Primary Rhinoplasty Before and After Gallery Vancouver | Dr. Buonassisi

Rhinoplasty Before & After Photos

Rhinoplasty Before & After Photos

* Individual results may vary. Please schedule a consultation to review your goals with your plastic surgeon.

Rhinoplasty Before & After Photos

Case Overview

A much more balanced profile following hump reduction, tip rotation, tip refinement and correction of a hanging columella. Many thanks to this patient for providing us with consent to display her photos.

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Surgical Approach

Dramatic changes to the tip area were planned, indicating an open rhinoplasty.

Exposing of Nasal Tip Cartilages

An inverted V incision was created in the columella skin to allow for an open approach rhinoplasty. The medial crura was separated to expose the caudal septum which was deviated towards the patient’s left.  A septoplasty was performed to correct this.

Correction of Hanging Columella

A slight amount of the caudal edge of the septum was removed as it was pushing the columella downward, causing a hanging columella.  The tip cartilage themselves were also quite soft with a poorly defined dome.  The dome defining sutures were place and this brought the dome defining position slightly inferiorly which improved part of the hanging columella.

Hump Reduction

The dorsal hump was removed using sharp scalpel and osteotome, followed by lateral percutaneous osteotomies to close the open roof.

Tip Refinement & Rotation

The medial crura were then scored to reduce there intrinsic curvature and these were gently retracted back onto the previously excised caudal septum to decrease the columellar show.  This was sutured in a mattress fashion through and through from the medial crura to the caudal septum.  This was done at 2 locations.  The posterior edge of each dome was then sutured to one another to gently indraw the nasal tip but maintain the separated dome-defining points.  The columellar flap was then re-approximated and closed.

Related Resources

  • Dome defining stitches
  • FAQ: What is an open roof deformity
  • Video: Hump reduction case study 1
  • Video: Keys to success with hump reduction
  • Before and after photos: hump reduction patient 19
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