Rhinoplasty
This patient is a 42-year-old female who is interested in cosmetic improvement for her nose. She is most concerned with the width of her nose. Upon physical examination the nose was found to have thick skin, short nasal bones, a bulbous tip as well as the alar base being too wide. Additionally on lateral view the dorsum and tip are both underprojected.
To address her concerns, we spoke in depth of two options in this particular case with regard to downtime, result, and difficulty. She was offered the choice of either an in office alar base reduction or a more significant rhinoplasty with tip grafting and caudal extension grafting to address the length deficiency. She was cautioned that because of her thick skin her degree of improvement would be subtle and more difficult to obtain however completely within the realm of achieving an ideal result. The patient elected to proceed with a rhinoplasty and is very pleased with her decision.
The after photos demonstrate the retention of an ethnic undertone the patient desired in order to retain a natural result yet has addressed the features of the nose that displeased the patient. On frontal view, adding to the dorsal height has eliminated the wide, washed out appearance of the dorsum and gives the impression that the eyes have been narrowed. The tip and alar base are also more refined and narrow and the light reflex along the dorsum and tip are straight and pleasing. On lateral view, the dorsal augmentation is visible with improved dorsal tip aesthetic lines. Additionally, the nose has been lengthened slightly giving it a better balance with the rest of the face and a more elegant appearance.
