Structural Male Rhinoseptoplasty: Asymmetry Correction (8 Months)

A young man came to see me with combined aesthetic and functional complaints. He was dissatisfied with a prominent hump in profile, as well as a noticeable nasal asymmetry, which was particularly visible from below. In addition to aesthetic discomfort, the patient complained of a severe nasal breathing impairment caused by an old injury.

Initial Anatomical Features (Before Surgery)

Male rhinoplasty always requires a special approach: here, it is important to meticulously eliminate defects without feminizing the face, meaning preserving straight, strong lines. When analyzing two projections, I highlighted the following features:

• Profile: Presence of a large, rigid osteocartilaginous hump. The nasal tip had insufficient projection and appeared excessively flat.
• Basal View (Bottom View): A severe deformity was clearly traceable here. The nasal tip was wide, and the domal cartilages were flattened. There was a pronounced asymmetry of the nostrils and a deviation of the columella (the cutaneous part of the nasal septum), which shifted to the side, almost completely blocking one of the nasal passages.
• Skin Quality: Thick, typically male skin with well-developed sebaceous glands. Working with this type of skin requires creating a powerful cartilaginous support framework; otherwise, the refined cartilages will simply not show through a thick layer of soft tissue.

Surgical Progress and Objectives

My primary goal was to restore symmetry, define clear nasal contours, and fully restore the patient’s free breathing.

During the open rhinoseptoplasty, I performed:

1. Restoration of Breathing: Performed a complex septoplasty. I completely reconstructed the deviated quadrangular cartilage, returned the columella strictly to the central position, and opened the nasal passages.
2. Dorsum Correction: Carefully removed the hump, shaping an absolutely straight, masculine dorsal line without any scooping.
3. Nasal Tip Modeling: This was the most time-consuming stage. I eliminated the excessive width of the tip, brought the domes of the alar cartilages closer together, and placed a strong columellar strut (cartilage graft). This made it possible to align the nostrils, achieve their symmetry in the basal view, and give the tip a sharp, stable projection capable of resisting the contraction of thick male skin.

Result After 8 Months

In the “After” photos, we see excellent progress after 8 months (the final contraction of the thick skin will take up to 1.5–2 years, but the main contours are already formed).

• In Profile: The hump is completely eliminated. The bridge of the nose became straight, and the tip was elevated to the ideal male angle, making the profile strong-willed and harmonious.
• In Basal View: We managed to achieve stunning symmetry. The nostrils took on a proper oval shape, the columella was positioned exactly in the center, and the nasal tip itself turned from flat and spread out into a neat, defined, and well-structured one.

The patient’s face began to look more open and harmonious, while fully retaining its masculinity. Nasal breathing was 100% restored, and the patient finally forgot about drops and congestion, remaining completely satisfied with the result of our work.