This 26-year-old woman from Los Angeles, California desired nose reshaping surgery (rhinoplasty) to improve her overall appearance. She was concerned about the size and position of the tip of her nose, but she was otherwise pleased with the appearance of her nose. She was able to breath through her nostrils without difficulty.

On examination in our Marina del Rey office, I felt that she had a bulbous nasal tip that drooped slightly, giving her a more masculine appearance. I also found that she had inadequate defintion of upper tip area which made her nose appear longer. The nasal bones and cartilage of the upper nose were already ideally shaped. Also, her nasal septum and turbinates were both normal.

I thoroughly discussed my findings with her and together we formulated a plan for surgery. At her preoperative visit six weeks later we again reviewed the surgical plan in detail.

In the operating room I performed an open rhinoplasty procedure to maximize the precision of the changes I planned for her nasal tip. I trimmed the excess cartilage from the upper portion of her bulbous tip and used fine calipers to improve symmetry. I also removed a portion of her prominent nasal septum on the dorsum that was preventing differentiation of her nasal tip and dorsum. On the lower portion of the septum, underneath the nose, I removed a triangular piece of cartilage in order to rotate her tip upward into a more perky position. I then used fine sutures to move the tip cartilage together to improve her tip definition. I closed the incisions with a meticulous technique and placed a small bandage on her nose.

The patient recovered beautifully from the surgery and was very pleased with her results. These pictures were taken before and five months after her nose reshaping operation. She now has an ideally shaped nasal tip that is perkier as well, consistent with her overall feminine appearance. She also has better differentiation of her tip from her dorsum that contributes to her natural appearing rhinoplasty result.