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This nose was injured in an automobile accident. Her nose was pushed
off to the right side of her face. When a nose is off center on the
face, the patient usually has a "good side" and a "bad
side." This right oblique view is the bad side of a nose that is
pushed to the right. The nose's leaning to the right looks like a
bulge from this angle.
As you are browsing this patient's views, compare this view with her "good
side," which is view 3.
After surgery, she has a much nicer straight dorsum with a tip that is
more distinct and narrow.
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Questioner:
Can this nose be fixed?
I need a seriously talented surgeon to do my third and hopefully final rhinoplasty. I need a grand slam and I will travel anywhere if I can find a surgeon who can perform these multiple techniques. I need someone who can: 1. Decrease nostril width 2. Decrease projection 3. Tip reconstruction using donor cartilage 4. Lengthening of the nose I don't see raising the bridge as the solution to avoiding having to decrease projection. Referrals welcomed also.
(Questioner submitted photos)
Dr. Denenberg's answer: You may not need all of the techniques/changes that you listed
First of all, I agree that, from these photos at least, it's not at all clear that you need to have your bridge raised. The "profile" shot isn't really a profile, because the camera is too high and is looking down at your face, but it appears that the tip of your nose has very strong projection, and bringing the tip substantially back closer to your face will make the relationship between the tip and the bridge much better, without raising the bridge.
Then, a significant de-projection of the tip often can make the nose *appear* longer, so you might not need as much lengthening as you thing you might.
It's also not clear that you'd need donor cartilage to help the tip. Often, even after previous surgery, modifying the cartilage that is still there is all that is needed.
See the attached video and Web reference links for some ideas.
If we had a pure profile, maybe a morph could be make to illustrate how deprojecting the tip also helps both the bridge and the length.
Link to this question on RealSelf.com
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