Introduction: Loss of rotation after surgery not only results in a deformed tip, but can also create a supratip deformity, requiring new interventions to correct these problems, which is performed by Secondary Rhinoplasty, which can be performed using the Keim Technique. Objectives: To describe the technique in detail, proving the satisfaction after secondary rhinoplasty in patients who used the Technique, without redoing the previous grafts. Methods: Qualitative, descriptive, observational, retrospective study. Data were obtained from the medical records of patients filed in the computerized system of the private practice of otorhinolaryngologist Dr Frederico Santos Keim. The analysis was based on the appreciation and synthesis of the data extracted from the medical records, performed in a descriptive manner, allowing observation, counting, description and classification of the data for the gathering of knowledge on the explored topic. Results: The revision technique created by otorhinolaryngologist Frederico Keim was used in six female patients who had already undergone rhinoplasty but wanted greater delicacy and definition of the nasal tip. They underwent secondary rhinoplasty with an open approach, using the Keim technique; the average follow-up time was 18 months, and a thorough in-person examination was required. Conclusion: Secondary rhinoplasty is a safe surgery, with a very low infection rate. With the presentation of this surgical technique, it can be seen that its use is a viable option, with good short- and medium-term results and low complication rates, but it must be performed by an experienced surgeon.

Dr. Júlia Gaspar is an Otorhinolaryngologist with a Medical Residency completed at the Federal University of the State of Rio de Janeiro (UNIRIO); Master in Medical Sciences from the Federal University of São Paulo (UNIFESP), did a Fellowship in Facial Plastic Surgery at the IPO Hospital (Paraná Institute of Otorhinolaryngology); and has a Postgraduate degree in Structural Rhinoplasty from the Jurado Institute.