Primary Female Rhinoplasty 389

Functional Rhinoplasty – Female in Her 20s

Goals
This patient in her 20s came to me for a functional rhinoplasty. She had a dorsal hump and a hanging tip, but the more challenging issue was a significant deviation through the middle third of her nose. She wanted a straighter nose with a smaller, narrower tip and a more refined nasal base while still looking natural.

Procedure
I performed an open rhinoplasty with septoplasty to correct the underlying deviation. Spreader grafts were used to straighten the middle portion of the nose, and a septal extension graft was used to support and shape the tip. Because she had thicker skin and wanted a smaller, more defined tip, I used bilateral lateral crural underlay grafts to narrow and reshape the tip while maintaining support. An alar base reduction was also performed to narrow the base of the nose.

Outcome
She now has a straighter nose, a narrower and more refined tip, and a smaller nasal base. The overall result is a cute, balanced nose that fits her face naturally. She was very happy with her new look.

Key Principle
In patients with a broad tip, particularly with thicker skin, simply removing more cartilage is not always the answer. Lateral crural underlay grafts can help narrow and shape the tip while maintaining the support needed to avoid an overly pinched or operated appearance.

Primary Rhinoplasty
The 7 Keys to a Great Rhinoplasty Result