Case 5
Major Deformity
Over-projected tip
Minor Deformities
Rhinion hump, twisted tip
History
A 29-year-old woman presented with symptomatic nasal airway obstruction secondary to nasal valve collapse, septal deviation to the left, and right inferior turbinate hypertrophy, seeking improved nasal function and enhanced nasal contour ( Fig. 5.1A–H ).
Analysis of Preoperative Photos
The nasal dorsum is wide with a modest rhinion hump and mild saddle indentation. Deep alar “dimples,” consistent with lateral crural recurvature, are present bilaterally and more prominent on the left side. The tip is over-projected, slightly counter- rotated, and deviated to the patient’s left side. The columella is also bowed to the left and the columellar pedestal is overly wide.
Interval from Surgery to Postoperative Photos
4 months
Analysis of Postoperative Photos
The bony dorsum is narrowed and the rhinion hump has been replaced with a straight dorsal profile. The alar dimples have been reduced and tip alignment is improved. Tip over-projection and counter-rotation have been corrected. The columella is now midline and slender, and both nasal valves are widely patent with good airway function.
Editor’s Note
Although the length of follow-up is less than could be desired, the early result here is excellent and the techniques shown are valuable options for the surgeon to consider.
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