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This 21 year old lady from Pittsburgh came to see me regarding a few cosmetic complaints about her nose. She was bothered by a high dorsum, slightly bulbous nasal tip. I indicated that we could lower the dorsum, while maintaining the nasal patency and refine the nasal tip with cartilage trimming and tip suturing. As with any of the surgeries I perform, the goal is to address patient concerns without creating an “operated” or unnatural looking appearance. This patient expressed that she was basically happy with her appearance, but wanted a modest refinement of her nose, with a focus on a modest reduction in the height of her nasal dorsum.
The changes on the frontal view for this patient are modest because she was quite happy with the frontal view. This view demonstrates subtle refinement of the nasal tip and modest tilting upward of the nasal tip (the surgical term is nasal tip rotation).
In the left lateral view, the hump of the nose has been flattened into a nice, even sloop. The tip of the nose has been slightly de-projected (brought closer to the plane of the face) and marginally rotated (tilted upwards). Again, the natural appearing result produces a nose that blends harmoniously with the face, rather than distracting from it.
This second profile view is taken with the patient smiling. Sometimes the tip of the nose dips downward when a person smiles. In this case, the patient’s nose only dips slightly with smiling. None-the-less, this is improved after the surgery. The smiling view illustrates the more elegant, less obstructive interaction of the nose and the face.
This right lateral view shows the improvement of the profile of the nose. The dorsum has been reduced in height without changing her overall look. She specifically requested that we not give her a supra-tip break (a small dip in the nasal dorsum above the level of the tip). Her goal for the rhinoplasty on the lateral view was a modest reduction in the height of the dorsum.
This view illustrates the more elegant and very natural changes in the dorsum and tip of the nose. The patient has a very attractive face – the nose no longer distracts from the remainder of the face, instead it complements it.
The basal view demonstrates slight improvement in the bulbous nature of the nasal tip. You’ll note that the tip has a more pyramidal and less trapezoidal appearance in the post-rhinoplasty view. Please also note that the incision between the nostrils (this patient had an external rhinoplasty) has healed very well.