There are a lot of factors to consider when undergoing rhinoplasty. In my practice, I strive to provide my patients with consistently elegant and natural results using my experience with over 1000 rhinoplasties to perfect my approach.
One of the most important factors in achieving a beautiful outcome every time is making sure the nose has ideal tip projection.
Tip projection is a mathematical measurement of the distance the nasal tip sticks out from the face (Image 1). When the tip is under projected compared to the nasal bridge, the overall all angle of the nose appears down sloping or convex (Image 2).
Patients frequently come to me complaining of a dorsal hump or a bump on the bridge of their nose leading to this downward nasal profile. They know they are not happy with the appearance of their nose and frequently focus on the dorsal hump as the reason for their dissatisfaction.
While removing some of the dorsal is an important part of many rhinoplasties, it is not the most important.
I perform structural or preservation rhinoplasty and always try to remove as little cartilage from the nose as possible.
Image 1
Dorsal humps are often over done in relation to the tip projection, leaving unnatural appearing noses that are smaller but have under projected round nasal tips. A critical eye can pick this out when examining before and after photos.
When patients are looking for the right rhinoplasty surgeon, I encourage them to look at as many before and after photos as possible and critically evaluate what was done in every rhinoplasty.
I perform structural preservation rhinoplasty and treat the nose as an entire structure that needs to balance well with the rest of the face. This frequently goes beyond just removing a dorsal hump. A good rhinoplasty result is invisible as it simply fades in with the other facial features.
I always focus on making sure the nasal tip is well supported with a cartilage graft called a caudal strut graft or a caudal septal extension graft. These grafts take additional time to harvest and contour, but are vital to making sure the nasal tip is well supported and maintains its ideal projection for the rest of a patient’s life.
When the nose is well supported the nasal tip can gently show through the nasal skin for a more elegant and refined look and less dorsal hump needs to be removed to achieve an ideal dorsal line (Image 3). This means more structural support for more long-lasting results and better nasal breathing.
As a double board-certified facial plastic surgeon, I specialize exclusively on the nose and face and strive to make sure I provide my patients with consistently beautiful and natural results.
If you are considering rhinoplasty, I invite you to schedule a consultation today and let me answer any questions you may have.
Image 2
Image 3