Dr. Steven Denenberg's facial plastic surgery before and afters: Rhinoplasty, combination noses #7

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In these photos we see another clue, that his nose is over-projecting. In the after photo, draw these two imaginary lines: a mostly-horizontal line drawn along the base of his nose, and a line drawn along the skin from the base of his nose down to his upper lip. Those two lines meet at a sharp angle. In the before picture, however, they don't. The line that traces the skin of his upper lip curves forward to meet the bottom of his nose in the before photo.

If you grab the tip of your nose and pull it forward, making your nose more projecting, your upper lip skin will do the same thing. When the upper lip skin pulls forward like that, we call it "tethering of the upper lip," and it's usually an indication that the nose is a projecting nose.

The rhinoplasty section of the Surgery tutorials contains a chapter that discusses the phenomenon of upper lip tethering (the surgery tutorials contain explicit photographs taken during surgery).

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All views of this rhinoplasty patient:

rhinoplasty 1: Right oblique	rhinoplasty 2: Left profile	rhinoplasty 3: Left oblique

rhinoplasty 4: Right oblique	rhinoplasty 5: Left oblique	rhinoplasty current: Right profile

rhinoplasty 7: Base

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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: I Want to Get the Bump Removed from my Nose, but Would I Need to Reconstruct the Tip of my Nose As Well?
(Questioner submitted photos)

Dr. Denenberg's answer: Working on the tip would allow your nose to get shorter and closer to your face
Hi. While the hump is the most prominent feature on your nose, if it is removed and nothing else is done, you probably would feel that your nose is still too large.

When a hump is taken off of the nose, the nose often looks longer, and your nose starts out sort of long-ish anyway. In the morph, besides lowering your hump, I also shortened your nose by raising the tip, and I brought the tip of the nose back closer to your face.

It's not a bad thing to work on the tip. In fact, it's rare to find a nose that *only* requires work on the hump. Still, work on the tip comprises the most advanced techniques in rhinoplasty, so you must insist on seeing before and after photos of your doctor's patients who had their tips elevated or brought closer to the face, so you can see that he was able to achieve for someone else exactly what you want for yourself.

Link to this question on RealSelf.com


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