A young woman came to me with pronounced aesthetic and functional complaints, concerned about a large, dominant nose. It did not simply disrupt the overall proportions of her face, but also visually added age, making her facial expression appear heavier. Furthermore, an examination revealed a deviated nasal septum, which significantly impeded full nasal breathing.
Anatomical Analysis “Before” Surgery
During the preoperative analysis, I identified several key issues that required meticulous surgical refinement:
- Nasal dorsum: The presence of a large, high osteocartilaginous hump that drastically disrupted the patient’s profile.
- Nasal tip: Massive, downward-pointing, with insufficient projection and a pronounced drooping (“bird’s beak” effect), which was particularly noticeable when smiling.
- Anatomical proportions: The nose appeared excessively long. The situation was further complicated by the patient’s rather thick skin—in such cases, skin envelope contraction takes time, and shaping the delicate contours of the nasal tip becomes more challenging.
Objectives and Course of the Surgery
My primary goal was not merely to reduce the size of the nose, but to fully harmonize the middle third of the face while preserving the patient’s individuality and southern expressiveness of her appearance.
During the surgery, I performed a delicate reduction of the osteocartilaginous section of the nasal dorsum, completely eliminating the hump and creating a smooth, elegant profile line. I paid special attention to the tip: I performed its rotation (lifted it upward), narrowed it, and reconstructed a stable support to prevent its drooping in the future. Simultaneously, a septoplasty was performed—I corrected the deviated parts of the septum, completely restoring unobstructed breathing.
Evaluation of Results: 10 Months and 3 Years Later
In the presented photographs, we can clearly observe the dynamics of recovery.
- At 10 months after the surgery (three-quarter photos), the primary swelling had subsided, the bridge became smooth, and the tip refined. However, the tissue reshaping process was still ongoing.
- At 3 years, we see the final, stable, and fully formed result. The skin has contracted perfectly over the new cartilaginous framework. The nose is neat, elegant, and well-proportioned to the rest of the facial features. The profile is soft and natural, and the frontal view is symmetrical and light.
The patient’s face began to look significantly younger, softer, and fresher. But most importantly, we achieved a stable functional and aesthetic success that will bring joy to the young woman throughout her life. The patient is completely satisfied with the result and the quality of her new breathing.
