Dr. Steven Denenberg's facial plastic surgery before and afters: Rhinoplasty, combination noses #1

Views of this rhinoplasty patient:

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Let's try to evaluate the surgical changes from this frontal view. You can see some of the changes from removing the hump: the before picture has two parallel vertical white stripes along the dorsum of his nose. Those stripes are the return from the flashes in my photo room. The stripes give you a feel for the position of the dorsum and the presence of the hump, and they are missing in the after picture.

Nasal length: in the after picture, we can see just a glimpse of his nostrils. That glimpse is our indication that his nose was shortened, because in the before picture, his somewhat droopy tip hung over and obscured our view of the nostrils.

Actually, he has his head tilted down slightly in the before picture, but the analysis is still valid. (You can tell that his head is tilted down a bit by looking at his right eye and his right ear. In the after picture, his right eye is at the level of the top of his ear. In the before picture, his right eye sits below the level of the top of the ear.)

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All views of this rhinoplasty patient:

rhinoplasty 1: Left oblique	rhinoplasty 2: Right profile	rhinoplasty current: Frontal

rhinoplasty 4: Right oblique	rhinoplasty 5: Left profile	rhinoplasty 6: Right oblique

rhinoplasty 7: Left oblique

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Next: an example of the solid advice Dr. Denenberg gives patients on RealSelf.com.
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Questioner: Can I Have a Tip Refinement Instead of Full Rhinoplasty?
(Questioner submitted photos)

Dr. Denenberg's answer: Probably a tip refinement wouldn't be best for your nose
It's only the rarest of cases where you can work *only* on the tip. Changing the tip's appearance also changes what we think of the other parts of the nose, and they almost always have to be adjusted so the nose matches aesthetically. See my "Web reference" link for a morph of what changes I see for your nose.

Besides the strong tip cartilages, the bridge of your nose is strong in its forward projection away from the face, particularly at the top of the nose, where the nose begins just below the eyebrows. In my morph, I reduced the strength of your nose up there, reduced the width of the tip. Then, I moved the tip a little closer to your face as well, because that's a change that often happens when we're narrowing a tip. And I elevated the tip a small amount, so it doesn't cover your upper lip as much on the frontal view. Then I tucked up the columella, which is the part of the nose between the left nostril and the right nostril. That part can be brought up a small amount, decreasing the amount of the inside of your nose that is visible from the profile view.

The doctor you consider using for your surgery should be able to put together for you all of the aesthetic areas that you notice, and show you how changing those areas have implications for the *rest* of the nose.

Link to this question on RealSelf.com


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