Open Rhinoplasty | Case 309
Our pleasant middle aged woman underwent rhinoplasty at aged fifteen because of snoring. She had internal nasal surgery and had her hump removed. The previous generation of surgeons were more aggressive than todays, as we now realize over aggressive resection can lead to nasal weakening over time. This can be seen in her pre-operative profile views. Her bridge has sunken giving her an operated look and a nose which verges on too small. She disliked the wide nasal tip she had developed over the years and wished for normal breathing again. There are irregularities to her nasal tip arising yet again from twisting due to excessive weakening of her cartilages. At the time of surgery, little of her cartilaginous septum remained. However further back inside her nose there was thin bone which fortunately could be harvested and used to rebuild her nose. Excessive resection of her tip cartilages had caused the bossing of her nasal tip and the collapse of her nasal side walls leading to her poor breathing. Her basal view from below the improvement in the twisting of her columella can be seen. It is improved, but not perfect. No rhinoplasty is perfect, and with revision rhinoplasty this is even truer. However her breathing is now restored to normal and she is happy with the degree of improvement achieved.
Before and After photos by Dr. Oakley Smith, a well known rhinoplasty surgeon in Toronto, Ontario