18.  Your rhinoplasty patient is very unhappy two weeks after rhinoplasty cause her nose is not quite straight and the tip is still boxey.  What should you do?

Answer:
The incidence of postsurgical nasal deformities requiring secondary correction varies from 5% to 12%, however, post-surgical tissue swelling may take several months to resolve.  Sheen lists five ground rules for the management of postsurgical nasal anomalies: 1) defer surgery until there is final resolution of tissue edema (at least 1 year); 2) have a well-defined esthetic concept; 3) make a proper diagnosis; 4) limit the dissection; 5) use only autogenous material.

The short answer to the question above is therefore to wait and postpone any revision for several months until tissue swelling has completely resolved.
 

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