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This patient is 36 years old and was bothered by the crookedness of her nose and the tip dropping down when she smiled.  She had a rhinoplasty in her native England at age 19 but several years later fell from a horse resulting in more crookedness and also some difficulty breathing on both sides.  Along with the considerable crookedness, I noticed that her tip was low for the relative height of her bridge and also looking from the side, the angle between her nose and upper lip was too sharp. This could be due to her previous surgery, trauma, or both.  I had a very detailed consultation with the patient and we developed a long list of issues to address with her rhinoplasty.  The goal was to make her nose as straight as possible while creating a nice feminine shape and also improving her breathing at the same time. I have written extensively and presented nationally and internationally on subtle tip repositioning that would be required with this patient.  There are now advanced surgical techniques that can predictably reposition the tip.
During surgery, I found her septum was extremely crooked and traditional methods of straightening her septum would leave her with a residual breathing problem and crookedness.  Therefore, much of her septum was removed, dissected and reconstructed by using the straightest pieces available.  With this reconstruction, I was able to make her septum not only more straight but with improvement of the tip position and also the relationship between the nose and the upper lip.  The recovery for this type of combined reconstructive and cosmetic procedure is actually no longer than most rhinoplasties.  The patient is thrilled with her straighter and more natural looking nose and the tip position, both with and without a smile.  The bumps and irregularities from previous surgery and trauma were taken care of and her breathing greatly improved. 

Surgeon: Dr. Thomas Hubbard
Patient Age: 36

Case Number: 109

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Practice Policy Update Regarding COVID-19 View Update Online Consultation

Practice Policy Update Regarding COVID-19

We are excited to announce our reopening as of May 1st. While many things have changed, one thing has remained the same: Our commitment to your safety.

Consultations are available in our office and we will continue to offer Virtual Consultations as well. You will be asked to complete your registration paperwork in our secure patient portal prior to your appointment and your consultation fee will be collected by phone to minimize contact.

Here are a few changes we have made as we transition to this new era:

  • Please reschedule your appointment if you are not feeling well, have a fever, have been exposed to anyone with Covid-19 or travelled internationally within the last month.
  • We will limit the number of people in the building and waiting area to maintain social distancing and our staff will be wearing masks until restrictions are eased.
  • Please wear a mask during your visit but do not wear gloves. You will be given hand sanitizer.

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