The Simple Reduction Rhinoplasty

As a primary and revision rhinoplasty specialist, Dr. Randal Haworth of Beverly Hills excels with all types of complicated nose jobs, but sometimes it is a simple pleasure to be confronted with a classic reduction rhinoplasty. Though these are relatively simple in concept, all nosejobs (or rhinoplasties) must be handled with utmost care and dedication to excellence.

Why does a prospective patient consult with me requesting a nosejob?

• Is it that their nose is asymmetrical, twisted, dented and scarred from a past rhinoplasty gone wrong?
• Is it that their nose is too small for their face with a flat bridge and wide flat tip perhaps due to Asian heritage?
• Is it that their nose is too wide with a bulbous tip?
• Or is it that their nose is too big, with an associated hump, wide bones and big, drooping tip (especially when smiling)?

Well, most come to me with the latter concerns such as: “Doc, my nose is just too big for my face”, “I always hated my hump”, “My tip is falling like a bird’s beak”, etc., etc.

Upon examination, the nose will usually manifest the aforementioned undesirable characteristics to varying degrees:

1. Is there a hump? Check
2. Is it comprised of bone and cartilage? Check
3. Does the nasal tip droop (with an acute angle between the upper lip and bottom of the nose/columella) especially with smiling? Check
4. Is the nasal tip wide and/or bulbous? Check
5. Are the nasal bones wide (where they emerge from the cheeks to form the bridge)? Check

If this common checklist is mainly affirmative, then the patient will need a classic reduction rhinoplasty. In this surgery, the tip is made narrow with either tip grafts (composed of cartilage usually invisibly harvested from the patient’s own septum), strategic suturing or both. The nasal hump is either chiseled or filed down and finally the nasal bones are narrowed by delicately in-fracturing them (“breaking the bones”). If this latter maneuver is bypassed, then an”open roof” deformity may likely arise in which the nasal bridge will look artificially flat and wide itself. Therefore the nasal bones (which comprise the sidewalls of the nose) are carefully angled inwards towards the midline in order to close the open roof which resulted from the hump removal in the first place.

Check out this patient, who underwent a classic reduction rhinoplasty on the Swan.

Here is a typical example of a classic reduction rhinoplasty,even though only subtle changes were performed. Note that a radix graft (to raise the nasal frontal angle) was placed to add  height and therefore elegance to her nose.

For a more general overview of rhinoplasty, go to: http://www.drhaworth.com/rhinoplasty/