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This 35-year-old woman was bothered by the shape of her nose for many years. However, she was reluctant to have surgery based on the experience of her friends who had difficulty breathing through their noses following rhinoplasty. Since she had no breathing issues, my surgical plan would include maintaining normal breathing while creating the cosmetic outcome she desired by using careful modern techniques.

Utilizing video imaging, we proceeded to discuss surgical options. Commonly, we find that there is not one particular part of nasal shape that requires a drastic change. Instead, with careful examination and attention to detail, we found quite a number of smaller issues that could be improved, giving her a much more beautiful nose. One part of the plan was rotating or tilting the tip up. Considering she is tall, we decided on a more subtle rotation, but I always make that decision with my patient. Her tip was not overly wide but improvements could be made. In her particular case, the tip cartilages had an orientation towards the inside of the eye instead of the outside. The tip surgery could be done in minutes if this particular detail was ignored. However, because these small but delicate details are important, we proceeded with the more advanced surgery of her tip. I completely reoriented her tip cartilages to a more normal direction towards the outside of her eye. Although this significantly extended the time of her surgery, safety and results are bigger issues. Safety is not compromised with this extra time in surgery.

Other details we addressed were some crookedness, a small hump on the bridge, and some extra width to her nasal bones. She is shown after surgery with many changes to her nose, none of them drastic. She breathes very well and the refinements to her nose enhance her overall appearance. She is extremely happy with the result of her surgery: “I love my nose!”

Surgeon: Dr. Thomas Hubbard

Case Number: 428

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