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Steven M. Denenberg, M.D.
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In the before picture, you can see some white marks in the middle of her dorsum that are reflections from the flash, right where the hump was.  The marks are crooked, indicating that her nose was a little crooked in that area before surgery.  I mentioned in the section on nasal reconstruction that correcting a crooked nose is one of the hardest changes to make in rhinoplasty.  However, if the crooked area is small, and if it's on the hump, sometimes simply removing the hump removes the crookedness entirely.

We also know that her nose was shortened somewhat during her rhinoplasty, because we get a better view of her nostrils in the after picture.


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Next: an example of the solid advice Dr. Denenberg gives patients on RealSelf.com.
Get that advice for your own situation by emailing your photos to Dr. Denenberg.

Questioner: Can I get rhinoplasty for bulbous tip and mid nose?
I am looking to get rhynoplasty done on my entire nose. Not only is the tip bulbous, but the cartilage/nasal bone is wide and pushing outwards. Please see the pictures attached. The cartilage/nasal bone creates a bump as I'm looking sideways at an angle, and overall both pictures look better than in person. I also have quite a long midface and was wondering if there are any procedures to make this look better based on work for the nose.
(Questioner submitted photos)

Dr. Denenberg's answer: Improvements can be made in a wide nose
Yes, it looks as though the cartilages in the tip of your nose are wider than they need to be, and the other issue you identified, the width of the bones and the cartilages in the upper part of your nose, often happens with a wide tip.  See the attached video and the Web reference link for some examples of what can be done in the right hands.

Your midface is fine. Anyway, your nose is short on that midface, and there's nothing we can do about the length of the midface anyway, except where it's so long as to be a true deformity.

Link to this question on RealSelf.com