Female Rhinoplasty*
3 week before and after pictures of a young lady who underwent reconstructive rhinoplasty, septoplasty and endoscopic sinus surgery. Rhinoplasty was done using a closed no scar approach. A tip supporting graft strut was placed retrograde via the internal septoplasty incision. As can be seen in the after pictures a moderate size dorsal hump was removed to give a more pleasing profile.
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.
Examples of some of Dr. Scaccia’s surgical results. All photos are untouched and shown with patient’s permission. Disclaimer: Results may vary*
Female Rhinoplasty*
5 month follow up for a rhinoplasty and septoplasty and sinus surgery patient. Small dorsal hump was removed and tip was narrowed and refined.
Female Rhinoplasty*
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.
Female Rhinoplasty*
3 month post op of patient who underwent surgical contouring of her nasal profile and tip modifications.
Female Rhinoplasty*
3 week postop views of a young lady who had refinement and narrowing of a bony cartilaginous hump
Female Rhinoplasty*
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.
Female Rhinoplasty*
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.
Female Rhinoplasty*
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.
Female Rhinoplasty*
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.
Female Rhinoplasty*
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.
Female Rhinoplasty*
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.
Female Rhinoplasty*
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.
Female Rhinoplasty*
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.
Female Rhinoplasty*
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.
Female Rhinoplasty*
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.
Female Rhinoplasty*
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.
Female Rhinoplasty*
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.
Female Rhinoplasty*
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.
Female Rhinoplasty*
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.
Female Rhinoplasty*
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.
Female Rhinoplasty*
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.
Rhinoplasty, Neck Lift, Chin Implant and Lip Enhancement*
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.
