Primary

In this young patient, the nose appears somewhat “heavy” in relation to the face. The aesthetic lines of the dorsum are irregular, and the tip is slightly bulbous. The nasolabial angle is too open for a male, and the nose appears somewhat “tense” and overly projected, although slightly short. In the profile view, a modest dorsal hump is clearly visible. This is a “refinement” rhinoplasty requiring several precise, almost millimetric adjustments. The patient wishes to “refine” his nose, achieving the greatest possible harmony with a natural, unoperated appearance. As always, computer imaging simulation is essential.

The aesthetic lines of the dorsum are now harmonious.

The tip has been triangularized and refined, reducing its bulbosity as much as possible considering the relatively thick skin. The columellar incision is not visible.

In the three-quarter view, the proportions between the dorsum and the tip are more harmonious.

In the profile view, the tip has been slightly lengthened and projected by means of appropriate sutures and small cartilage grafts, while the dorsum has been lowered and kept straight. The result is the desired natural profile.

These photos, taken two weeks after surgery, are useful to understand what typically occurs in the postoperative period: usually, about 70% of swelling has resolved after two weeks, 80% after one month, and the remainder—quite slowly—over the following 6–9 months. The columellar access scar is slightly reddened.