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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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"He is communicative and down-to-earth. "
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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: Why is my Tip Still Droopy After Rhinoplasty?
I had closed rhinoplasty. If my tip was lifted, why does it still look the same as before? I'm frustrated... It just seems like the distance between my tip and upper lip is a bit different, but the tip is droopy and shaped droopy-like just like before. Why? was it the technique?
(Questioner submitted photos)

Dr. Denenberg's answer: It's certainly possible that you nose simply wasn't shortened in the previous operation
Hi. The photos you sent are sort of tiny, but they do show the relationship between the bottom of your nose and your upper lip, and it appears that the nose is still long. See my "Web reference" link for a morph I made of your nose, showing what it might look like if it were shortened.

Shortening a nose, in expert hands, is one of the more predictable changes to make in a nose, even in a revision, but it requires some complicated work on the tip cartilages. Still, no operation is 100% successful. You have a decision to make about using your same surgeon for a revision. If you feel that you selected him well, and you saw lots of his before and after photos, proving that he has shortened long noses for other patients and does excellent work in general, then take his advice about a revision to try again to shorten your nose.

However, if you did not see lots of before and after photos, and you suspect that he might not have been able to shorten your nose in the first place, then you should not have him revise your nose, because he is unlikely to succeed, and it can get you into more trouble.

Link to this question on RealSelf.com