RHINOPLASTY – NOSE SURGERY

A 15-year-old Miami plastic surgery patient presents to our cosmetic surgery center requesting nose surgery. She complained about her long nose with bulky, droopy tip and a hump. She also had difficulties breathing in effort (exercise, running).

After a thorough clinical evaluation of external and internal nose deformity we discussed with patient and her mother possible areas of improvement. The outside aspect of the nose needed removal of the hump and rotation of the nose tip to create more balanced profile. She also needed correction of septum deviation to improve her breathing.

Her surgery was done in the hospital (pediatric patient) in general anesthesia. We used open rhinoplasty approach through an incision placed across the columella and then inside of the nose. A small hump from dorsum of the nose was removed; nose tip cartilages were reshaped and slightly elevated to improve tip width and projection. A portion of the nose septum cartilage was removed to correct obstruction of nasal passages. A small cartilage graft taken from the septum was used to further support elevated nose tip. Finally nose bones were cut on both sides to narrow the entire nose. Splints were placed inside and outside of the nose to diminish postoperative swelling. Internal nose splint was removed 1 day after surgery; external splint was removed 7 days after nose job.

Images before nose shaping surgery and correction of nose obstruction (left) and 1 year after septo-rhinoplasty (right). Notice improvement of the nasal tip, length and height of the nose; nose tip is rotated upward and placed as the most prominent point of the nose. Notice improvement of the angle between the lip and the nose and overall improvement in facial balance and harmony. A small chin implant would further improve her profile. Performing nose surgery in girls 14 years and older is a generally accepted and safe concept since the facial growth is mostly completed by that age.

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