The patient turned to me for help to bring harmony and softness to her face. The main source of her dissatisfaction was her nose, which visually weighed down the central part of her face, depriving it of refinement.
Initial Anatomical Presentation (Before Surgery)
When analyzing the face in three-quarters and full face, I identified a complex of anatomical features that required delicate surgical intervention:
- Nasal bridge: was identified as excessively wide, flattened, and lacking clearly defined aesthetic lines.
- Nasal tip: appeared bulky, rounded (a so-called “bulbous” tip), and was slightly drooped downwards, giving the facial expression an unnecessarily stern look.
- Skin quality: the patient has rather thick, porous skin in the area of the nasal tip. This is always a challenge for a plastic surgeon: thick skin contracts reluctantly and tends to “smooth out” the refined framework created by the surgeon, so the work with the cartilages must be as precise and structural as possible.
My main goal was to narrow the nose along its entire length, give the tip a beautiful definition, and soften the profile while preserving the absolute naturalness of the appearance.
Surgical Procedure and Professional Nuances
Working with thick skin requires creating a reliable and distinct support. During the surgery, I performed a careful reduction of the osteocartilaginous framework to narrow the nasal bridge and model the correct light reflections.
The main stage of the procedure took place on the nasal tip. I performed a meticulous resection and suturing of the alar cartilages to eliminate excess volume and rid the patient of the “blurry” tip appearance. To ensure that the thick skin draped beautifully over the new framework, I reconstructed the tip using rigid cartilage grafts—this allowed not only fixing it in a slightly elevated, refined position but also preventing it from drooping in the future.
Result After 15 Months
In the photo on the right, we see a stable result 1 year and 3 months after the surgery. The thick skin has fully adapted to the new, reduced framework, and the swelling has completely subsided.
The nasal bridge became straight, well-defined, and elegant. The tip acquired the desired definition, became refined, and was neatly elevated, opening the nasolabial angle. Notice how significantly the overall perception of the face has changed: due to the harmonization of the nasal proportions, the patient’s gaze became softer, and the face itself visually looks much younger and fresher. The patient is completely satisfied with the result of our work, and for me, this is the best reward.
