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Steven M. Denenberg, M.D.
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The nasal septum is the wall that divides the inside of the nose into a left airway and a right airway.  When the septum doesn't sit in the middle, it can obstruct airflow through the nose instead of guiding the airflow.  We then call it a "deviated septum," and that deviated or crooked septum can be straightened during a rhinoplasty.

Most commonly, the deviation of the septum cannot be seen from the outside of the nose.  The deviation that obstructs the airflow is deeper inside the nose, where you can't see it.  This patient's septum was so bad that you could see it before surgery.


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Questioner: Are my expectations for my desired Rhinoplasty results unreasonable?
I'm getting a rhinoplasty in 2 weeks and am really hoping for a specific result. I know everyone is different in terms of what's reasonable but in your opinion, is what I want do-able? I've posted photos of myself and also of what I'm hoping for...
(Questioner submitted photos)

Dr. Denenberg's answer: Improvement is possible for your nose, and the posted before-and-after is a great result.
Hi,
You do appear to be an excellent candidate for a rhinoplasty. As I see it, the goals would be to lower the hump, narrow the bridge and tip of the nose, raise the tip some amount, and definitely bring the entire nose back closer to the face.
Be sure you have seen many of your doctor's before and after photos, of other patients who had the same kinds of changes that you want for yourself. Yours is a difficult rhinoplasty, requiring advanced techniques, and most plastic surgeons would not be able to handle it well. Board certification diplomas tell you almost nothing about a doctor's skill in this field.
Also, I guess I have to disagree with some of the other posters about whether you need a chin implant. Your chin is very short vertically: measuring on the profile view from your lips vertically down to the bottom of the chin. That's a great, great feminine feature to have, and to my eye, it means that your chin doesn't have to project as far forward as it might on someone else. Further, just as a chin implant can make a nose look smaller, a reduction rhinoplasty can make the chin look a little bigger, and I think you'd look fine without the implant.

Link to this question on RealSelf.com