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Steven M. Denenberg, M.D.
Dr. Denenberg's articles on Medium.com.
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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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"I was extremely fortunate to have him
perform my primary rhinoplasty. "
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Next: an example of the solid advice Dr. Denenberg gives patients on RealSelf.com.
Get that advice for your own situation by emailing your photos to Dr. Denenberg.

Questioner: What to do to narrow my nose, especially the area in between my eyes? Wide nose with boxy, amorphous tip.
The Dr. I saw recently gave 2 options to slim my bridge, specifically the area between my eyes. 1. Brow modification, a minor lift to narrow the part of my nose in between my eyes & streamline it with my new thinner bridge. 2. Trimming some muscle fibers out of this area at the top part of my bridge. I chose not to do the brow modification, I am worried it will change the look of my eyes. Is the trimming of the muscles on that part of the bridge a regularly practiced part of thinning out a nose?
(Questioner submitted photos)

Dr. Denenberg's answer: Nope. Nope. Nope. Your doctor's recommendations won't work.
When your doctor raises the inside corners of your eyebrows just a little bit, it pulls and tightens the skin exactly between the inner corners of your eyes, and that top part of your nose, between your eyes, looks narrower. It's *not* possible to make that happen with surgery. It's one of those things in plastic surgery that seems to make perfect mechanical sense, but it never works when you try it. And it's not at all risk free to "try."

Similarly, "Trimming some muscle fibers out of this area at the top part of my bridge:" how's he gonna do that? With an external scar that you'll hate? From an incision up in the hair line? From within the nose? This can't work anyway. And if he does get to some "muscle fibers," the scar tissue that results from pulling out those fibers will more than fill the void created by the loss of the muscle, and the area will look wider, or asymmetrical, or puckered with a lump of scar, or something else nasty.

Look at the video link, below. I made a simulation of a possible rhinoplasty result on you. Seems to me that the main event would be narrowing the cartilages in the tip of your nose. I simulated that, as well as a smaller narrowing of the cartilages above the tip, and of the nasal bones. The top of the nasal bones, about at the level of the white arrow, cannot be narrowed, so don't let someone talk you into something goofy.

Actually, it *is* possible to narrow that area, but it narrows if an implant is placed there: if that part of your nose is very close to your face, if you had an Asian nose, for example, then placing an implant to build it up can make it *look* more narrow, but that's not a possibility in your nose, because the height of your bridge there is excellent, and you would never want an implant along your bridge.

This all make sense?

Link to this question on RealSelf.com