Revision rhinoplasty remains one of the most challenging procedures in facial plastic surgery due to altered anatomy, scar tissue, and limited availability of native cartilage. Recent advances in imaging and surgical planning have enabled more precise, individualized approaches to complex nasal reconstruction. To evaluate the effectiveness of a precision-based approach to revision rhinoplasty combining costal cartilage grafting with preoperative computed tomography (CT) and three-dimensional (3D) imaging. A prospective clinical analysis was conducted on patients undergoing revision rhinoplasty. Preoperative planning incorporated CT imaging and 3D surface scanning to assess anatomical deformities and guide surgical strategy. Costal cartilage grafts were utilized to reconstruct structural deficits and restore nasal support. Outcomes were evaluated using functional (NOSE scale) and aesthetic (ROE questionnaire) parameters, along with complication rates. The integration of advanced imaging with an algorithmic surgical approach enabled accurate identification of structural abnormalities and individualized operative planning. Significant improvements were observed in both nasal airflow and aesthetic outcomes. Mean NOSE scores decreased substantially postoperatively, while ROE scores demonstrated high patient satisfaction. The use of costal cartilage provided reliable structural support in complex cases, with a low complication rate.

Conclusions: Precision-guided revision rhinoplasty combining costal cartilage grafting with CT and 3D planning represents a safe and effective strategy for managing complex nasal deformities. This approach enhances surgical predictability, optimizes functional and aesthetic outcomes, and supports the evolution of personalized rhinoplasty techniques.

Pawel Szychta is a Professor of Medical Sciences and a board-certified plastic surgeon specializing in advanced rhinoplasty and aesthetic surgery. He is internationally recognized for his work in precision rhinoplasty, particularly in revision cases integrating costal cartilage grafting with cutting-edge imaging technologies such as computed tomography and 3D planning. He trained in leading European and international centers, including the United Kingdom, Belgium, Italy, Turkey and the United States, collaborating with world-renowned experts in aesthetic and reconstructive surgery. His clinical and research work focuses on combining surgical innovation with modern diagnostic tools to achieve highly individualized, predictable outcomes. He has authored numerous peer-reviewed publications in high-impact international journals and has received multiple awards from prestigious scientific societies, including the American Society of Plastic Surgeons. His research has contributed to the development of novel algorithms and techniques in rhinoplasty and aesthetic surgery. He is an active member of international organizations such as ISAPS and ASPS, and serves on editorial boards of scientific journals. As a frequent invited speaker, he shares his expertise worldwide, promoting a modern, precision-based approach to facial aesthetic surgery.