Rhinoplasty Open with Septoplasty

Functional & Cosmetic Rhinoplasty | Male, 30s

Goals: Improve nasal breathing while creating a smaller, softer, and better-balanced nose that maintained a masculine appearance. He presented with nasal obstruction from a deviated septum and turbinate hypertrophy, along with an overprojected and hanging nasal tip. The goal was to de-emphasize the nose while preserving his identity and avoiding an overly rotated or upturned tip.

Procedure: Open functional and cosmetic rhinoplasty with correction of the deviated septum, turbinate reduction, spreader grafts, septal extension graft, and bilateral alar rim grafts. The lower lateral cartilages were fully released to allow controlled tip deprojection and repositioning. Tip reconstruction also included correction of dome asymmetry and subtle reduction of the sublobule. The rim grafts provided additional support and helped maintain smooth, stable alar contours.

Outcome: An open nasal airway with a smaller, deprojected, and better-proportioned nose. The dorsum is softer, and the previously hanging tip is slightly elevated without becoming upturned. The result remains true to his appearance while creating better balance with the rest of his face.

Key Principle: Maintaining masculinity in rhinoplasty is an exercise in precision and judgment. Millimeters matter. The amount of dorsal reduction, tip deprojection, and rotation must be carefully controlled to soften and balance the nose without feminizing it or changing the patient’s identity.