Rhinoplasty #288

These are photos of our patient before and 15 months following functional and cosmetic rhinoplasty surgery. Her main issues were that she had a dorsal hump, and she also did not like how wide her nasal bones stuck out in the area where they attached to her cheeks. She also had some preoperative nostril asymmetry that was addressed at the time of surgery.

Her operation consisted of correcting her deviated nasal septum, lowering her bridge, performing osteotomies, utilizing an extended shield graft to gain definition of her tip through her thick skin, and placing spreader grafts on both sides to open up her internal nasal valves.

Her postoperative course was complicated by a severe nosebleed that occurred on the right side the evening of surgery. Since all of our patients have access to my personal cell phone, we met in the office in the middle of the night, and the bleeding was controlled with right-sided nasal packing. Her packing was removed 48 hours later, and there was no subsequent bleeding or problem with her healing.

We do not place nasal packing routinely in anybody; however, since a nasal hemorrhage after rhinoplasty surgery can occur in approximately 1% of cases—about once or twice a year—we need to utilize packing to control an emergency nosebleed situation. It has been our experience that nasal packing for a nosebleed does not affect someone’s final result, and this is the case here.

You can see a natural-looking, less distracting, and more feminine nasal appearance. I would also like to mention that this patient is a very strong and kind woman, and I am most grateful that she has allowed us to post her beautiful results.