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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.
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Questioner: Will Fixing Bulbous Tip Make the Nose Look Thinner?
I have a bulbous tip nose. I want to get my nose to have a normal tip but also want it to look thinner. If I get the bulbous tip fixed, will my nose automatically look skinnier?
(Questioner submitted photos)

Dr. Denenberg's answer: The tip and the bridge can be narrowed at the same time, but using different techniques
Hi,
The work done during surgery to narrow the tip of the nose won't change the appearance of the upper part of the nose -- that part can also be narrowed, as a different part of the operation.

Careful, though, because narrowing a nasal tip is an advanced technique, and you should see before and after photos, before selecting your doctor, of other patients who specifically had their nasal tips narrowed. A profile view won't show that to you; it's the angled views, like the one you posted, that show the width of the tip.

Link to this question on RealSelf.com