Cosmetic & Functional Rhinoplasty Surgeon, Ear Nose, Throat, Head & Neck Surgeon

Overview

Young lady with a broad nose, irregular dorsum, assymetrical columella (skin between her nostrils), dorsal hump and boxy tip. She had a very deviated septum with nasal obstruction. Had some nasal filler injected prior to seeing me to try and flatten her hump. Medium skin thickness. Left alar piercing.
No previous surgery.

She had an open septo-rhinoplasty. I took support grafts of cartilage from her native septal cartilage to reinforce her septum and straighten her nose as well as shape her tip and support her alar (Alar rim grafts). Her nasal bridge (dorsum) was lowered to remove her hump and narrowed for a more pleasing frontal aesthetic.

Photos pre and post op 10 months apart.

In the pre-op photos when tightening her upper lip her tip would droop (plunging tip/ animated tip) which was corrected and is evident in the post of photo of her smiling.

Nasal piercings are always closed with surgery and do raise the risk of infection.

Preoperative

Post-operative

Overview

Young lady with very thin skin, a crooked nose (significant asymmetry from the base and frontal views), a twisted tip, asymmetrical nostril size and shape, small dorsal (bridge) hump and a deviated septum with very poor nasal airflow. No previous surgery.

Pre and post op 9 months apart.

She had an open septo-rhinoplasty. Quite a complex reconstruction because of her asymmetry and thin, delicate structures. Septal cartilage used for grafts to strengthen and straighten the nose, especially her tip. Alar rim grafts to reposition and hold nostril / alar shape. These also help define the tip. Hump reduced but otherwise minimal bony work on the upper nasal framework. Septum straightened internally.

Still some minor post op nostril asymmetry but patient very happy with result and not interested in further refinement.

Preoperative

Post-operative

Overview

18 year old with a dramatically twisted septum and no effective airway on the right side. Resultant externally crooked nose on frontal and base views.

Pre and post op photos 9 months apart.

Had an open septo-rhinoplasty. The entire septum was removed (extra-corporeal septoplasty) reconstructed and replaced using only the patients own cartilage as grafts for strengthening (I do not use any synthetic implants or supports). The nasal tip was re-supported and the bony nasal bridge reset to the midline. I do all bony work with a piezotome (fine oscillating drill/ saw) as it allows greater control and finesse than traditional chisels and rasping.

Huge improvement in nasal airway.

Preoperative

Post-operative

Overview

Fellow who had previous nasal surgery and nasal trauma. Loss of tip support and collapse of the mid third (saddle nose). Poor airway due to collapse and septal deviation. Apparent hump in profile but actually collapse of the cartilage supports resulting in prominence and exposure of a normal bony bridge.

Pre and post op photos 9 months apart.

Open septo-rhinoplasty with use of what was left of his native septal cartilage for strengthening and support grafts as well as a small portion of ear cartilage to improve the aesthetic of his saddle nose in profile. A resultant better supported and functionally better nose. No bony work was needed. His cartilage framework just needed lifting up and strengthening.

Preoperative

Post-operative

Overview

Gentleman with past history of major facial trauma resulting in nasal deformity, obstruction and an orbital blowout fracture. Had previous nasal and sinus surgery that was unsuccessful. Issues include a combined (bony and cartilaginous) hump in profile, crooked dorsum (bridge) and deviated septum. Poor nasal airway. Mild sinus symptoms and congestion on CT scan.

Photos 13 months apart.

Had a revision open-septo-rhinoplasty and Mini-FESS (Sinus surgery performed endoscopically). Expecting to require rib cartilage but was able to find adequate septal cartilage for support graft to straighten and strengthen his nasal framework. Hump reduced and nose straightened using piezotome.

Preoperative

Post-operative

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