Hump Reduction & Tip Rotation Case Study 3
Video transcript: This is a case study of a patient that needs a hump reduction and also a tip rotation procedure done as well. In the pre operative analysis I can see that this patient’s bridge is a little too high and also the angle that her tip made between her upper lip and the tip of her nose is probably a little too acute so we cal lthat ptosis a little bit of ptotic nasal tip otherwise the tip itself and the relationship of the two sides of the tip was quite normal so what I recommended was hump reduction and tip rotation.
For the hump reduction as we mentioned in previous videos we basically take away some of the cartilage and bone that forms a hump and then we perform osteotomies on the side walls of her nose to actually narrow the nose again back to its original position. Now, in her case if we had done just the hump reduction then we would end up with a fairly straight dorsal profile but in a way it kind of accentuates the droopiness of the tip so for her I also wanted to elevate the tip upward and we had made that decision pre operatively.
This is as if we had just done the hump reduction and now what I want to show is how we rotate the tip in an upward direction essentially in her case we took the central part of her nasal tip which is really the collumelar and we actually tilted it backwards and then re-suspended it back onto her nasal septum.
I will show you how that’s, done essentially the cartilages were tilting down a little too much so they were separated from the under lying septum which normally holds the tip and bridge and was replaced and repositioned in a higher orientation and that’s secured in place with stitches that are there permenantly and that’s all done underneath the skin of course. What you see in the patient is that we take the nasal tip cartilages that are tilted downwards slightly and elevate them a little bit so that I think you can probably see the difference between those two slides but that will elevate the tip. And this is the actual results of the patient so before hand she has a high bridge and a ptotic tip whereas now her bridge is straight and we tilted her tip upwards and you will see on her three quarter views as well that gives her a very nice result and makes the nose look quite a bit smaller