Rhinoplasty – Patient 132
A woman who first came to see us when she was 18 and had an open rhinoplasty an a chin implant. She came back to see us 9 years later, because the implant shifted slightly, which is more common when an implant is place through an incision inside the lower lip. I replaced this with a new implant placed through an incision under the chin, which allows us to anchor the implant so it will not move. She is shown then 6 months after this second procedure. So the postop views are 9 years after the rhinoplasty and 6 months after the chin implant replacement.
Rhinoplasty – Patient 131
A woman in her mid 20’s who is bothered by a dorsal hump and by fullness of the tip. She is shown before and again, 6 weeks after an open rhinoplasty. The tip will continue to improve in refinement over the next 3 years as the swelling slowly decreases and unveils the structure that we have created at her tip. She is already thrilled with her early result. She has a “weak chin” with her chin point being behind “reidel’s line”, a line drawn connecting the lips. But she has some facial asymmetry and was concerned that a chin implant might draw more attention to this.
Rhinoplasty – Patient 130
A woman in her mid 20’s who is bothered by a dorsal hump as well as a nose which is too long for her face. She has issues with breathing as well with internal valve collapse. She is shown before and again, 6 weeks after an open rhinoplasty with septoplasty and placement of spreader grafts to correct her “vestibular stenosis” or collapse of the nasal valve area. Spreader grafts are a kind of internal “breasth rite strips” . Her breathing is corrected and she loves the improved but natural appearance of her nose after surgery.
Rhinoplasty – Patient 129
A student in her later teens who is bothered by a small dorsal hump and poor projection and definition of the tip. She is shown before and again, 6 weeks after an open rhinoplasty. The tip will continue to appear more refined over the next 3 years as swelling slowly diminishes.
Rhinoplasty – Patient 128
A woman of color in her mid 20’s who is bothered by a dorsal hump and drooping of the tip. She is shown before and again, just 6 weeks after an open rhinoplasty. Already she has a nice improvement in her contour. The nasal tip will continue to improve in refinement and appearance for 3 years as swelling slowly diminishes.
Update: Our patient is now seen at 6 months. The nose continues to gain in refinement as the swelling slowly diminishes and the underlying structure that we have created is revealed
Rhinoplasty – Patient 127
A Hispanic woman in her middle 20’s who feels that her nose is “too big” for her face and does not like a dorsal “bump”. She feels that her nostrils are too big and the tip is drooping and too flat. She has had a septoplasty elsewhere in the past.
She is shown just 6 weeks after an open rhinoplasty with reduction of the dorsal hump and nondestructive tip rhinoplasty, combined with an anatomic chin implant placed through a submental incision. The tip will continue to soften and improve in definition as swelling resolves over the next 3 years. Already she has a more elegant and refined profile.
Update: Our pt is now seen 9 months after surgery and shows continued refinement as the swelling slowly diminishes. The “dorsal lines” show an elegant and straight nose from the front. The side view shows a slight elevation of the tip above the dorsum and an natural, elegant appearance.
Rhinoplasty – Patient 126
A student in her early 20’s who had nasal obstruction before surgery which caused her to snore at night and wake up with a dry mouth in the morning. She is also bothered by a dorsal “hump” and a drooping appearance of the tip of her nose. She was diagnosed with vestibular stenosis or collapse of the internal nasal valve. This can be improved temporarily with Breath-Rite” strips but can be improved surgically with the placement of “spreader grafts”. This is a strip of cartilage in the shape of a match stick that is placed between the top of the septum and the upper lateral cartilages to prevent collapse when a patient inhales through the nose. She is shown before and again, 5 ½ weeks after an open rhinoplasty with placement of spreader grafts. Her breathing is normal now and she loves the early improvement in the shape of the nose. The nose will typically continue to develop more refinement over the next 3 years a s swelling slowly resolves.
Update: At nearly 1 ½ years after surgery, the nose has gained a more refined look at the tip, as the swelling slowly diminishes and the underlying structure that we have created at the time of surgery is better revealed. We can expect this to continue to improve for about 3 years.
Rhinoplasty – Patient 125
A 13 1/2 year follow-up on a woman who was bothered by the appearance of her nose. This was before computer simulation and I have sketched out the changes that we wanted to make in a side view. She had deviation of the septum a marked collapse of the internal nasal valve ( a Breath rite strip is used to temporarily improve this sometimes). She is shown before and again, 13 1/2 years after an open rhinoplasty with bilateral spreader graft placement as well as placement of a columnellar support strut from the septum to stabilize her nasal tip. Her nose is no longer blocked and she loves the natural appearance of her nose after surgery. The dorsum is straight and the tip is refined in appearance.
Rhinoplasty – Patient 124
A woman in her mid 40’s who is bothered by drooping of the nasal tip and a dorsal hump. The tip is also bulbous in appearance. She snores and wakes up with a dry mouth in the morning. On exam she has a positive “Cottle” maneuver bilaterally demonstrated collapse at the internal nasal valve ( the area that is improved with “breath rite strips”) as well as septal deviation. She is shown before and again, 2 ½ years after an open rhinoplasty with septoplasty and correction of the vestibular stenosis with bilateral spreader graft placement. Her nasal obstruction has resolved, and she is pleased with the natural appearing improvement of her nose.
Rhinoplasty/Restylane – Patient 123
A woman in her late 40’s who was bothered by a “bump” on her left mid nose. She first noticed this after being struck by a ball in the nose a few years before. On examination she has very thin skin and has a prominent cartilage bump under the skin. A surgical rhinoplasty is an option to reshape the cartilages and add a strip of fascia from her scalp under the skin to add more thickness and help to camouflage this area. I recommended that she might try a “non surgical rhinoplasty” first with the use of Restylane injected under the skin to camouflage the area. This was done in a few minutes in the office with a topical anesthetic. She is shown 2 weeks after and has a significant improvement with ½ cc of Restylane. Although this is not permanent, it typically lasts for a year or longer in this area and is easy to repeat. She is pleased with her improvement. The nose looks straighter, and the “bump” is no longer as noticeable. The side view shows an improvement in the dorsum.