22 year old with wide nose and dorsal deformity- 6 months postop open rhinoplasty

29 year old female with large nose and dorsal deformity. Procedure perform- Closed rhinoplasty

22 year old white female 5’4” 125lbs with nasal deformity. Procedure performed- Open rhinoplasty

This is a 26 year old healthy white female. She is 5’7” and 120lbs. She was initially seen 5 years ago by an ENT for sinus headaches and was noted to have a deviated septum at the time. Unfortunately her symptoms had not improved over the years. She is a mouth breather which is worse at night. Examination showed a dorsal deformity, a wide proximal and mid third, a very bulbous tip with longitudely placed lower lateral cartilages. The internal exam did confirm the deviated septum as well as enlarged turbinates. In order to correct her problem she underwent an open septorhinoplasty with submucus resection. The dorsal deformity was taken down. She underwent the submucus resection, an infracture, repositioning of the lower lateral cartilages and the caudal septum was shortened and angulated. Her postop course was unremarkable. Examination at 2 months shows that the nose is markedly improved from both a cosmetic and functional standpoint. The dorsum is straight, the proximal portion is narrower and the lower lateral cartilage is better positioned. Her breathing is markedly improved. She is quite pleased with her results knowing that it will continue to improve over time.

This is a healthy 21 year old young woman who for several years has been bothered by the appearance of her nose. The nose itself is slightly large; it has a convex dorsum with an overhang and a bulbous tip. In order to correct this she would require an open rhinoplasty with a takedown of the dorsum, infracturing, a tipplasty with suture stabilization and slight shortening and angulation of the caudal septum. Having discussed all of the risks and benefits with her and her mom she decided to proceed. Her surgery was unremarkable as was her postoperative course. Early photos at four months show that she has achieved her desired result. The nose is smaller with a gentle angulation to the dorsum with removal of the convexity. The tip is more triangular and she has a more feminine lip columallar angle. She is quite pleased with her result and knows that this will continue to improve over the ensuing months.

This is a 16 year old young girl. She is 5’8”, 125lbs and her only pervious surgery was for her wisdom teeth. Since she was a child she has had problems breathing through her nose. She also had a significant dorsal deformity with a bit of overhang. She has been followed by ENT over the years and has been treated with sprays, antihistamines and the like without any significant improvement. Examination confirmed the dorsal deformity with slight deviation of the septum to the left and an overhanging tip. Internal exam did show the deviated septum as well as enlarged turbinates. She underwent an uncomplicated septorhinoplasty, submucus resection and cauterization of the turbinates. Her postoperative course was without incident and almost immediately she had improvement in her breathing. Photos obtained at two and a half months demonstrate that the nose is healing nicely from a cosmetic standpoint. She no longer has the dorsal deformity; the nose is smaller and more delicate. She has achieved both of her goals with significant improvement in her breathing and a more feminine appearance to the nose itself. This will continue to improve over the ensuing months and she is quite pleased with her surgical result.

This is a 19 year old young healthy girl who in 2012 underwent a septoplasty and resection of her frontal mucus seal in her home city. Since she was younger she has been bothered by the appearance of her nose. It is slightly larger than ideal, with a small dorsal deformity and slight bulbous tip. She still had some residual bowing of the septum from her previous septoplasty. In order to improve her appearance she would require an open rhinoplasty with a takedown of the dorsum, infracting and tipplasty with slight shortening and angulation of the caudal septum. Having discussed all of the risks and benefits she decided to proceed and underwent an unremarkable septorhinoplasty. At three months she is healing nicely. The nose is in good position and is now more feminine and smaller. The tip is less bulbous and will continue to soften over the coming months. She and her mom are quite pleased with her surgical outcome.

This is a 19 year old young male in good health. He is 5’6” and 145lbs, who two years ago sustained a significantly displaced nasal fracture. It was only partially set in the emergency room and since then he has been left with a markedly deviated nose and septum with a C shaped deformity and airway obstruction. Also the large size of his nose as well as the poor definition to the tip were of concern to him. In order to correct this he underwent an open septorhinoplasty, a takedown of the dorsum, infracturing, submucus resection with release and tipplasty. His postoperative course was unremarkable. Three months postoperatively he had healed nicely. The septum and nose are now straight, his breathing is improved and he is quite pleased with his cosmetic appearance.

This is a 22 year old healthy white female. She is 5’8” and 155lbs. She has had no previous surgeries. She is a non-smoker. For many years she has been concerned about her nose which she feels is more like her fathers. The nose has a convex dorsum, a little widening of the proximal third, a bulbous tip with bifidity of the lower lateral cartilage. In order to correct this we discussed an open rhinoplasty with a takedown of the dorsum, slight shorting and angulation of the caudal septum and a tip plasty. She chose to proceed and underwent an uncomplicated open rhinoplasty. Early photos taken at six weeks demonstrate that she is healing nicely and has achieved her desired result. The dorsum now has a slight angulation which is more feminine in appearance with a nice transition to the tip. She no longer has an overhang and the tip itself is less bulbous without the noticeable bifidity of the cartilages. She is quite pleased and the nose itself will continue to soften and improve over the coming months.

This is an 18 year old young woman in good health. She is 5’8” and 135lbs. Her only previous surgery was for her wisdom teeth. Since she was very young she has had a very large nose with a significant dorsal deformity and overhang. The nose is also a bit too long for her face and required more tip definition. Having discussed the risks, benefits and alternatives of surgery at length she chose to proceed with an open rhinoplasty in which the dorsal hump was removed, the tip was elevated and the nose was shortened. At the same time she had a gentle tipplasty to improve the tip presentation. Her postoperative course was completely unremarkable. Photos obtained at two months demonstrate that she has achieved her desired result. The nose is smaller with better definition and without the dorsal hump and overhang. She is back to all activities. Her breathing is normal and she and her family are quite pleased with her surgical outcome.

This is a 24 year old white female. She is 5’2” and 110lbs. She had, for many years been concerned about her nose. She is otherwise in good health with her only previous surgery being for her wisdom teeth. Examination showed that she had a small dorsal deformity with a bit of overhang, a bulbous tip and over all her nose was too large for her delicate face. In order to correct this she underwent an open Rhinoplasty with a takedown of the dorsal deformity, infracturing and a tip plasty to remove the bulbousness. Her postoperative course was unremarkable and photos obtained at six months demonstrate that she has achieved her desired result. Her nose is smaller, more delicate and raised. The tip is more triangular and much less bulbous. The appearance of her nose has significantly improved without having the appearance of a “nose job”.

This set of before and after photos features a 21 year old white female who has had no previous surgery. She is a nursing student in good health. She is 5’ 2” 120 lbs. Since she was 13 she has been bothered by the appearance of her nose. She has a significant dorsal deformity but a reasonable presentation to her tip. Her breathing was fine. In order to achieve her cosmetic objectives she underwent an open rhinoplasty with a gentle takedown of the dorsal deformity, refinement to the tip, and infracture. Postoperatively she did well. Two months later she has achieved her desired appearance. The nose is more delicate. There is no longer a dorsal deformity with a nice delineation between the dorsum and midtip. The nose appears very natural and fits her face perfectly.

This is a 25 year old white male whose only previous surgery was for scoliosis as a child. What was of concern for him at this time was his nose. He had previous trauma which resulted in a dorsal bump and deviation of the septum. This significantly diminished his capacity to breathe through his nose. He also had an enlarged turbenance particularily on the left side. Examination confirmed the dorsal bump and slight deviation of the nasal bone as well as deviation of the septum. The tip itself was actually well formed. In order to correct his breathing difficulty as well as make fine adjustments to the nose he underwent a radical submucous resection with a closed septorhinoplasty. The nose was packed postoperatively for two days and the splint remained for a week. As soon as the packing was removed he noted significant improvement in airflow. Two months postoperatively the nose is well healed. It is straight without a dorsal bump and more refined with only subtle changes for an overall improvement. This is a classic example of less can be more.

This set of rhinoplasty before and after photos features a 19 year old young woman in good health who had been bothered for many years by her nose. An examination revealed that she had a dorsal deformity, a wide proximal and mid third and a poorly defined tip. The tip itself was bulbous and showed some bifidity (which you can see in the oblique before photo - it's that split in the middle of the tip). These features combined to create a nose whose masculine nature drew considerable attention away from the more delicate and aesthetically attractive features of her face. Because of the need for proper visualization of the tip, an open rhinoplasty with tip refinement was performed. During surgery, the dorsum was gently lowered and a tip-plasty was carried out with stabilization sutures. The nose was shortened (causing the tip to turn ever-so-slightly upward to create a more delicate/graceful profile) and an infracture was carried out to reduce the width of the bridge. Her post-operative course was uneventful and photos taken 6 months post-op show a naturally beautiful result. Her previously masculine nose is now feminine, delicate and sized/shaped in a way that refocuses attention onto her lovely facial features (which is the goal of most every cosmetic rhinoplasty). The patient loves her 'new' nose and the added confidence it has provided.

This set of rhinoplasty before and after photos features a 20 year old young women who since childhood has been plagued with breathing difficulties related to allergies. She had been evaluated by ENT on many occasions and had been treated conservatively with nasal sprays and allergy medication. She did undergo an adenoidectomy as a child. Examination confirmed a deviated nose with a dorsal deformity, poorly defined tip with overhang, and a deviated septum with near complete airway obstruction. In order to correct both her cosmetic as well as functional problems she underwent an open rhinoplasty with a slight takedown of the dorsum, a radical sub mucus resection, septoplasty to straighten the septum, tip plasty with suture stabilization to give better definition to the tip, both in and out fracturing of the nasal bones, and caurterization of the turbinates. The septum was stabilized with internal splinting for three days. Her postop course was completely unremarkable. Two months later she is breathing better than she has had her entire life. The nose itself has been improved cosmetically. It is straight, more feminine, with better tip definition. Both she and her mother are ecstatic with the results.

This set of rhinoplasty before and after photos features a 25 year old woman from Albany, NY who has long been bothered by the appearance of her nose - specifically, that it was distracting from the overall delicate features of her face. She presented with a a long nose with prominent dorsal bump and a bulbous, overhanging tip. This was corrected with an open rhinoplasty with take down of the dorsum, shortening of the caudal septum and slight elevation of the tip. A tip-plasty was also performed to give the nose a finer, more triangular appearance. Lastly, an in-fracture was carried out to reposition the nasal bones and close the open roof created by the removal of the bump. Photo taken just 6 weeks later show the nose to be healing wonderfully. By addressing the irregularities and asymmetries of her pre-surgery nose, we were able to achieve a much more harmonious shape and size. Her nose now has a refined, elegant and natural appearance that enhances the rest of her face (especially the eyes).

This set of rhinoplasty before and after photos features a 27 year old white male who has had no previous surgery. He has been concerned about his nose for quite some time. The nose itself was somewhat prominent and he felt elevated from his face more than he desired. There was also a slight bump and a bifidity to the tip. He wished refinement rather than traumatic alteration and of course to maintain masculine charastics to the nose itself. In order to achieve this result he underwent an open rhinoplasty during which there was a slight take down of the dorsum, a tip plasty with excision of the upper portion of the lower lateral cartliges and suture stabilization. An infracturing was likewise and carried out ever so slightly to the proximal and mid third of the nose. Finally an alar wedge excision to balance the nostrils with the remainder of the nose itself. His postoperative course was unremarkable with immediate improvement demonstrated once the splint was removed. Three months later the majority of the healing has occured and he has achieved his desired goal. The nose is slightly small and set back closer to the face with nicer definition to the tip. Above all he has maintained his masculine qualities and only improved.

This set of rhinoplasty before and after photos features a 23 year old female who for many years had not like the appearance of her nose. While there was no specific or significant trauma to speak, the nose and septum were nontheless deviated, a dorsal deformity was present and the tip was irregular. She also suffered from breathing difficulties related to the deviated septum. This was corrected with an open approach rhinoplasty with a sub-mucous resection (SMR) septoplasty. Six weeks later the nost has healed very nicely. It is now more delicate, elegant and in balance with her facial features. She can breath normally and is quite pleased as noted in her testimonial.

This set of rhinoplasty before and after photos features a 38 year old white female who had been concerned about the appearance of her nose for many years. I had previous performed a rhinoplasty on her cousin 6 months ago and both she and her cousin were quite pleased with the results. On examination, she presented with a long nose, significant dorsal deformity (hump) and a bit of overhang (which was worsened by smiling). She also had some separation/indentation of the tip cartilage (otherwise known as a bifid or ‘cleft’ nasal tip. We corrected these issues with a full, open septorhinoplasty that featured the 7 following adjustments. 1.) The dorsal deformity was taken down and 2.) infractures were performed. 3.) The nose was shortened and 4.) angled slightly upward to create a more delicate/graceful profile and 5.) a tip-plasty was performed to reform the seperation of cartilage in the middle of the bifid/cleft tip. 6.) I also released the septum from the upper lip so that it would no longer be pulled down when she smiled. 7.) Bilateral alar wedge resections were also performed to slightly diminish the size of the nostril opening. Photos taken 3 months after surgery show a well healed and beautifully shaped nose that fits the patient’s face perfectly. The difference is, on the whole, dramatic, yet in the particulars, really quite subtle.

This set of rhinoplasty before and after photos features a 19 year old girl who was getting ready to go off to college. She presented with a large overhanging nose and troubled breath. This was corrected with an open rhinoplasty with a submucus resection and septoplasty. Two months later the nose is well healed and the patient can breath with ease. It is smaller and every-so-slightly elevated with a very attractive natural appearance. It does not look like a "nose job" and this makes her very happy.

This set of rhinoplasty before and after photos features a 36 year old woman (from Niskayuna, NY) who had been unhappy with the appearance of her nose for quite some time. Specifically, she did not like the prominent dorsal bump/hump (which had developed during adolescence) and felt that the tip lacked refinement due to it's thickness and subtle droop. To correct these concerns, the patient underwent open rhinoplasty to reduce the dorsal hump and set back and refine the hanging tip. Photos taken only 1 month later show her nose to be healing wonderfully. The dorsal bump is no longer present and the nose has a much softer and delicate appearance without looking overdone or unnatural. The eyes now enjoy the most attention and her face has taken on a softer and more youthful look since surgery. I expect this result to become even more refined and attractive as residual swelling continues to subside over the next 6-9 months.

This set of rhinoplasty before and after photos features a 18 year old South American young lady who wished to have her rose reshaped. The nose was long and overhanging with a prominent dorsum. Her tip was slightly ill-defined as well. This was corrected with an open rhinoplasty to remodel the underlying hang and cartilaginous structures. The goal was to make the nose smaller, delicately defined and more in sync with the other features of her face. Two months later her nose has healed quite nicely and the patient was very pleased with the results of her rhinoplasty surgery.

This set of rhinoplasty before and after photos features a 23 year old white female who over the years due to sports has had several fractures to her nose. The last fracture resulted in deviation of her septum and a collapse of the nasal valve on the right side. This has worsened over the years and makes breathing difficult. Particularily when she is running. The appearance of her nose also was of some concern with a small dorsal deformity and mild asymmetry to the tip which would pull down when she smiled. In order to correct both her functional and cosmetic issues she underwent an open septorhinoplasty and submucus recection. We did a mild take down of the dorsum with infracturing, stabilization of the lower lateral cartilage and a spreader graft to support the right internal valve. She also had the upper lip released in order to not affect smiling. Her postoperative course was uneventful and at 2 months the majority of the healing has occured. The nose is more delicate and straight without a dramatic change in the overall appearance which was her desire. Her breathing has improved significantly and there is no further collapse of the internal valve. She is no longer self concious when she smiles broadly.