The patient is a 26 year old who wanted to “have the bump taken down” and felt her nose was too large compared with her face. She liked the tip of her nose and didn’t want much change to it.
Rhinoplasty surgeons want to gain the maximal improvement for the patient and so first listen to the patient and find out what the patient “sees”. The plastic surgeon then offers an opinion and a plan for treatment that can get the patient to their goals while also bringing out the best result for the patient’s anatomy. For this patient, a slight narrowing of the tip was recommended because it could not only refine and beautify the tip further but would also harmonize with the other parts of the nose once they were changed during the rhinoplasty. Each part of the nose was reduced but the basic shape of the nose was retained as per the patient’s wishes. This meant care was taken not to make the bridge or the tip of the nose too narrow because her face was vertically shorter and slightly wider and a too narrow nose might have accentuated that. When a significant amount of “bump” is removed from the middle of the nose, it usually makes the eyes look like they are farther apart as with this patient. In her, it just matches the facial width and plastic surgeons are aware of these subtle effects on the face. This is just another reason not to take too much off in the bump area.
The angle that the nasal tip makes with the vertical line of the lip has been kept unchanged with the surgery but the tip has been softened as can be seen from rhinoplasty before and after photos. Keeping the tip at the same angle helps to retain the patient’s “character” but the softening of the tip has created also some softness and calm in the area of the nostrils. Not rotating the tip upwards also retains length, keeping the nose as long as it can be because it was relatively short preoperatively.
Rhinoplasty Results
The patient was really elated with her cosmetic results. She felt that she looked like the same person but that her nose looked a lot better without sacrificing her original look.
