In this frontal view, we can see that the nose was shortened because the
after picture shows some of the patients nostrils, invisible in the before
picture. In a frontal view, a long, drooping tip will cover the nostrils.
Also, look at the two white dots on the tip of her nose. The white dots
are created by the flashes reflecting off of her tip cartilages. The dots
are about at the level of her nostrils in the before picture, and they're well
above the level of the nostrils in the after picture.
Finally, if you look carefully at the lower edge of the
tip of her nose, you'll see that I narrowed her tip and filled in a little dent that
existed between her two tip cartilages.
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I'm trying to understand my surgeon's operative report in order to understand what was and wasn't done. Please help?
As the photos demonstrate, my primary rhinoplasty was not successful in any way, shape, or form. Since acquiring my surgeon's operative report, I've been trying to make sense of the medical terminology in order to understand what was done to my nose during my operation... Thus educating myself. I want to fully understand as I navigate my revision consults. I keep telling people that the "tip wasn't touched at all," but aside from that, could someone please help me interpret the report? (Photos).
(Questioner submitted photos)
Dr. Denenberg's answer: It doesn't look as though much was done to your tip.
The report says "a portion of the lower lateral cartilages" was removed. That *can* result in a tip that is less wide, or less projecting, but it's the rare, rare tip that will respond completely to a simple removal of some of the tip cartilages as described. Perhaps your tip requires much more advanced work to change it's size and shape.
If you are seeking a revision, be very careful. Revision rhinoplasty is far, far more difficult than a first-time rhinoplasty, and even in a first-time rhinoplasty, most plastic surgeons are not expert enough to handle more difficult tip structures. You must see before and after photos of a doctor's work before deciding whether to use him for your revision. See the attached video and the Web reference link for examples of the changes that are possible in expert hands.
Link to this question on RealSelf.com