19 Year Old Patient Gets Customized Nose Reshaping By Dr. Guida, New York, New York (10028)
Highlights: Traumatic break resulting in a prominent bump. Desired a relatively straight, natural bridge with strong tip support. The lack of tip support required a columellar supportive strut. "Open approach" required. This 19 year old patient has a history of trauma to the nose, causing a broken nose, elevated and crooked bump, and a severely deviated nasal septum, which completely blocked her nasal airway. In addition to not being able to breathe through her nose, she was also not happy with the overall shape. She did not like the prominent bump, the asymmetry of the bridge and tip, and the pronounced droop that occurred when she smiled. She has attractive facial features, but the nasal anatomy was out of balance with her otherwise well balanced facial features. An exam revealed a palpable and visible nasal bone fracture and bump, a very crooked internal septal deviation, wide asymmetric tip cartilage, and an off-center, wide nasal bridge from the trauma. She also had very little tip support, making the droopy tip much worse when smiling. Because of the tip asymmetry and lack of support, an open approach was used to achieve symmetry and definition of the tip cartilages, and for precise insertion of a columellar strut, using her own septal cartilage. Also, her dorsal bump was lowered significantly, the tip elevated, the bridge narrowed and the nasal obstruction fixed. (Sep 6, 2019)