• Rhinoplasty
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Steven M. Denenberg, M.D.
Steven M. Denenberg, M.D.
rhinoplasty
 
Views of this rhinoplasty patient:

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The frontal view shows the narrowing of the wide area where her hump was, and the elevation of the tip of her nose after surgery.  We can see a glimpse of her nostrils in the after picture; they were hidden in the before picture by her drooping tip.

One way to evaluate the shortening of the nose from the frontal view is to pay attention to the two white dots on the tip of the nose.  Those white dots are reflections from the flashes.  Compare the white dots' positions in the two photos above.


next view of this patient

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All views of this rhinoplasty patient:
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current: Frontal
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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: Could You Explain How the "Scoring" Technique Works in Rhinoplasty?
Hello,I have a dorsal hump on my nose, and when smiling a slightly bulbous, droopy and boxy tip. My surgeon, an ENT, is going to perform endonasal/closed rhinoplasty. For my tip he has suggested minimal changes with sutures and scoring. I have thin skin, so any resections of cartilage or grafts will show through. I wanted a more refined tip, but I am thinking that scoring of the cartilage will make for a bigger bulkier appearance of the tip. If I am wrong please explain how scoring works Thanks!
(Questioner submitted photos)

Dr. Denenberg's answer: Scoring alone can have disappointing results
Hi, Sissi,

In my experience, scoring alone is not adequate for reducing the size of a bulbous, droopy, and boxy tip. The rationale is that by making a series of scratches, or cuts that don't go through-and-through the cartilage, you can weaken the cartilage to fold over somehow and look more narrow. But it's not predictable, or very controllable. Also, it can disturb the cartilage enough that in the not-so-unlikely event that you would seek a revision, the scoring of the cartilage can put a limit on the amount of improvement the revision surgeon can make.

And in the case of *shortening* a nose, I just don't think it can be done at all by scoring.

Did your doctor show you lots of before and after photos of his other patients where he made attractive changes in the width and position of the tip by using scoring? If not, you should stay away.

Link to this question on RealSelf.com



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