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Surgeon: Dr. Thomas Hubbard

This professional Virginia Beach woman in her 20s was bothered by how her nose appears crooked in front view and there is a hump on her side view. She also was not pleased with the degree her tip pointed downward; however, she wanted a very conservative amount of change. Her tip was very asymmetric as the areas of the left tip were concaved. With an open rhinoplasty approach using what are called structural techniques, we were able to accomplish the changes she wanted. With these type of techniques, actual millimeters of rotation and setting the tip back can be measured. Her tip was set back 2 mm and the tip was rotated upward 2.5 mm. I recommended a little more rotation, but she is pleased with her nose up slightly. I shared with her a lecture I presented to The Rhinoplasty Society National Meeting on millimeters of rotation. There are a certain number of millimeters I rotate the tip up when the tip points down to the floor, a certain number of millimeters when it is at 90 degrees and if the tip is already rotated up, it must be even more conservative. Her tip was actually pointing down somewhat and she would have been in a category to rotate it more, but again the bottom line is she is happy with the result.

Case Number: 636

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