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This 30 year old Norfolk woman was greatly bothered by the tip of her nose.  She did not like the shape, nor how it protruded and pointed downward.  She felt that her nose was not feminine and the downward projection gave her a more aged appearance.  During our consultation, we discussed the hollow area to the left of the tip and the fullness to the right of the tip.  Observing her side view, the tip protrudes out and has a downward point. Also, the nostril margins have an unattractive arch.  Through an open rhinoplasty, all of these issues were addressed.  Clearly, she would need her tip set back and rotated up or shortened.  Using a special type of graft with a new technique called repositioning of the lateral crura with a lateral crural strut graft, all of the remaining tip issues were addressed.  With the graft, the left side cartilage was straightened.  The bulging cartilage on the right was made straighter.  Since both of her cartilages swept upward, instead of to the side, she was lacking the attractive shadows of a beautiful tip.  This could only be accomplished by repositioning her cartilages in a new direction. Even with some residual swelling in these four month post-op photos, she clearly has a more feminine nose.  The tip is symmetric.  As the swelling resides, she is getting more and more of that beautiful shadow above and to the side of her tip.  

Surgeon: Dr. Thomas Hubbard

Case Number: 479

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