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Rhinoplasty techniques have advanced greatly the past few decades.  As to tip surgery, a quite significant advance in refinement occurred in just the past few years.  This is the development of reliable means to reposition the tip cartilages.  In the past, certain patients with large nostrils, flaring nostrils and bulges above both sides of the tip could be improved, but the results were sometimes disappointing with traditional techniques.  Now some surgeons with advanced expertise who are willing to spend more time in surgery can completely reposition the tip cartilages and accomplish refinements. This Virginia Beach woman in her early twenties is a good example of these advances. Traditional techniques would have left her nose a version of the old one with excessive nostril show and an inadequate bridge.  With advanced cartilage repositioning techniques, we can have less nostril show and hold the tip in the ideal position.  This allows the hump to be lowered but not excessively.  

Notice, I pointed out other techniques would likely have left the bridge too low.  This is because traditional methods drop the tip back so the bridge must be lowered more to match the lower tip.  When the tip is set back too far, the nostrils flare out. When the bridge is then lowered more to match the tip, it creates an optical illusion of a wider bridge and more likelihood of a breathing problem.

As her photos demonstrate, when there is less nostril show from the side, there is also a more attractive tip from the front.  The columella, or skin bridge, does not hang down so much in the front view. 

Surgeon: Dr. Thomas Hubbard
Patient Age: 25

Case Number: 405

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