I was just thinking a few weeks ago that the badly scarred-shut airways I used to see are so uncommon now, compared to 2 decades ago. Most surgeons are getting more careful, and they have taken rhinoplasty learning very seriously. That point was brought home by a woman whom I just scheduled for surgery. Her first operation was in 1970, and the surgeon removed so much lining that she has been trying to breathe though tiny pinholes since then. In a second surgery, another surgeon collapsed her bridge.
I do not understand how she put up with it so long, but she has had enough. This will be a tough correction, but she certainly can be helped significantly. Because the collapsed bridge severely affects the stability of the sidewalls, I have to correct that, and I also have to add lining to open the scarred airways. Neither procedure alone will help her, so they need to be combined, which is tricky but very possible to do safely. However, her appearance should be significantly better and she will have a nasal airway, something she hasn’t had since she was a 20 year old. It will be very gratifying for both of us.