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Patient ID#: 2510

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This 34 year old lady from Pittsburgh was unhappy with a number of different aspects of her nose. She felt that her dorsum was high and didn’t like the small bump on the dorsum. She felt that the tip of her nose was bulbous. She was particularly unhappy with how the nose drooped, which became even worse when she smiled. She requested I reduce the height of her dorsum, give a nose a supratip break (minor upward tilt of nasal tip), remove the dorsal hump, refine the shape of her nasal tip, rotate the tip upward, and stop the tip from drooping when she smiled. he also felt that her dorsum was too high and requested a supratip break. A supratip break is a minor upward tilt of the nasal tip, which is common in Caucasian women. I discussed with her that in order to reduce the degree to which her tip droops when smiling, I would cut the depressor muscle (risks were discussed in detail). She is very pleased with her results and continues to heal nicely.

Frontal:

Please note the more refined nasal tip and slightly thinner nasal bridge on the frontal view. This view also gives a view of the slightly more rotated (tilted up) nasal tip. You’ll notice that you can just barely see her nostrils in the post-rhinoplasty picture, whereas you cannot see them at all in the pre-rhinoplasty pictures. Being able to see the nostrils (just a bit!) is more appropriate for the female nose on the frontal view.

Frontal Smiling:

The tip of the nose droops a little further when the patient smiles. This tip droop on smiling is much improved in the post-op picture.

Left Oblique:

This view quite clearly illustrates the improvement in the nasal tip and the more elegant dorsum.

Right Oblique:

This view illustrates the more elegant, less droopy tip, and the reduced height of the dorsum. Like many of my patients, this lady was interested in modest and natural appearing changing to her nose. I always tell my patients –“If it doesn’t look natural, it doesn’t look good.”

Left Lateral:

This viewpoint shows how dramatic her results were, without revealing any indication of surgery. The height of the dorsum has been reduced, and the nasal tip has been raised.

Left Lateral Smiling:

Again, you are able to see you the operation reduced the tendency of the tip to droop on smiling.

Right Lateral:

The post-rhinoplasty the reduction in the height of the dorsum, elimination of the nasal hump, the subtle rotation (turning up) of the nasal tip, the formation of a supratip break, and the slight deprojection (moving the tip of the nose closer to the face).

Right Lateral Smiling:

This view nicely shows how the drooping of the tip, particularly evident on smiling, has been significantly improved. Stopping the tip from drooping involves reducing the strength of a muscle in the upper lip that pulls the tip down.

Basal View:

Some cosmetic rhinoplasty surgeries have a functional (nasal breathing) component, in addition to simply making the nose look better. As a facial plastic surgeon, I am dedicated to trying to optimize the breathing of the nose, as well as improving its appearance. This basal view shows how the nasal septum (the part of the nose that separates the two nostrils) is leaning to the patient’s left. This deviation caused some difficulty with the patient’s breathing. You can see you the post-rhinoplasty picture shows that the septum has been placed back in the middle. You’ll also note that the incision on the columella (the skin between the nostrils) has healed wonderfully.

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