative nasal obstruction (17 cases) reported an improvement in breathing. On the other hand, 95% (19 cases) were satisfied with their aesthetic results.