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Steven M. Denenberg, M.D.
Steven M. Denenberg, M.D.
rhinoplasty
 
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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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"...he exceeded my expectations while still
making my nose extremely natural looking. "
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Questioner: Shall I consider a revision? Wide & asymmetrical nose by the front and tip is sticking out. 6 months Rhinoplasty post-op.
I got Closed Rhinoplasty 6 months ago because my nose was huge, with a big dorsal hump and a deviated septum. When the cast was removed, I liked my nose very much by the side because it looked straight and small. However as the swelling was going down, the bone became smaller and my tip started to stick out so much. I think my tip now looks much bigger than right after removing the cast. Is that swelling? Do you think that my nose can improve with time or shall I consider a revision?
(Questioner submitted photos)

Dr. Denenberg's answer: I don't think the tip problem is swelling
I think the problem is that the tip was too projecting, given the position of the bridge, and when the cast came off, there was so much swelling on the bridge that we couldn't see the problem. Now that the bridge swelling has gone down, we see how prominent the tip is.

I don't consider this a polly beak. A polly beak is where the there is unwanted fullness above the tip, and if that fullness weren't present, the tip would look about right. in your case, if that fullness about the tip goes down, your nose would look even longer, which would pose a new problem. Also, a polly beak is usually scar or cartilage *above* the tip cartilages, but the fullness we see there could very well be the tip cartilages themselves.

Seems to me, you need a revision, where advanced work would be done on the tip, to deproject it, and especially to elevate it upwards. In expert hands, these can be fairly predictable changes to make, even in a revision, but all plastic surgeons would not possess the skill to accomplish the changes. So you need to be sure to see before and after photos before you launch into an operation like that.

Link to this question on RealSelf.com



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