Rhinoplasty – Case 319
Our twenty something female had already undergone two septoplasties and rhinoplasties, one and three years prior to her third nasal operation. Her breathing was initially normalized for the first four months after her first surgery and fortunately was permanently improved after her second. She felt there had been partial improvement in her appearance but wished for more. She objected to the residual dorsal bump, a depression on her left mid third of the bridge, ridging of her tip and the deviation to her nasal tip. She didn’t like the openness of her left nostril.
Residual issues of irregularity, asymmetry and lack of smoothness of the bridge is common after rhinoplasty unfortunately. The thinner the skin, the more likely these visual issues occur. It is the nature of the anatomy of this part of the nose which allows these issues to happen. Underneath the nasal bump or hump lies ridges and valleys which are exposed when the bridge is deprojected and the hump is removed. they cannot be eliminated. They can only be made as smooth as the anatomy will permit. The degree of improvement and the risk of these issues occurring are the result of three factors. The anatomy of the patient, the skill and experience of the surgeon and the healing process afterwards .Of the three, the most important are the first two. Using the open approach facilitates technical precision and so increases the probability of a successful outcome. Her incision can be seen under her nose. When reopening this incision, although improvements can sometimes be obtained, the final scar is never as good as when it was done well the first time.
These before and after photos show a typical result by the rhinoplasty surgeon Dr Oakley Smith from Toronto.