Our beautiful patient is seen before and six and a half months after rhinoplasty surgery in our practice. She is noted to have relatively thick nasal skin with a wide appearance in her bridge, tip, and nostrils. This is associated with a slight tension lip deformity, an overprojected and droopy tip appearance, and a dorsal hump. Our goals were to provide a narrowed appearance in her bridge, tip, and nostrils on front view, and a less distracting and more feminine nasal profile appearance, without excessive tip rotation. The maneuvers we used during her operation included resection of a prominent anterior nasal spine and a prominent posterior septal angle. Additionally, we lowered her bridge and performed medial and lateral osteotomies for maximum nasal narrowing. We also used an extended shield graft in her tip, and we performed alarplasty and narrowed her nostrils. In this case, and in most rhinoplasties that we perform, there was no need to remove excessive amounts of her native tip cartilage. When too much cartilage is removed from someone’s nasal tip, this tends to cause deepening of the alar creases, excessive rotation, and nasal obstruction by weakening the external nasal valves. We also left her upper lateral cartilages and lower lateral cartilages intact at the scroll region to avoid excessive rotation and to make sure that her airway remains patent. You can see a smaller, more feminine, and less distracting nasal appearance, with less nostril show on front view and no stigmata of previous surgery. We are grateful that our beautiful patient has allowed us to post her photos.
