Rhinoplasty Before & After: Improved Nostril Asymmetry, Smoothed a Dorsal Hump, & Fixed a Deviated Septum
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.
Rhinoplasty Before & After: Addressed Irregularities After Prior Septoplasty
Rhinoplasty #287
Our beautiful patient is seen before, and one month after, rhinoplasty surgery for severe dissatisfaction with her nasal appearance. Her case is somewhat unusual, since she had septoplasty and endoscopic sinus surgery performed by another doctor, which resulted in loss of support of her nasal tip, along with an indentation in her low nasal bridge. You can see in her before photo that she has a divot above her tip, and this is associated with a droopy tip and a dorsal hump. On front view, she had a bit of a wide appearance in the lower 1/3 of her nose, and there were some visible irregularities along her upper bridge.
When I examined her, I noticed that she did not have adequate nasal septal cartilage remaining for grafting purposes, so we purchased a sheet of MTF Profile cartilage for reconstruction. She required a columella strut graft to support her tip and improve the appearance of her retracted columella, and we also placed spreader grafts on both sides to open up her internal nasal valves. You can see that we deprojected her nasal profile appearance, rotated her tip upward, and removed her dorsal hump.
At only one month postoperative, she still appears swollen and wide on front view, and she has a bit of nostril asymmetry because there is more swelling involving her right nostril compared to her left. This will naturally get better over the ensuing several months. After rhinoplasty surgery, patience is a virtue, since it takes at least 12 months for all swelling to dissipate. This is one of the many reasons why we advocate keeping your rhinoplasty specialist close to home, since small irregularities tend to be magnified by long distances.
Rhinoplasty Before & After: 13 Months After Functional + Cosmetic Rhinoplasty
Rhinoplasty #286
Our stunningly beautiful patient is seen before and 13 months after functional and cosmetic rhinoplasty performed in our practice. When she met us, her nasal appearance was her biggest insecurity. She was self-conscious about her crooked nose, dorsal hump, and wide, droopy tip. She also had chronic nasal obstruction due to a severely deviated septum and enlarged turbinates. Our goals were to achieve a narrower and straighter nasal appearance on front view, with nasal tip deprojection and rotation on profile, along with dorsal lowering. During surgery, we corrected her deviated septum, reduced her turbinates, and utilized an extended shield graft to provide natural-looking tip definition and support. We are thrilled that our patient is breathing better and happy with her results.
Rhinoplasty Before & After: Post-Traumatic Hump Removal & a Tip Lift at Age 70+
Rhinoplasty #286
Is being over 70 too old for rhinoplasty? Absolutely not, if you are in good health. Our beautiful patient is seen before and one year after rhinoplasty surgery in our practice. The impetus for pursuing surgery was a recent nasal trauma that worsened her dorsal hump.
The goals of surgery were to create a narrower and straighter nasal appearance on front view, lift the tip on profile, and remove the hump. We also corrected her severely deviated septum to the right, which was post-traumatic in nature.
You can now see a natural-looking, less distracting, and more feminine nasal appearance. My rhinoplasty teacher taught me many years ago that rhinoplasty surgery often leads to a more youthful facial appearance by lifting the nasal tip. We are beyond grateful that our patient has allowed us to share her photographs.
Rhinoplasty Before & After: Addressed a Deviated Septum, Valve Weakness & an Overprojected Tip
Rhinoplasty #285
Our beautiful patient is seen before and one year after functional and cosmetic rhinoplasty surgery in our practice. Her preoperative nasal obstruction was due to a severely deviated septum to the right and congenital weakness of her external nasal valves on both sides. From a cosmetic perspective, she was dissatisfied with her long and overprojected nasal profile. During surgery, we corrected her deviated septum and utilized lateral crural extension grafts to support her external nasal valves and keep her airway open. One year after surgery, her nose appears smaller, less distracting, and more feminine, without any stigmata of prior surgery. Just as importantly, her nasal airway is now widely patent, allowing her to breathe better than ever before.