Clinical: A 37-Year-Old Actress With A Large Bump & Inability To Breath.

Performed A Dorsal Reduction, Repaired Droopy Tip & Cartilage Strut. A Portion Was Covered By Insurance.

Clinical: A 25-Year-Old Patient With Thin Skin Dorsal Bump & Wide Tip

Performed A 2MM Reduction In Dorsum & Thinned The Tip

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.