Female Rhinoplasty

Three month post op views of a young lady who underwent reduction rhinoplasty that included removing a small dorsal hump of bone and cartilage and also narrowing of a bulbous boxy wide tip . The tip was narrowed using a combination of conservative cartilage removal and spanning and domal sutures to obtain a more pleasing feminine tip that is natural in appearance and not overly pinched.

45 year old lady 4 weeks post op rhinoplasty and septoplasty. Multiple septal cartilage grafts were used to widen and straighten mid portion of her nose and also to fill in depressions and sculpture her tip. Notice improvement in dorsal hump and excessive nostril show.

3 month post op of patient who underwent surgical contouring of her nasal profile and tip modifications.

3 week postop views of a young lady who had refinement and narrowing of a bony cartilaginous hump

5 month post op for a young lady who underwent nasal refinement to smooth a small dorsal bump, straighten a crooked nose, and narrow a broad tip. A subtle upper and lower lip augmentation was also done.

3 week post view of a middle age lady who underwent rhinoplasty that involved bony dorsum improvement, tip retropdisplacement and refinement, and cartilaginous graft augmentation to lower half of dorsum, strut support to raise droopy tip, and plumping grafts to angle below nose columella.

Early 3 week postop result with moderate swelling obvious still on frontal views. A one sided cartilaginous spreader graft placed to widen and straighten mid portion of nose. Lateral view demonstrates improvement in bony hump and less caudal nostril show.

4 week postop view of young lady who had removal of bony and cartilaginous hump which can be appreciated on side and 3/4 views. Tip was also slightly raised and narrowed but with moderate swelling still present.

Early six week postoperative view of a young lady who underwent a reconstructive rhinoplasty which included improvement of both her nasal profile, frontal view, oblique and submental bird’s eye view. As can be seen in her frontal picture, there is more narrowing and refinement of her nasal tip which will continue to improve as swelling subsides. On the profile view, the bony cartilaginous hump has been lessened and smoothed for a more pleasant, elegant look. Her bird’s eye submental view demonstrates conversion of her boxy tip to a more tripod narrowed tip with an improvement in nostril asymmetry. The open rhinoplasty scar is still somewhat visible at these early stages but will with time almost completely disappear.

18 month post-op view of a young lady who underwent cosmetic rhinoplasty that included correction of a bony cartilaginous hump and narrowing of her nose. Patient was so happy with the final appearance of her nose that she shared her wedding photos with us.

Three week postoperative view of a young lady who underwent correction rhinoplasty, septoplasty and bilateral inferior turbinectomy. She was not concerned about the appearance of her tip and for this reason it was not surgically altered during the procedure. She underwent a closed/endonasal rhinoplasty which involved correction of her bony and cartilaginous hump as can be seen on her profile and three-quarter view and also a slight correction in columella show which allowed a mild decrease in the amount of nostril show on lateral view and a more pleasing nasolabial angle. Since preoperatively her nose was straight and there was no manipulation of the tip, pre and post frontal views demonstrate minimal change. All of the obvious improvement in her nasal appearance can be seen on the lateral and three-quarter views. As she is still early in her postoperative healing, the nose will continue to define and narrow in appearance.

Very early 12 day postoperative result of a young lady who underwent correction rhinoplasty, septoplasty and inferior turbinectomy. As seen in her preoperative pictures, the nasal deformity included a prominent cartilaginous nasal hump and over-projected, under rotated bulbous tip with a resulting short white upper lip deformity. Utilizing an open rhinoplasty approach, the patient can be seen in the postoperative pictures to now have a more pleasing aesthetic profile with the correction of the bony cartilaginous hump. The tip is now raised and debulked in a more elegant and natural fashion. In addition, the face appears more balanced from lifting up the tip as more of her skin between the nose and vermillion border of the upper lip is now visible with a hint now of some nostril show. There is also some mild swelling towards the top of the nose between the eyes as a result of correcting bone in that area which will dissipate with time. The patient has also noted significant improvement in her breathing.

Six week postoperative view of a young lady who underwent correction rhinoplasty, septoplasty, turbinectomy and endoscopic sinus surgery. As can be seen in the postoperative pictures, on frontal view her nose is now straighter. The tip is lifted and less bulbous. The tip will continue to narrow and define as it heals over the next few months. On profile, her bony cartilaginous hump was corrected to a more aesthetically appealing profile which also again is demonstrated on her three-quarter view. In addition, her breathing and sinus symptoms have significantly improved.

Three week postoperative views of a young lady who underwent aesthetic rhinoplasty and septoplasty and turbinectomy. As can be seen in her preoperative pictures, the patient was unhappy with the appearance of her nose because of a moderately size dorsal bony cartilaginous hump, a mild boxy wide tip, slight over-projection of the nose mostly related to excessive nasal spine protuberance and a deviated cartilaginous septum that could be seen extending caudally into her left nostril. An open rhinoplasty was performed along with a septoplasty and partial inferior turbinectomies to improve her breathing. As demonstrated in the postoperative pictures, it is already obvious in this early postoperative period that her nose is more aesthetically pleasing with more attractive contours and more proportionate to the rest of her facial features. Her transcolumellar incision used for the open rhinoplasty is still visible but healing well and should be almost invisible when healed. No cartilaginous grafts were necessary or utilized for the procedure.

Preoperative and only 13 day postoperative views of a young lady who underwent correction rhinoplasty along with septoplasty, turbinectomy and endoscopic sinus surgery. As can be seen in the preoperative pictures, on frontal view her tip was somewhat twisted with a hanging medial crura to the left and a mildly deformed bulbous tip. Lateral view demonstrates a moderately sized cartilaginous bony dorsal hump and excessive nostril/columella show. Postoperatively, we can see even at this early stage of healing all these issues have been corrected. By performing an open rhinoplasty approach and an internasal septoplasty, her nose has become not only more proportioned and straightened in the upper two-thirds of her nose but also in the area of her tip and nostrils. The caudal septum was slightly shortened to allow for a more aesthetically pleasing alar columellar vertical distance. The tip is now thinner and more symmetric and the medial crura had been trimmed and repositioned into a more proportioned alignment. The dorsal bony hump was corrected and osteotomies were done to infracture and narrow the nose. No tip grafting was necessary in this case. In addition to improving the aesthetic appearance, the surgery has also benefitted her functionally by opening up her airway and correcting sinus congestion, headaches and postnasal drip that she previously suffered from.

Two year postoperative view of a young lady who underwent correction rhinoplasty along with a septoplasty, turbinectomy and sinus surgery. As can be seen in her preoperative photographs, the patient had a moderate sized bony cartilaginous dorsal hump. Her entire nose from the nasion down to the tip was deviated to the left. Her bony hump was somewhat asymmetric and more prominent on her right side. The patient underwent a correction rhinoplasty which involved cartilaginous and bony hump correction and osteotomies to narrow and straighten the nose. No tip work was necessary as her preoperative natural tip was already quite symmetric and aesthetically pleasing. In addition to the cosmetic improvements, her chronic sinus condition and breathing are much improved also.

Five week postoperative view of a young lady who underwent reconstructive rhinoplasty along with septoplasty, endoscopic sinus surgery and inferior turbinectomy. In addition, she also had Juvéderm injections to her upper and lower lips. As can be seen in the before images, her nasal deformities included an over-projected bulbous tip with a small cartilaginous bony hump with excessive caudal/nostril show. She also had significant breathing problems, especially on the left side, chronic sinusitis and nasal polyps. The patient underwent an open correction rhinoplasty that involved trimming, rotation and correction of her cartilaginous tip with further correction using a spanning suture and a small cartilaginous tip graft taken from her septum. A small bony cartilaginous hump was also corrected along with osteotomies. As can be seen in the five week postoperative image, the bulbosity of her tip and over-projection of her tip has been corrected. The overall shape and profile of her nose is more aesthetically pleasing and conforms to the shape of her face. She was also pleased with the increased projection and volume of her upper and lower lips and the improvement in her breathing and sinus symptoms.

Very early two week postoperative view of a young lady who underwent correction rhinoplasty along with septoplasty and turbinectomy to correct her breathing. No tip work was performed as the shape of her tip was quite acceptable preoperatively. On lateral view, an obvious bony cartilaginous hump was noted and corrected to a more aesthetically pleasing profile. In addition, her nasolabial angle connected to the bottom of her nose to her upper lip was quite obtuse and full and this was corrected by correcting some caudal septum and nasal spine. In addition, as can be seen on the bird’s-eye view, her deviated septum extended into a caudal dislocation into her left nostril which was successfully placed into the midline to improve her breathing on the left side of her nasal cavity which resulted in symmetrically shaped nostrils. The patient is still quite swollen especially around the bridge of the nose from the osteotomies that were performed to narrow it. It will continue to narrow and define over the next few weeks to months.

Three week postoperative views of a young lady who underwent rhinoplasty, septoplasty, turbinectomy and functional endoscopic sinus surgery. As can be seen in her preoperative views, the patient presented with a boxy wide tip that lacked support and drooped especially when smiling. She also had a wide dorsum with a prominent bony cartilaginous hump. Aggressive narrowing of the tip was done by resecting cartilage from the tip and using tip suturing techniques to help shape the nose into a more trapezoidal structure. In addition, cartilaginous grafts harvested from her septum were used to construct a strut to help support the tip along with a tip graft to add definition to her tip. As can be seen in the postoperative views, her tip is more narrowed, triangular in shape and lifted so that there is some nostril show from the anterior frontal view. Attempts were also made to deepen her nasal frontal angle just below the eyebrows, although this is a difficult area to treat because of dense bone. There is still significant swelling in that area which should resolve with time. Her dorsum is also somewhat swollen but improvements in correction of the bony cartilaginous hump are already evident. Base view demonstrates improved symmetry and shape of her nostrils with repair of a dislocated caudal septum into her left nares. An open rhinoplasty approach was used with an incision made in the middle of her columella which even at three weeks it is barely visible. The appearance of her nose will continue to improve after the next few months. In addition, her sinus symptoms and breathing are quite improved already.

Six week postoperative view of a young lady who underwent a correction rhinoplasty to improve the appearance of her nose and a septoplasty and turbinectomy to improve her breathing. In addition, a cartilaginous strut graft taken from her septum during the septoplasty was used to help lift up the tip to not only improve her breathing by opening up her nostrils and nasal valve but also to give more support to her drooping tip and more nostril show as seen in the lateral views. Postoperatively you can also see a correction in her moderately size bony cartilaginous hump, a smoother, femininely contoured profile. A dome correction along with spanning sutures were used in the tip to both decrease the projection of the tip from the face and also to narrow the tip cartilages as can be seen in her frontal AP views. Her nostril skin was not narrowed. All narrowing was done by correcting, debulking and suturing her nasal tip cartilages. Her tip definition and overall appearance of the nose will continue to improve as swelling subsides over the next few months.

Three week postoperative view of a young lady who underwent multiple procedures including reconstructive rhinoplasty, septoplasty and adenoidectomy and turbinectomy to improve her breathing, upper lip vermilion border lip lift, chin implant and neck liposuction and submental neck tuck. As can be seen in the preoperative pictures, the patient presented with a markedly deviated nose to the right probably secondary to a prior fracture with a small bony hump and spicules. She also had a depression in the mid vault of her nose on the left side with narrowing of her mid vault region as seen on the three-quarter view. She also had a small upper red mucosa of her lip, elongated white upper lip region between the red lip and the base of her nose. She also had somewhat of a mildly recessed chin and submental neck fat hypertrophy. It was felt that her neck was not only in the subcutaneous compartment but also in the deeper facial planes of the submental area underneath the platysma. For this reason it was felt that both liposuction of the neck and a submental neck tuck with deep fat correction and platysma muscle suturing was necessary. Her rhinoplasty involved correcting a small bony hump and placing a cartilaginous graft over her left mid vault depression. The lip advancement was done by excising 4.5 mm of upper lip skin to make her upper lip more in proportion with her lower lip and the rest of her face. A nice Cupid’s bow was also developed. A small extended prejowl implant was placed through the submental incision and the submental neck tuck as previously described was done. As can be seen in the postoperative pictures, she now has a more pleasing appearance to both her profile and frontal views of her face. Her chin, neck, upper lip and nose have more pleasing contours now and in balance with all three zones of her face. In addition, her breathing is significantly improved after correcting the deviated septum and performing the inferior turbinectomy and adenoidectomy. Her appearance will continue to improve as she is only at a three weeks postop.

Six month postoperative view of a young lady who underwent septorhinoplasty with functional endoscopic sinus surgery and liposuction of the neck. As can be seen in her side profile, a prominent dorsal cartilaginous bony hump was corrected to give her a more aesthetically pleasing profile. In addition, she was noted preoperatively to have over-projection of her tip secondary to excessive nasal spine bone in her upper lip. This was corrected to set back the nose at the base of the nostrils, again to enhance the appearance of the nose. Her wide amorphous tip was also narrowed to a more pleasing triangular configuration. Liposuction of her neck was also done through a single quarter-inch incision in the submental area to correct excessive fat in her upper and mid neck. This helped contour and delineate her mandible in a cervical mental angle. She was very happy with her aesthetic result and improvements in her breathing and sinus symptoms.

Four week postoperative view of a young lady who underwent correction rhinoplasty. As can be seen in the postoperative views, she presented with a prominent bony cartilaginous dorsal hump and a moderately broad bulbous tip. The goal of surgery was to correct the hump and to narrow the tip without rotating the tip any higher than it presented preoperatively. This required the placement of a double tip graft constructed from her own septal cartilage to add more definition and prevent upward rotation of her tip and maintain her natural nasolabial angle. As can be seen in high in the nasal frontal area of her nose, there is still some considerable swelling causing some blunting of the angle, however this should resolve with time and eventually she will present with a more acute starting angle of the dorsum of her nose. She is already breathing much better from her septoplasty and partial turbinectomy.

Six week follow-up of a lady who underwent FINESSE correction rhinoplasty, septoplasty and turbinectomy for her nasal obstruction. The patient was in need of only minor refinements of a slightly bulbous tip and dorsal bony cartilaginous hump. In addition, her nasal obstruction on the left side was secondary not only to a deviated septum and swollen turbinates but she also had a collapsing left nasal valve that was addressed with a batten graft of cartilage placed over her weakened left alar cartilage. Her dorsum was also noted to be somewhat asymmetric and she required only a left osteotomy with nasal bone infracture. She also required a strut to help support the tip. As can be seen in the early postoperative pictures, her tip is now more symmetric and defined and the small bump on the dorsum of her nose is now gone.

Six week postoperative view of a young lady who underwent Finesse correction rhinoplasty.

As can be seen in her preoperative pictures, the patient presented with only a mild bulbosity of her nasal tip and a small dorsal bony cartilaginous nasal hump. This required refinement of the nasal tip using a double-dome and spanning suture technique with a conservative correction of tip cartilages. No tip grafting was necessary. She also had a small hump correction of both bony and cartilaginous tissue to help correct the small projection on her lateral view. Her more refined and narrowed tip can be observed both on frontal and three-quarter view where the domal highlights are now more closely approximated. In addition, she underwent functional corrective surgery for her impaired breathing and chronic sinusitis.

Very early two week postoperative views of a young lady who underwent correction rhinoplasty. As can be seen in the preoperative picture, she had a congenitally large nose with a very prominent bony cartilaginous dorsal hump and a long ptotic tip whose downward slant was accentuated with smiling. Her nose was also wide and her breathing was obstructed secondary to a deviated septum. As demonstrated in the postoperative pictures, the nasal hump is now gone, the tip is now rotated into a more pleasing position so that a hint of nostrils is now apparent on AP straight image and the nose is more feminine and aesthetically balanced to her face. Her breathing is also much improved since a septoplasty and turbinectomy were also performed during this procedure. There is obviously still significant swelling throughout her nose and inflammation around the incision that was made in her mid columella for the open rhinoplasty approach all of which should improve over the next few months.

A young lady with before and after photos demonstrating correction of nasal deformity that resulted from both trauma to the nose and underlying congenital aesthetic issues. As can be seen in the preoperative picture, the patient had a prominent dorsal bony cartilaginous hump and deviation of the bony cartilaginous dorsum to her left. She also had somewhat of a wide bulbous tip that was ill-defined. In the after pictures, you can notice that the nose is now midline, the bony cartilaginous hump has been corrected to a more aesthetically pleasing feminine profile and her nasal tip has been narrowed, slightly lifted and defined. A cartilaginous tip graft harvested from her septum was utilized to help provide more support and structure to her tip. In addition, her breathing was improved with a septoplasty and partial turbinectomy. The patient is only six weeks postop and will continue to improve as swelling subsides.

Before and after photos of a young lady who underwent a correction rhinoplasty and chin augmentation. The patient was also unhappy with her breathing and sinuses and that was corrected at the same time with a very successful outcome. As can be noted on the preoperative exam, especially on the anterior view, you can notice that she had somewhat of a small chin and her face was out of proportion with the lower third of her face being not harmonious with the dimensions of her upper and middle third of her face. Also, the lateral view depicts a weak chin that was mildly behind the ideal projection line which is up to the vermilion border of the lower lip. Her nose had a small dorsal cartilaginous bony hump and bulbosity. She was happy with the angle of her tip and desired to have only minimal elevation of the nasal tip. It was thought that her rhinoplasty would result in greater than desired rotation of her tip upwards unless a septal cartilage tip graft was placed at the end to counteract this. This was done during the surgery which added a slight amount of bulbosity to the tip but yet prevented her from being rotated excessively in the postoperative period. She was very happy with the result. As you can see in the postoperative results, her nose has a more elegant feminine dorsal appearance. The tip is not excessively rotated. It is still somewhat swollen at two months and should continue to improve and now she has harmonious balance between the lower portion of her face, chin/mandible area in relation to her mid-face and forehead because of the chin implant that was placed.

Pre and postoperative views of a young lady who underwent a correction rhinoplasty for a mildly crooked nose with a small, subtle bony cartilaginous hump. As can be seen in the postoperative views taken at three weeks, her nose appears much more symmetrical and straight in the frontal shots and three-quarters view. The bony cartilaginous prominence noted in the mid portion of the dorsum of her nose is now smooth and straight. Lateral side shots demonstrate a conservative correction of the bony cartilaginous hump. This was all done using an open rhinoplasty approach to help obtain the narrowing and subtle corrections that were necessary to improve the appearance of her nose. In addition, the patient obtained improvement in her breathing from a septoplasty and turbinectomy that was done at the same time.

Three month postoperative view of a young lady who underwent correction rhinoplasty.

As can be seen in the postoperative pictures, a small bony cartilaginous dorsal hump was corrected to help soften and feminize her profile. Her tip was modestly debulked and narrowed.

A double tip graft utilizing her septal cartilage was also used to add definition to the end of the tip and to prevent any unwanted upward rotation at the tip as preoperatively she already had some pre-existing upward tip rotation. The placement of the tip grafts was to prevent any further rotation during the surgical tip maneuvers. The patient was also quite pleased not only with her aesthetic result but her functional ability to breathe much easier as a septoplasty was done to straighten out her septum and partial turbinectomies were done to correct the size of her turbinates.

Very early eight day postoperative view (immediately after cast correction in the office) of a young lady who underwent correction rhinoplasty. As can be seen on the lateral view, the patient presented with a very large dorsal bony and cartilaginous hump which was successfully corrected. She also had a high nasal frontal angle which was corrected, although there is still some evidence of swelling in that area postoperatively. Excessive caudal septal show which resulted in slightly enlarged nostrils was corrected as can be seen on the lateral view also. The frontal view demonstrates a more narrowed and defined tip that is mildly lifted into a more aesthetically pleasing fashion. Her nose also appears straighter. The bifidity between her tip domes has been corrected and her nasal obstruction has been corrected and her breathing has improved.

After eight days, she has minimal bruising around the eyes and nose due to a meticulous technique. Residual swelling has resolved after two months.

Three month postoperative views of a teenager who underwent correction rhinoplasty. As depicted in her postoperative pictures, surgery included correction of a bony cartilaginous hump, elevation and narrowing of her bulbous tip elevation and narrowing of the nostrils. The procedure was done via an open rhinoplasty approach where her lower lateral cartilages were trimmed and multiple suture techniques, including a spanning suture, were used to help narrow her strong bulbous tip. Because her nostrils still flared at the end of the procedure, modified Weir excisions were done to narrow the base of her nose. A slight prominence was left on the dorsum of her nose to balance out her strong chin. In addition, a septoplasty and turbinectomy were done to improve her breathing. Her nose is now more elegant and appropriate for her face and although a significant amount of work was done, she still maintains a very natural appearance.

Early five week postoperative result of celebrity reality star, Amy Fisher, who underwent a revision rhinoplasty. Amy had her original nasal surgery many years ago by another surgeon and was never happy with the appearance of her nose and breathing. It was determined that her nasal functional obstruction was due to a combination of enlarged hypertrophic turbinates and some collapse of her external nasal valve due to over-resection of her tip cartilages from the previous surgery. Because she did not have adequate septal cartilage available due to her prior surgery, her own ear cartilage was harvested so that it could be used in the reconstruction. An open rhinoplasty approach was used so that a more accurate assessment and treatment could be used. She was noted preoperatively, as can be seen on her frontal view, to have collapse and pinching of her alar tip, retraction of her nostril rims and a noticeable bossae of her right tip cartilage. This was causing asymmetry of her tip with an outward prominence and irregularity of her tip. This was corrected by correcting the distorted and abnormally shaped underlying tip cartilages and replacing them with strategically shaped ear cartilage grafts that were used both along the alar sidewall and as tip grafts. As can be seen in the postoperative view, the tip is now more symmetric and straight, although there is still some swelling which has subsided as can be seen in her one year professional picture above. On the three-quarter views, her preoperative depressions and irregularities of her tip are now corrected and replaced with a much smoother and natural contour. Postoperative views demonstrate a more symmetric and natural tip and nostrils with only slight evidence of the open rhinoplasty incisional scar which is all but invisible at this time.

Very early three week postoperative view of a young lady who underwent a cosmetic rhinoplasty and septoplasty and turbinectomy for breathing issues. As can be seen in the frontal view, her nose preoperatively was twisted to the right with an over-projected hanging tip that was corrected via an open rhinoplasty approach to a transcolumellar incision that can be seen in the submental worm’s-eye view and the inverted-V scar is seen to be healing quite well and almost imperceptible even at the three week period. She also underwent a left Weir nostril narrowing because of asymmetric nostrils. That scar will also continue to heal in the months ahead. As can be seen in the postoperative view, her tip is lifted to a more elegant retro-displaced position and also narrowed and debulked. Despite thin skin, the highlights of her tip appear well defined and symmetric. Lateral views postoperatively demonstrate a shortening of her caudal septum that resulted in less nostril show and also correction of her bony and cartilaginous dorsal hump producing a more aesthetically pleasing and feminine profile. Osteotomies were done to help narrow the nose. Swelling is still obvious along the sides of her nose. As the swelling subsides, the nose will appear more narrowed as she continues to heal.

This case demonstrates the ten week postoperative result of a young lady who underwent a correction rhinoplasty and a septoplasty and turbinectomy for nasal obstruction. As can be seen from the frontal view, the patient presented with somewhat of a bulbous, ptotic, hanging tip. Her skin was thick which obscured definitions of her tip cartilages. Side view demonstrated again a weak, ptotic tip that was crowding her upper lip with an obvious bony cartilaginous nasal hump. She also had asymmetric increased lateral spread of the width of her nostrils, more prominent on the left. The patient underwent a correction rhinoplasty via the open approach with correction of the bony hump, placement of a tip graft to allow for more definition, rotation of the tip in a more upward aesthetically pleasing position along with the use of a spanning suture to help obtain maximum narrowing of the tip as can be seen in the worm’s-eye basal view. The nose is now more narrowed and defined and elegant in appearance and will continue to improve as the swelling subsides over the next few months.

Very early 17 day postoperative pictures of a young lady who underwent correction rhinoplasty.

As can be seen in the preoperative pictures, the patient had a significant deviation of her nasal dorsum to the left probably secondary to previous trauma. In addition, she had a very prominent bony and cartilaginous dorsal hump and over-projected nose with excessive caudal septal show and crowding of the upper lip. As can be seen in the postoperative pictures, although there still is significant swelling, she now has a more straight symmetric and aesthetically pleasing nose. The dorsal hump has now been corrected to a nice feminine profile slope. Her caudal septum although still somewhat swollen has been shortened, the tip has been brought back closer to her face and narrowed. Osteotomies were only done on the left side of the nose as that was all that was needed to straighten and help narrow the nose. Her breathing was also significantly improved with a septoplasty and turbinectomy. The tip and dorsum of the nose will continue to improve and narrow as swelling subsides over the ensuing months.

Two month postoperative view of a young lady who underwent reconstructive correction rhinoplasty. As can be seen in the after pictures, the patient underwent subtle significant improvement in both narrowing of her bulbous tip and correction of her prominent bony and cartilaginous dorsum. Also note in the subnasally worm’s-eye view the shape of her boxy tip was converted from a square type shape to a more pleasing trapezoidal triangular shape. Her nostrils are also more symmetric. The open rhinoplasty scar is still slightly visible but healing nicely. Also notice that her tip on the lateral view has been slightly rotated in a more upward fashion for a more feminine, elegant appearance. Further refinements will become obvious as the swelling continues to subside. In addition, her breathing has been substantially improved as she also underwent simultaneously a septoplasty and turbinectomy.

Three month postoperative views of a patient who underwent open rhinoplasty to correct multiple congenital nasal deformities. As can be seen on the preoperative views, the patient exhibited somewhat of a hypoplastic twisted tip to the right. In addition, her tip was somewhat bulbous and rotated up and she demonstrated a moderately sized cartilaginous and bony hump. Postoperatively, we successfully corrected her hump to a more aesthetically pleasing feminine profile. In addition, we narrowed her bulbous tip and prevented any further upward rotation by placing double cartilaginous tip grafts at the end of the nose. The cartilage was harvested from her deviated septum during the septoplasty that was done initially to improve her breathing. Also note the vascular telangiectasia vessel that can be seen preoperatively on the inferior margin of her left nostril which is seen in the three-quarter oblique view that is now gone after obliterating it with the radio surgical device during the procedure. Also notice the three pigmented lesions on her forehead, cheek and chin that were also corrected using a sutureless radio surgical ablation technique.

Nine month postoperative views of a young lady who underwent correction rhinoplasty. Preoperatively, the patient demonstrates mild bulbosity to her tip and a small bump/prominence to the dorsum of her nose. Because the patient’s preoperative nose only exhibited mild deformities, the surgery only required subtle changes. Anything too dramatic would have resulted in an overdone, unnatural look. As can be seen in the nine month postoperative view, her tip is now more narrowed and defined and the bony cartilaginous hump on profile and three-quarter view has been corrected to a more feminine, aesthetically pleasing profile height.

Eight month postoperative result of a young lady who underwent correction rhinoplasty.

As can be seen in the postoperative changes, only subtle refinement was necessary in order to preserve the natural beauty of her face and to improve on the aesthetic contours of her nose. A small hump was corrected. The nasal bridge and tip were narrowed, both of which can be appreciated on the lateral view and three-quarter view. In addition, hypertrophic inferior turbinates and a deviated septum were corrected to improve her breathing.

Two month postoperative views of a young lady who underwent correction rhinoplasty. As can be seen in her preoperative pictures, the patient presented with a bulbous wide tip and over-projected nose. She also had excessive caudal nostril show obvious on the lateral view. Retrodisplacement of the tip along with debulking of the tip and a modest hump correction allowed for a more refined and aesthetically appealing nose.

Two month postoperative views of a young lady who underwent a correction rhinoplasty with septoplasty and inferior turbinectomies to improve her appearance and breathing. As can be seen in the postoperative view, her previously crooked and off centered nose is now straighter and balanced. Her nose shifted to the left preoperatively causing a convexity and protuberance in her left tip area along with a lengthening and drooping of her tip. The lateral views demonstrate an over-projected tip with a moderate size hump that was successfully corrected to a more pleasing, straighter and feminine profile. Her caudal nostril size was diminished. Her tip is now more defined and symmetric with a supratip break. The overall appearance of her nose will continue to improve as lingering swelling subsides over the next few months.

One year postoperative view of a young lady who underwent correction rhinoplasty and liposuction of the neck. In addition, she had septoplasty, turbinectomy and endoscopic sinus surgery for a chronic sinus condition and nasal obstruction. As can be seen in the frontal view, bulkiness and roundness of her tip was thinned and softened for a more pyramidal and less boxy look. Lateral views demonstrate a more graceful profile as her bony and cartilaginous hump/prominence was corrected. In addition, a slight de-projection of the tip was done with a softening of her nasal upper lip angle. Bird’s-eye view demonstrates in the postoperative picture a transformation of a boxy tip to a more trapezoidal tip with improvement in the appearance and asymmetry of the nostrils by repositioning her deviated septum which was projecting into her left nostril into the midline. Because her bony nasal framework was already narrow, no osteotomies/fracturing of bone were necessary.

Early three week postoperative views of a young lady who underwent cosmetic rhinoplasty and functional septoplasty/turbinectomy to improve her breathing. As can be seen by the frontal pictures, her prominent nasal hump has been corrected, the deviated middle third of her nose has been straightened and her droopy non-supportive tip has been lifted so that a portion of her nostrils can be seen. On lateral view, you can see that her caudal septum has been shortened to decrease nostril show. On the side shot, again a more pleasing, elegant and feminine profile has been created. All of this can also be appreciated in her three-quarter views. The appearance of her nose will continue to improve as additional swelling resolves over the next few months.

Two month postoperative result that demonstrates the remarkable transformation that can occur in a highly motivated individual who undergoes a combination of successful plastic surgical procedures and follows a strictly regimented diet and exercise program. Surgically, the patient underwent a reconstructive rhinoplasty utilizing the open approach so that her asymmetric drooping tip could be lifted in a more prominent, symmetric, and aesthetically pleasing position. As noted in the preoperative pictures, her nostril openings were absent from the frontal view whereas now some visualization of the nostrils, which is desired, can be seen. In addition, her flaring nostrils, especially on the left side, were corrected with a Weir excision. The twisted C-shaped deformity of her nose is now straight in the midline. On her profile, however, we can see that there is too much nostril/columella show preoperatively and this was decreased to compliment her now more defined, stronger tip that stands apart from a lowered, more streamlined dorsum as some bony cartilaginous hump was corrected. In addition, meticulously performed neck and jaw liposuction/sculpture was done in order to refine her neck. This was all achieved through a quarter inch incision placed in her submental, under the chin, skin crease. No facelifting or other invasive type procedure was necessary as her skin retracted quite well to her underlying bone structure. Good results for this portion of her surgery was already being seen after a weekend length of time. Losing weight in the postoperative period also positively impacted her final results and is obviously partially responsible for her final outcome and its importance should not be ignored. During the same procedure, the patient also had radio surgical ablation to correct small vessels of her cheeks and to correct small protruding lesions on her chin and other areas of her face. As can be seen in her postoperative pictures, the tone of her skin is more even and healthier appearing. The patient also underwent a small amount of Juvoderm injection to her to add some more pout and bulk to her upper and lower lips. Finally, some neurotoxin was injected in the glabella and forehead regions to further smooth her forehead and to allow for some eyebrow elevation which is especially noted on her three-quarter view. The patient’s breathing was significantly improved by simultaneously performing a septoplasty and turbinectomy during the rhinoplasty procedure.

Very early three week postoperative results of a lady who underwent rhinoplasty, repair of a deviated septum, chin implant and mini-neck lift. As can be seen in the postoperative photos, even at this early stage of healing with significant edema/swelling, the face is now more symmetric secondary to the placement of her chin implant, her more sculptured neck and refined nose. A rather large prominent bony cartilaginous hump on the nose is now corrected to a more streamlined, elegant lateral profile. In addition, her droopy, asymmetric tip is now lifted into a more natural aesthetically pleasing position. Her nostrils can now be viewed partially on a frontal view. This not only improves her appearance but improves her breathing. The septoplasty and turbinectomy which she also underwent also allows for a functional improvement in her nasal airway. A customized small implant was placed to allow for more prominence in the chin area and to also allow for a better neck plateau. Improvements were made in her neck profile where we utilized direct submental liposuction and correction of fat with plication of her platysma muscles in the midline. No facelifting or incisions in the front of the ear or behind the ear were necessary, although doing this at a later date possibly could improve her neck definition even more so.

Three-month postoperative view of a young lady who underwent reconstructive septorhinoplasty. Post-operatively her tip was narrowed and converted from a boxy tip to a more pyramidal/triangular shape. The nostrils were slightly elevated so that they could be seen partially on a straight-on view. Laterally, post-operatively it is evident that her nose has been de-projected and brought back closer to her face so it is an overall shorter and less projecting nose. A small dorsal nasal hump was corrected existing of cartilage and bone. In addition, fullness in the area underneath her columella has shortened and brought back decreasing the amount of tissue below her nostrils to allow for a more elegant and harmonious flow of her nose into her upper lip.

Seven-week postoperative views of a young lady who underwent correction rhinoplasty. As can be seen in both the frontal and lateral views, the patient suffered from severe tip ptosis (droopy tip) along with overly depressed radix. As can be seen in the lateral view, the starting point of her nose is lacking bony projection and was corrected with a radix graft composed of a small piece of bony septum. In addition, her droopy tip was raised by overlapping her tip cartilages and supporting her tip with a tip graft also made from her septal cartilage. A small bony dorsal hump was also corrected and, along with the radix graft, a nice sleek but aesthetically refined feminine profile was developed.

Five-week postoperative view of a young lady who underwent a closed correction rhinoplasty procedure. Her basic deformity as can be seen on lateral profile was a prominent dorsal hump, which was corrected to give her a more aesthetic appearing profile. No tip work was necessary. Frontal views demonstrate the lack of prominence in the upper one half of her nose secondary to correction of the dorsal bony cartilaginous hump. In addition, a septoplasty and turbinectomy were done to improve her breathing.

Six-month postoperative result of one of our own employees who desired to have aesthetic improvement to the shape of her nose. As can be seen in frontal views, her asymmetric distorted tip is now corrected, more midline and elegant in appearance. On lateral views, her prominent dorsal hump has been corrected to a straighter more refined profile.

Four-week postoperative result of a young lady who underwent correction rhinoplasty. As can be seen from her frontal views, the nose was initially twisted from a previous fracture but now post-operatively it is straighter. Lateral views demonstrate a correction of a large bony cartilaginous hump and some lessening of nostril show. In addition, double tip grafts were placed at the end of the nose in an effort to prevent rotation of the tip and to actually allow some counter-rotation so that the tip of the nose does not appear overly turned up. In addition, her breathing was successfully improved with a combined septoplasty and turbinectomy.

Long-term five year postoperative views of young lady who underwent correction rhinoplasty. As can be seen by her frontal views, the tip of her nose is now lifted in a more elegant and aesthetically pleasing position. On profile, post-operative views demonstrate a marked correction in the prominence of her bony and cartilaginous dorsal hump. In addition, the overall outward projection of the tip of her nose has been set back closer to her face. Her nose is now more symmetric and proportionally sized to the rest of the features of her face.

Five month postoperative view of patient who underwent primary corrective rhinoplasty to correct a nose that was crooked and deviated to her left side. As can be seen in the post-operative pictures, after performing successful osteotomies the nose is now midline and more symmetric in appearance. In addition, on profile marked improvement can also be seen in the correction of a prominent cartilaginous and bony hump. Bird’s-eye view demonstrates a more aesthetically pleasing tip that has been deprojected and brought close to the face. The external columellar incision scar is almost absent even at this early stage of healing.

Three-month postoperative view of a young lady who underwent reconstructive rhinoplasty for a prominent dorsal hump, over-projected tip and excessive nostril exposure. As can be seen in the post-operative views, the patient now has a straighter, more narrow and defined nose with a more natural and elegant appearing tip and a more subtle nostril appearance.

Postoperative views (nine months) of young lady who underwent a correction rhinoplasty. As can be seen by her frontal pictures, the bony irregularity along the dorsum of her nose was corrected. Her broad nasal tip was narrowed and lifted. Her nostrils were also proportionally narrowed. On the lateral view, post-operatively it is evident that her nasal dorsum has been corrected by correcting the bony and cartilaginous hump. Her nostril tip and upper lip relationship is also now more elegant and harmonious.

Four week postoperative view of young lady who presented with “hanging columella” deformity. As can be noted on the frontal and side shots, the caudal “end” portion of her nose was shortened so that the lower portion of her nose looks more balanced. In addition, the nostrils were also narrowed to correct flaring. Lateral pictures demonstrate correction of small bony and cartilaginous hump to allow for more feminine and harmonious profile.