Rhinoplasty Complications


Pollybeak Deformity or Suptratip Deformity

Rhinoplasty Surgery complications can be either functional (related to breathing), cosmetic, or a combination of both; one of the more frequent complications is known as Pollybeak Deformity (or Suptratip Deformity), which necessitates a secondary revision in most cases.

A nose with Pollybeak or Suptratip Deformity shows protuberance with a rounded downward pointing tip, very much like that of a parrot’s beak. If the surgeon does not understand the relationship of the tip and the supratip regions of the nose, then the outcome of Rhinoplasty can include this and other undesirable complications. From a cosmetic standpoint, the area from the nasal bridge to nasal tip should be aligned and straight. Causes of this particular deformity are the result of essential surgical errors or a combination thereof, all relating to surgeon inexperience and/or lack of surgical skill in Rhinoplasty Surgery.

  • The surgeon inadequately resected the dorsal septal cartilage during dorsal hump Reduction Rhinoplasty. In other words, the bony hump was reduced but inadequate cartilage, which is distal to the bone, or further down the nose of the bone, was left untreated or was under-resected and not aligned with the nasal bridge. This protuberant piece of cartilage can then appear as a Pollybeak Deformity.
  • Over-reduction of dorsal bony hump without adequate resection of the dorsal nasal septum.
  • Over-resection of the lower lateral cartilages (nasal tip) leading to loss of support in the nasal tip.
  • Excess scar tissue in the area of the dorsal septal cartilage or supratip region, which can cause a protuberant deformity, becoming more apparent once swelling following the surgery has resolved.
  • Excess scar tissue can also form in patients with thick skin and the thicker the skin, the more apparent the deformity.

Behind most if not all the mechanisms leading to a Pollybeak complication is unfortunately the inability of a surgeon to properly execute Rhinoplasty Surgery. Dr. Slupchynskyj, a Dual Board Certified Facial Plastic Surgeon and Revision Rhinoplasty expert, sees many patients who are dissatisfied with this birdlike appearance of their nose following a prior Rhinoplasty Surgery with another doctor. Dr. Slupchynskyj sees many cases where those deformities are quite obvious or prevalent, while other patients have mild forms of the deformity and are not fully aware they have this condition. Dr. Slupchynskyj finds that Pollybeak Deformity is often not properly diagnosed, even by the doctor who performed the patient’s Primary Rhinoplasty Surgery. His/her surgeon may tell the patient that the protuberance is simply swelling as a result of the surgery, even a year or more following surgery when normal transient swelling resolves. In this case, the patient may undergo a few or numerous steroid injections with little or no change. Many of these patients have reported to Dr. Slupchynskyj that they experienced excessive swelling following Rhinoplasty Surgery with their other doctor, yet once swelling had completely resolved, the protuberance had not disappeared or reduced in size as they were advised would happen.

As a trained, experienced Rhinoplasty Surgery expert with proven results, Dr. Slupchynskyj is regularly sought out to address both aesthetic and functional Rhinoplasty complications resulting from previous Rhinoplasty Surgeries performed by other doctors. Dr. Slupchynskyj’s approach is always tailored to the patient’s specific needs, and correction of a Pollybeak Deformity depends upon the underlying cause, which can be multifactorial.

Dr. Slupchnynskyj first advises non-surgical therapy to patients coming to see him within the first 12 months following their initial surgery with another doctor. Plans for surgical revision can be made after this time period and specifically if the deformity has not responsive to steroid treatment/injections. A word of warning: If your doctor is treating you with steroid injections to reduce swelling, he/she should advise you of the attendant risks. Steroid injections must be used with caution as over-treatment can produce atrophy and lead to a Saddle Nose Deformity.

Rhinoplasty Surgical Treatment

Dr. Slupchynskyj’s revision surgery will always be based upon his patient’s specific case, (i.e. what was or were the reasons leading to this complication). There is no universal technique for correcting a Pollybeak Deformity. For patients with an over-projected dorsum, surgical revision can include resecting the excess dorsal septal cartilage and may include concurrent support of the nasal tip. Re-supporting the lower lateral cartilages, also known as the tip cartilages, can be necessary to restore the proper aesthetic relationship between nasal bridge and tip. It is preferable that surgical correction and revision of a Pollybeak Deformity be addressed through an Open Rhinoplasty technique as nasal cavities and scar tissue may be directly visualized.

The safest and best method for avoiding such a complication and undergoing a Secondary Revision Rhinoplasty is to select an expertly trained and experienced Double Board Certified Facial Plastic Surgeon who will create a proper surgical plan and perform your Primary Rhinoplasty Surgery right the first time. If you are interested in learning more about undergoing Rhinoplasty with Dr. Oleh Slupchynskyj, contact Aesthetic Institute of New York & New Jersey today.

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