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This 30 year old lady from Pittsburgh came to see me regarding a very large septal defect and complaints of breathing difficulties. After reviewing her nose externally and internally, I concluded that the best plan of action would be to repair the septal defect, support and strengthen the dorsum and tip of the nose, and slightly refine the nasal tip. In this case, a donor rib cartilage graft would be needed to provide support to the dorsum and tip of nose. The post-rhinoplasty pictures are shown at one year.
The frontal view demonstrates the more harmonious relationship between the nose and the face following the rhinoplasty. The brow tip aesthetic lines (a term used to describe how the nose presents in the context of the eyes and the rest of the face) is improved. The frontal view also demonstrates the slight refinement of the nasal tip.
The right oblique view illustrates the improvement in the dorsum of the nose. The horizontal ridge on the before picture has been addressed. The patient also reported improved breathing.
The right lateral view demonstrates a significant divot in the dorsum of the nose resulting from the septal defect inside the nose. This divot was repaired through the use of donor rib cartilage as part of the rhinoplasty procedure. Internally the support for the dorsum of the nose and the tip was reinforced.
The post-rhinoplasty basal view is important to examine for two reason. Firstly, this rhinoplasty was performed by an external approach, which involves a small incision in the part of the nose between the nostrils called the columella. This incision has healed very well and is essentially invisible. The basal view also nicely demonstrates the increased tip projection, the tip has been projected further from the face. Please also note that the shape of the nostrils is improved, with a rounder, less-oval configuration of the nostrils.