Primary

In the frontal view, the dorsal lines are asymmetric, and the tip, deviated to the patient's right, appears disproportionate relative to the dorsum. The tip cartilages are asymmetric and visible through the thin skin. In profile, the root is slightly low and the tip poorly projected. The hump is partly real and partly "apparent," meaning it is more pronounced due to the depression at the root and the insufficient tip height. The goal is to reestablish correct proportions, widening the dorsum, narrowing the tip, and harmonizing the profile with a "structural" rhinoplasty—that is, restoring support and shape where lacking while simultaneously reducing excess parts. Optimizing the "structure" by redistributing proportions through the use of cartilage "grafts" harvested from the tip cartilages themselves and from the septum ensures long-term stability of results. To this end, it is necessary both to maximize preservation of bony and cartilaginous support, avoiding a pinched tip and a scooped dorsum, and to refine the tip and dorsum by redistributing the various available elements. This avoids the use of any "alloplastic" material (foreign to the body) and preserves and improves respiratory function.

The deviated septum on the patient's left is repositioned to the center. The tip is harmonious relative to the dorsum.

In the three-quarter views, the proportions have been corrected. The tip cartilages are no longer visible through the thin skin thanks to the use of small, thin grafts harvested from the upper portion of the same cartilages.

In the view from above, the aesthetic lines of the dorsum have been corrected with the use of "autospreaders" (specific sutures of the dorsal cartilages), creating the correct "hourglass" shape and correcting the deviation.