Nose Surgery | Plastic surgery Austin, Texas

Nose Surgery (Rhinoplasty)

Rhinoplasty

This is a young woman who was interested in a rhinoplasty or “nose job”. Basically she felt her nose was large, unrefined and didn’t fit her face or her personality. She is seen here about one year after her procedure. The goal was to reduce the overall size of her nose and to try to refine the tip better. This was accomplished by reducing her nasal dorsal hump and refining her tip with sutures and cartilage remodeling.

The results are obvious and I think we accomplished some of our goals. She is very happy. Sometimes there are limits to what can reasonably be achieved with a rhinoplasty. The limits are often imposed on your surgeon by your anatomy, or they are your surgeons limitations from a skill standpoint. A rhinoplasty is a challenging procedure because of the tremendous variability of anatomy amongst patients and the somewhat unpredictable nature of the healing process. It takes several years for the nose to “settle” after your procedure. Most of the edema or swelling is early on in the first several months and gradually subsides over the coming year or two (this is not something that you will actually see).

A “balanced” nose job refers to changes in the nose that make the nose appear most natural and proportional to your face and itself. It often combines removing and adding cartilage in certain areas to produce the most harmony.

Age 32: Rhinoplasty/Mole Removal

This woman was interested in a rhinoplasty or changes to her nose. She desired refinement and felt her nose was a bit to strong for her face.

She has a nice nose. The problem area was that her dorsum or bridge of the nose was a bit high, especially relative to her lower nasal tip. Her tip itself was shaped well.

She is seen here after a “finesse” type rhinoplasty. I reduced about two millimeters of her dorsum, and elevated her tip with a suture technique. I fractured her nasal bones to narrow the dorsum of the nose after removing the hump.

Her results are quite natural. She has an improved nasal/facial balance. When you don’t have a lot of issues, you generally don’t need a lot of surgery. Keeping it simple in her case resulted in a welcome improvement without drama.

Age: 19 Rhinoplasty

This young woman had a history of trauma to her nose when she was a child that resulted in complete obstruction of her nasal breathing. She has the ability only to breathe through her mouth which was bothersome particularly when she was engaged in sports. On her pre-operative photographs you can see that her nose is very deviated to her right. Internal exam revealed severe deviation of her nasal septum (internal portion of the nose in the midline that divides it into two halves) as well as turbinate enlargement on both sides (air conditioning units in the nose that can become enlarged and obstructing). She also has a small dorsal hump.

The primary goal of surgery is to correct her breathing. The secondary goal is to straighten out her nose as best possible and reduce a small dorsal hump. It is extremely difficult if not impossible to straighten out a crooked nose. Perfection is not possible but oftentimes a very big improvement can be achieved. I performed a complex rhinoplasty with correction of her septal deviation. Seen below at four months after her procedure, her nose is certainly straighter and better proportioned. More importantly, she is able to breathe through her nose for the first time since early childhood!

She is seen below about one year after her rhinoplasty. Both internal and external work was performed. It’s hard to believe but it actually takes about three years for all the swelling to resolve. Her internal exam shows a straight septum and smaller turbinates and unobstructed breathing passages.

Age: 28 Rhinoplasty

This attractive woman requested a smaller and more refined nose. She had a prominent dorsal hump with an overly projecting tip. We performed a rhinoplasty which included a reduction of the hump (with rotation) and lowering of the tip. Notice how her nose appears smaller and more refined while preserving a natural appearance. She does not have an “operated look.”

Age: 30 Rhinoplasty

This patient desired a rhinoplasty because she had a large, poorly shaped nose that she believed didn’t fit her face or her personality. Indeed, you can clearly see in the pre-operative photographs that her nose was not only large for her face, but it was also poorly shaped with a hump on the bridge and a rounded, over-projecting tip.

She is seen in these photos about six months from her rhinoplasty. It was performed through an incision on the columella. The cartilage was reduced and reshaped with sutures, and the bones were narrowed. Her nose was made shorter as well. There is swelling that continues in her nasal tip. Her nose certainly fits her face better–she actually looks quite different, but it’s still her. What is most impressive is that the change in the nose (the center of the face) has such an impact on the appearance of her face in general.

It takes about two years or more for all the healing to occur in the nose. It will still continue to change albeit in small ways over time. Her breathing is good after surgery, which is important because if you make the nose smaller, you can also make the airway smaller possibly resulting in breathing compromise. There are steps that I will perform at the time of the procedure to ensure that this is unlikely. She couldn’t be happier with her early results. I look forward to seeing her at two or three years out from her procedure to see how she changes over time.

Age: 39 Rhinoplasty

This women presented to my office seeking improvements on her nose. She had a previous Rhinoplasty performed and wasn’t quite sure she got what she wanted.

On my examination, she unfortunately had some issues related to her previous work. She had lost projection of her tip and had what we call an “inverted V deformity.” This means she had some collapse of the mid part of her nose. She also had a “supra tip” deformity, which means the high point of her nasal roof was not the actual tip but the area right before it, resulting in a nose that lacks character, definition, and finesse.

She is a secondary Rhinoplasty patient—someone who had previous work and is choosing for refinements. In her case, I used come grafting material from her scalp and put it in her nose, shaved the cartilage where needed, and elevated and rotated her tip a bit. She is seen here about a year from her surgery. The shape and appearance of the nose is better and it now has more character and attitude.

Rhinoplasty is a challenging procedure as the results can be somewhat unpredictable. Make sure that you choose a Board Certified Plastic Surgeon who has extensive experience with this challenging, and rewarding task.

Age: 32 Rhinoplasty

This woman never liked her nose. She had a typical “high tension nose”–which means the mid-aspect of the bridge is overly prominent and the tip of the nose appears plunging. In addition, she has extreme “columella show”–which is shown on side view. We performed a rhinoplasty (through the nostrils):