Examples of some of Dr. Scaccia’s surgical results. All photos are untouched and shown with patient’s permission. Disclaimer: Results may vary*
Male Nasal Sculpturing*
Very early 3 week post op pictures of a young man that underwent reduction rhinoplasty which included removal of a nasal hump, straightening of a crooked nose, improvement of breathing by a septoplasty and partial inferior turbinectomy, correction of webbing below the nostrils as seen on profile , refinement of columella nostril show, and support, narrowing and correction of asymmetries of the tip.
Male Nasal Sculpturing*
1 week post op rhinoplasty with narrowing and correction of tip deformities. Swelling still very evident.
Male Nasal Sculpturing*
1 week post op rhinoplasty that involved extensive Tip contouring with cartilage grafts below tip to expand retracted nostrils. Small hump removed with narrowing of nose and nostrils too.
Male Nasal Sculpturing*
3 month post op of patient who presented with a severely deformed nose which included a depressed right nasal bone, a twisted tip, boney cartilaginous hump, obtuse nasolabial angle and extremely deviated septum. Complete reconstruction of the septum was done along with bony cartilaginous repair and multiple cartilaginous grafts were placed including a right spreader graft and right alar grafts.
Male Rhinoplasty*
3½ months post op photos of a young man who underwent open rhinoplasty to correct an over projected and bifid split tip. Double alar cartilaginous grafts were placed over the right concave tip segment for symmetry to other side. A cartilaginous spreader graft on dorsum was also placed with bony reduction above it. Patient had trauma to nose prior to surgery causing a severe caudal septal deflection that required almost complete removal of septum with reconstruction replacement to open his airway.
Male Nasal Sculpturing*
7 week post operative views of a young man who underwent corrective rhinoplasty to eliminate a small nasal hump, narrow the tip, and to lift the tip to a more pleasing angle so that a small amount of the nostrils are now visible.
Male Nasal Sculpturing*
Three week postoperative view of a middle age man who underwent septoplasty, reconstructive rhinoplasty and sinus surgery. He had suffered trauma to his nose at a very young age and was unable to breathe through his nose, especially on the left side, because of the severe deflection of his septum that was not only evident on the right but was severely deflected caudally towards the end of his nose as can be seen in the preoperative picture where his deviated septum is obstructing his left nostril. Because of the location and severe angularity of his deflected caudal septum, a routine septoplasty was not possible. The patient required correction of almost his entire cartilaginous septum that was then reshaped into a straight strong piece of cartilage that was replaced in-between the mucus membranes of his septum and secured between the medial crura cartilages between his nostrils. This resulted in a straight septum that totally relieved his obstruction of both nasal cavities and gave a more symmetric open appearance to both nostrils. It also lifted up his tip and gave him more support. Because of privacy issues, the patient is only allowing this subnasale view of his nose, however the entire nose on all views was improved in both appearance and function.
Male Nasal Sculpturing*
Very early three day postoperative view of a 13-year-old male who presented with a severely twisted lower half of his nose and severe nasal obstruction secondary to an extremely deviated septum and hypertrophic inferior turbinates, worse on the right. The internal external deformity was believed to be secondary to trauma that he experienced when he was six-years-old to his nose. As a result, he experienced a small amount of bony deviation but mostly cartilaginous deviation of his dorsal, caudal and posterior septum. The surgery was mostly done for nasal obstruction with the hopes of correcting his external deviation at the same time. It was thought that in order to fully correct his deviated septum and C-shaped curved deformity of his nasal dorsum that possibly an open rhinoplasty approach would be needed in order to totally correct the septum, reshape it and replace it in a more anatomically correct position. However after performing a totally aggressive endonasal septal approach and correcting part of the septal septum and freeing the septum from the lower edge of the maxillary crest, the dorsal aspect of the nose relocated to a more midline position without having to resort to opening up the nose and performing a rhinoplasty in order to totally correct the septum. A portion of the caudal septum that was corrected was replaced with some of the posterior septum that was corrected and placed as a midline graft between the medial crura at the base of his nose. This was secured to the remaining remnant of his cartilaginous septum. In addition, turbinectomies were done and sinus surgery was also done for a chronic sinus condition where pus was released from his right sinus cavities. The result was widely patent nasal airways on both sides and a much straighter nose that was successfully done through a totally endonasal approach that mostly addressed his deviated septum.
Male Nasal Sculpturing*
Two-and-a-half month postoperative views of a young man who underwent reconstructive rhinoplasty along with septoplasty and inferior turbinectomy. As can be seen in his preoperative pictures, the patient had somewhat of a twisted nose to the right with a depression and concavity on the mid left lateral sidewall. He also had a very prominent dorsal hump composed of mostly cartilage and also some bone. This was corrected by correcting the bony cartilaginous hump and placing a cartilaginous onlay graft intranasally into the left depressed mid section of his nose.In addition as can be seen on his lateral view, the patient had significant columnella caudal show which was corrected by correcting excessive caudal septum and mucosa so that a more pleasing nostril alar rim symmetry could be obtained. In addition, his breathing was improved by a septoplasty, turbinectomy and valve support from the cartilaginous onlay graft.
Male Nasal Sculpturing*
4 weeks postoperative pictures of a man who underwent reconstructive rhinoplasty, septoplasty and turbinectomy. He has a history of significant trauma to his face, including a nasal fracture several years ago. In the preoperative pictures, you can notice some twisting of the tip with a depression in the left tip and mid vault area. He also had a prominent cartilaginous bony hump that can be seen on profile. After performing a septoplasty and turbinectomy to improve his breathing, the rhinoplasty part of the procedure was then performed entirely endonasally with no outside incisions. The nasal hump was corrected for a more pleasing, straighter profile. A large piece of cartilage that was harvested from his septum during the septoplasty was then fashioned into a graft that was placed endonasally on the left side to fill in the depression to give the lower third and mid third of the nose an allusion of being more symmetric and straight.
Male Nasal Sculpturing*
Two month postoperative view of a young man who underwent reconstruction of some congenital deformities of his nose. In addition, he had a severely deviated septum to his left from previous trauma that was successfully corrected. The septal cartilage that was corrected from his deviated septum was then used to reconstruct his nose. He had poor tip support and a twisted tip to the right and a bifid tip that caused a split between his two cartilaginous domes. As you can see in the postoperative pictures, his nose was considerably straightened by performing a left osteotomy and performing open rhinoplasty and repositioning all of his deformed cartilages. A strut was placed between his domal cartilages to re-support the tip. A shield graft made of septal cartilage was also placed to help increase tip projection and definition and to camouflage and fill in his bifid tip deformity as can be seen in his before frontal shot with an indentation in the lower part of his tip. Also, as can be seen in his before lateral picture, severe webbing in his upper lip region causing an over-projected nose was corrected by correcting part of his nasal spine and cartilaginous caudal end of his septum. The nasal hump composed of cartilage of bone was also corrected. His nose is now more refined but yet still masculine. Improvements will continue as swelling subsides over the next several months.
Male Nasal Sculpturing*
Very early three week postoperative view of a young man who underwent reconstructive rhinoplasty and correction of a deviated septum and hypertrophic turbinates. As can be seen in his after pictures, his mildly deviated and broad tip were straightened and narrowed. On lateral view, his nasal bony and cartilaginous hump was corrected but yet still maintained a strong masculine profile with correction of a pollybeak deformity along with increased sculpturing and definition of his previous blunt tip. The nose is now more defined. Webbing in the upper lip area was also corrected. The caudal lower end of the septum was shortened to have less nostril show. Weir excisions were done to help narrow the nasal base. No osteotomies or breaking of the nasal bones were necessary as it was felt that his nose was narrowed enough on head-on view. Additional improvements and definition will be apparent as swelling further subsides over the next several months.
Male Nasal Sculpturing*
Six week post-operative view of a male who underwent rhinoplasty to correct significant nasal deformities present since childhood as a result of trauma to his nose. As can be seen in his preoperative pictures, multiple deformities were present, which included a severely crooked nasal dorsum to the left and a twisted asymmetric nasal tip and bifidity of his nasal tip. As can be seen in his post-operative pictures, he successfully underwent correction of all these deformities with straightening of his nose and realignment of his alar cartilages using a combination of suture and graft techniques. Multiple onlay cartilage grafts were placed over the deficient areas and in his right alar tip. An onlay cartilage graft taken from his septum was placed over the right mid dorsum of his nose to help camouflage a depression in that area. A tip graft was also used to help camouflage and correct the bifidity of his tip. In addition, he underwent chin augmentation to better balance the lower third of his face.
Male Nasal Sculpturing*
Early 10-day post-operative result of a young man who underwent a reconstructive correction rhinoplasty and chin augmentation. As can be seen on his lateral profile, a moderate cartilaginous and bony nasal hump was corrected to create a more pleasing and straighter dorsal profile. In addition, nostril show was also slightly corrected to improve nasal appearance. The nasal tip was also refined utilizing suture and tip grafting techniques. Small alar wedge resections were also done to correct flaring nostrils. The nose is more defined and structured in appearance but yet still maintains masculine qualities. In addition, notice the improvement in chin projection as provided by a silastic implant that was placed through a submental incision. Care was taken not to over-project the chin as the patient already had a pre-existing deep sulcus below the lower lip and efforts were made not to over-exaggerate this.
Male Nasal Sculpturing*
Very early 12-day post-operative result of a young man who underwent reconstructive rhinoplasty and chin augmentation. As can be seen, especially on his lateral views, a large dorsal, bony and cartilaginous hump was corrected, excessive nostril show was corrected and a cartilage tip graft was placed to help prevent over-rotation of the tip. In addition, the full nasolabil angle was corrected and brought back to allow for a more pleasing lip/nose junction. An extended medium-sized pre-jowl implant was placed through an external approach to allow for a very subtle but more contoured jawline. “Worm’s-eye” base view demonstrates a more symmetric tip and nostril appearance. The external columella scar which was utilized for this open approach is barely visible even at 12 days. Some residual swelling and echymosis (black and blue) can still be seen around his eyes in these early post-operative views, but should resolve shortly.
Male Nasal Sculpturing*
Two month post-op result of a male correction rhinoplasty. Nose now appears straighter and more balanced on frontal view. Tip definition is beginning to appear but will improve as swelling subsides months later. Lateral view demonstrates better profile alignment with correction of hump but with maintenance of masculine features. End of nose was also shortened to make nostrils less apparent on side view.
Male Nasal Sculpturing*
Dramatic but natural appearing correction of nasal hump appreciated best on side view. Decrease in bulbousity of nasal tip also performed. Note lack of significant swelling or bruising seen at one week post-op (middle picture) immediately after cast and tape corrected from nose. Meticulous surgical technique allows for quick recovery. On “worm’s-eye view,” note correction of uneven nostrils which is important for obtaining natural balanced result.
Male Nasal Sculpturing*
Hump correction and narrowing of middle third sidewall region. Note also improvement in skin quality secondary to acne therapy.
Male Nasal Sculpturing*
Small nasal hump correction and minimal tip work done to refine nose but yet maintain strong masculine characteristics.
Male Rhinoplasty, Chin Augmentation, Neck Liposuction, Buccal Fat Extraction*
Cartilate graft from inside the nose taken to improve his breathing were saved and then used later as tip graft (triple layer) to correct “turned up” appearance at the end of his nose. The tip was also softened and blended into the rest of his nose. A small dorsal hump was rasped and nostrils narrowed. The rhinoplasty complimented the other procedures he had done.
Male Nasal Sculpturing*
Finesse rhinoplasty in young man who desired subtle changes in the appearance of his nose. Five week post-op view with some swelling still evident. Note improvement in lateral view with correction of bony and cartilaginous hump while maintaining strong masculine appearance.
Male Rhinoplasty*
Congenitally deformed tip with asymmetric nostrils corrected with cartilage grafting. Three week post-op result still swollen but depicts a straightened and more natural nose.