Pre: A 36 year old actress with a large bump and inability to breathe.

Post: Performed a dorsal reduction, repaired droopy tip and cartilage strut. Partially covered by insurance.

Pre: This 26 year old had a deviated septum and nasal bones as well as a cosmetic deformity.

Post: The patient underwent a septoplasty, inferior turbinectomy, nasal bone correction, and tip correction. The result was improved function and form.

Pre: This 50 year old professional wanted a natural appearing nose.

Post: 4 day post op. The dorsum was reduced and the tip was thinned.

Pre:This 40 year old professional requested a reduction on the bump and slight tip projection, without being too obvious.

Post: The result was a straightened nose on profile with slight tip projection.

PROBLEMS:

Large nose, dorsal hump, wide nose, deviated nose, tip deformities, hanging nose, depressed dorsum, nasal trauma

ANALYSIS

The history is important for previous trauma, nosebleeds, procedures, allergies, breathing abnormalities.

The nose is examined internally for any obstructions or potential problems. Rhinometry may be required.

The nose is then viewed in relationship to the rest of the face. How are the forehead, cheek bones, lips and chin? Dimensions and proportions in the frontal and lateral are noted.

Measurements of the upper 1/3 flow from the forehead, along the top or dorsum, to the tip, the upper 1/3 projection from the corneal plane, tip dimensions including width, projection, cartilage visibility, bifidity, middle 1/3 projection, width and symmetry are all noted. Photographs are taken.

The analysis can then estimate as best as possible the existing anatomy.

SURGICAL CORRECTION

The surgical correction depends upon the existing anatomy, your goals and factoring concommitant risks. A surgical plan of multiple surgical manuevers are then chosen to create the desired effect. Consideration of how one change affects the overall nasal proportion is noted. The retention or improvement of functionality is paramount. The skin elasticity which can only be marginally altered but is responsible on how the skin re-drapes is carefully noted as it can thwart the outcome. Each anatomical part from turbinates, septum, bone, cartilage and skin is planned.

In general, the nose is approached by either a closed or inside incisions or by an open or external incision.

The range can be from simple tiplasty, to partial to complete nasalplasty including and correcting the nasal obstructions. The options are nearly infinate.

The procedures are performed in our accredited clinic or outpatient at hospital.

General anesthesia is rarely used and gives an added risk. Sedation with airway protection provides for a pain-free relaxed experience. Observation for at least 2 hours post operatively to ensure no bleeding is common.

RECOVERY

Recovery depends upon the extent of the procedure. It can range from 2 days to up to 1 year for the subtle tip definitions to occur. The splint (if one is used) comes off within 6 days post operatively. Packing is almost never used. Internal splints are rarely used. Internal swelling can take weeks to resolve although incisions are closed.