Total Reconstruction of the Nasal Axis (5 Days Post-Op)

To correct a pronounced deformity, a young female patient approached me complaining of a crooked nose and concomitant severe difficulty in nasal breathing. This case clearly demonstrates how closely aesthetics and function are linked: a severe external deformity always indicates serious internal disruptions of the nasal architectonics.

Initial Anatomical Features (“Before” Photos)

Upon examination in frontal and three-quarter views, the following issues were evident:

• Deviation of the nasal axis: The nasal dorsum was severely shifted to the right side (relative to the patient), disrupting the facial midline and distorting the proportions.
• Nasal tip: Under-projected, wide, and asymmetric. It followed the deviated dorsum, making the alar wings appear disproportionate.
• Functional state: Due to an S-shaped nasal septal deviation, the airflow on one side was almost completely blocked. The patient had been suffering from chronic congestion for years.

Surgical Objectives and Procedure

This was a technically challenging case of simultaneous rhinoseptoplasty. I had to perform a total reconstruction of the nasal framework to return it to a strictly central position.

First, I performed a deep septoplasty — straightening the deviated cartilaginous and bony parts of the septum, completely restoring the normal diameter of the airways. Then, using structural rhinoplasty techniques, I carefully repositioned the bony structures of the nasal dorsum to the center. The final stage was the symmetrical refinement of the nasal tip: I narrowed, lifted, and stabilized it with cartilage grafts precisely along the midline of the face.

Result on Day 5 (“After” Photos)

The presented photographs show the result just 5 days after surgery, immediately following the removal of the rigid plaster cast.

• Swelling and bruising: Granted, moderate postoperative swelling and yellowish bruising are still present on the face, which is absolutely natural for such an early stage. The tissues still face a long recovery process.
• Aesthetic outcome: Despite the initial swelling, the difference is colossal. The nose became impeccably straight, with the axis perfectly centered. The tip acquired defined contours, narrowed, and blended harmoniously into the new facial proportions.
• Functional outcome: Immediately after the removal of the internal splints, the patient took her first full breath in years.

Even at such an early stage of rehabilitation, the patient’s face was transformed, looking symmetrical, soft, and balanced. Ahead lies the process of gradual swelling subsidence, but the magnificent final result is already apparent.