Introduction and Main Complaints
A young patient with highly complex nasal anatomy was admitted for a consultation. This was a classic case where pronounced aesthetic discomfort is closely linked to serious functional impairments.
Initial Anatomical Presentation
Analyzing the initial case and the computed tomography data, I immediately noticed a severe deformation of the internal structures. The patient had a grossly deviated nasal septum with significant shifting to the right, along with pronounced asymmetry of the nasal bones and the pyriform aperture. It was entirely obvious that such an internal “framework” critically obstructed nasal breathing and reduced the young woman’s quality of life.
Externally, the situation was no less challenging. The nasal axis was severely deviated to the side, and when viewed from below (basal view), a total asymmetry of the right and left halves with deformed nostrils was striking. The aesthetic presentation was further compounded by a small hump on the nasal dorsum and a hypertrophied, drooping nasal tip. Such a shape always visually elongates the face, coarsens its features, and gives it a tired appearance.
Course of the Operation and Surgical Nuances
I faced a large-scale task: to perform a total nose reconstruction, combining functional septoplasty with delicate aesthetic correction. My main goal was to restore full breathing and create a harmonious, proper profile.
The operation was meticulous and lasted 2 hours and 10 minutes. During this time, I performed the complex work of straightening the nasal septum and an osteotomy to bring symmetry to the nasal bones. I paid special attention to shaping the new tip: I needed to delicately excise the excess cartilage tissue and lift it to restore lightness to the face.
Outcome: Harmony and Functionality
Evaluating the result immediately after the operation, I can see that we succeeded in achieving our goals. I completely straightened the central nasal axis and eliminated the hump, creating a beautiful, smooth bridge. The nostrils acquired a proper, symmetrical shape. The massive, drooping nasal tip was transformed into a delicate and neat one, which instantly refreshed the face, making it look younger and more open. Most importantly, we achieved not only excellent aesthetics but also restored the patient’s free, clear breathing.
