Case Studies Rhinoplasty

  • Before
  • After
  • Before
  • After
  • Before
  • After

*Individual results may vary. Please see full disclaimer.

Chief Complaint

The patient is a world-class masters swimmer who presented in her mid-30’s. Her main desire was to reduce the slight dorsal hump and to refine her nasal tip. She had no breathing difficulties.

Assessment

The patient had a boxy, flat nasal tip with  wide lower lateral cartilages leading to an amorphous contour. The profile was 3-millimeters  too high. Her nose slightly deviated to the right. There was adequate tip support and no evidence of breathing difficulty.

Procedure

Under general anesthesia, in a certified outpatient surgical center, the patient had an open rhinoplasty. The procedure began by making a small incision underneath the nose and then lifting the skin up to reveal the nasal structure. This was followed by  reduction of her boney and cartilaginous dorsal (profile) hump and nasal tip refinement. This was accomplished by reducing the width of the tip cartilages and then suturing them together with an inter-domal suture to further refine and support the tip. This will allow the nose to age well and look great for many years to come. Finally, the surgically created open roof deformity, which is a consequence of hump reduction, was closed with lateral osteotomies (bone cuts) and narrowing the nasal bones, bringing the upper half of the nose into harmony with the lower, more elegant nasal form and straightening the nose. The patient is shown 1 year after surgery.

Disclaimer: Individual results will vary and no guarantee is stated or implied by any photo use or any statement on this website. Please see full disclaimer.

  • Before
  • After
  • Before
  • After
  • Before
  • After

*Individual results may vary. Please see full disclaimer.

Chief Complaint

The patient is a woman in her mid-20’s. Her main desire was to have a more refined and elegant nasal tip and narrower nostrils. She had no breathing problems.

Assessment

The patient had a broad, flat nasal tip with poor projection and support and 4-millimeters of excess nostril width per side. Her nasal dorsum was straight. Her nose was midline. There was no evidence of functional difficulties.

Procedure

Under general anesthesia, in a certified outpatient surgical center, the patient had an open rhinoplasty. The procedure began by making a small incision underneath the nose and then lifting the skin up to reveal the nasal structure. Next, her nasal profile was lowered by 1 mm . Her nasal tip was  refined  by reducing the width of the tip cartilages and then suturing them together with an inter-domal suture to further refine and support the tip. To augment the strength and support of her nasal tip, cartilage from her nasal septum was placed as a columella strut, between the tip cartilages. This will allow the nose to age well and look great for many years to come. Three millimeters of excess nostril width was removed from each side (weir excisions) to narrow the nostrils. Medial and lateral osteotomies (bone cuts) were performed and the nasal bones narrowed to bring the upper half of the nose into harmony with the new lower, more elegant nasal form.  The patient is shown 1 year after surgery.

Disclaimer: Individual results will vary and no guarantee is stated or implied by any photo use or any statement on this website. Please see full disclaimer.

  • Before
  • After
  • Before
  • After
  • Before
  • After

*Individual results may vary. Please see full disclaimer.

Chief Complaint

The patient is a woman in her mid-20’s. Her main desire was to create a more elegant nose that was not as long. She had no breathing difficulties.

Assessment

The patient had a boxy nasal tip with wide lower lateral cartilages leading to an angular, over-projected nasal tip. Her nose was midline. The nose had adequate tip support and there was no evidence of breathing difficulty.

Procedure

Under general anesthesia, in a certified outpatient surgical center, the patient had an open rhinoplasty. The procedure began by making a small incision underneath the nose and then lifting the skin up to reveal the nasal structure. Nasal projection and tip refinement were accomplished with a tripod reduction of her lower lateral cartilages. Both her medial and lateral crura were shortened with an overlay technique. This in combination with a cephalic trim and inter-domal suturing of her nasal tip cartilages reduced the boxy shape of her tip and reduced the over-projection of her nose, giving her a smaller and more appealing nasal contour. Lastly, I reduced her polybeak deformity which lowered the height of her profile in the lower one-third of her nose and performed medial and lateral osteotomies  (bone cuts) to narrow the upper third of her nose and put it into proportion with her new nasal tip contour. The patient is shown 1 year after surgery.

Disclaimer: Individual results will vary and no guarantee is stated or implied by any photo use or any statement on this website. Please see full disclaimer.

  • Before
  • After
  • Before
  • After
  • Before
  • After

*Individual results may vary. Please see full disclaimer.

Chief Complaint

The patient is a man in his 40’s who suffered a severe facial trauma resulting in multiple facial fractures and a crushed nose. He had facial trauma reconstruction and a delayed nasal reconstruction with irradiated rib cartilage graft. The patient presented with a severe secondary nasal deformity and nasal airway obstruction on the left side.

Assessment

The patient had an obvious C-shaped deformity of his nasal dorsum, an under projected and poorly supported nasal tip, columella retraction and a collapsed left nostril.

Procedure

Under general anesthesia, in a certified outpatient surgical center, the patient underwent an open rhinoplasty. The procedure began by making a small incision underneath the nose and then lifting the skin up to reveal the nasal structure. The previously place twisted rib graft was removed and the irregular profile smoothed. To lift the left nostril, a suture suspension technique was performed. Stacked cartilage grafts taken from his ear were used to build up his nasal tip to improve his nasal projection and a columella strut, also fashioned from ear cartilage was placed between his nasal tip cartilages to improve tip support. Lastly, a variably stacked ePTFE dorsal implant was fashioned and secured to correct the dorsal (profile) collapse. The patient is shown 3 months after surgery. The patient obviously looks much better but it was his improved self-confidence that was most meaningful to him.

Disclaimer: Individual results will vary and no guarantee is stated or implied by any photo use or any statement on this website. Please see full disclaimer.

  • Before
  • After
  • Before
  • After
  • Before
  • After

*Individual results may vary. Please see full disclaimer.

Chief Complaint

The patient is a man in his early-20’s. His main concern was his profile and he wanted a more handsome looking nose. He had no breathing problems.

Assessment

The patient had a broad nasal tip due to wide tip cartilages and 3-millimeters of excess nostril width per side. His nasal profile was 4-millimeters to high. The nose deviated to his left. There was good tip support and no evidence of functional difficulties.

Procedure

Under general anesthesia, in a certified outpatient surgical center, the patient had an open rhinoplasty. The procedure began by making a small incision underneath the nose and then lifting the skin up to reveal the nasal structure.  His profile was reduced by 4-millimeters. His nasal tip was  refined  by reducing the width of the tip cartilages and then suturing them together with an inter-domal suture to further refine and support the tip. This will allow the nose to age well and look great for many years to come. Three millimeters of excess nostril width was removed from each side (weir excisions) to narrow the nostrils. Medial and lateral osteotomies (bone cuts) were performed to straighten the nose and eliminate the surgically created open-roof deformity (a consequence of hump reduction). The nasal bones were then narrowed to bring the upper half of the nose into harmony with the new lower, more handsome nasal form.  The patient is shown 1.5 years after surgery.

Disclaimer: Individual results will vary and no guarantee is stated or implied by any photo use or any statement on this website. Please see full disclaimer.