Case 71: Tip and nostril width and overall nasal projection made the nose feel dominant for this young woman. Rhinoplasty involved making her whole nose smaller by deprojecting, refining the tip, and removing some nostril flare. At the same time, a nasal fracture and breathing concerns were addressed. Neck Liposuction also helped to define and re-balance her jawline to create the improved facial proportions that she desired.
The surgeon makes incisions in the skin, usually on the crease under the breast, around the areola and along the underside of the breast. After removing excess skin, the doctor will move the areola and nipple to a new, higher position, pull the skin down to reshape the breast, and then stitch the incisions. Usually, the procedure requires general anesthesia. The American Society of Plastic Surgeons[1] provides a detailed description of the surgery.
Case 44: One of the hardest things to accomplish in a nose job is giving a person a smaller version of the same nose. In Los Angeles, where small differences can mean everything, doing Finesse Rhinoplasty is common. Even at 6 months, you can see that, on profile, this patient’s tip is less projected but he still has a strong masculine profile. On base view, you will also notice the deprojection and the fact that alar base reduction can be done with no visible scars and maintenance of the natural nostril curve.
Case 89: This patient had broken her nose with consequent severe loss of tip support, tip rounding, crookedness, and a traumatic bump. In this case, a lateral crural overlay technique was used to reduce and lift the tip along with a septal extension to help with support and straightening which has improved tremendously as seen on the base view. Even though she’s still swollen in these early photos, she already has a great result and it’s only going to get better.
Some people opt for a temporary nonsurgical nose job—also called a liquid rhinoplasty—with hyaluronic=acid-based injectable fillers, like Voluma or Restylane Lyft. This minimally invasive procedure can camouflage bumps, create more symmetry, or lift and build up the tip of your nose. This approach has its limitations though. “If you have a large nose, it’s not going to get any smaller with fillers,” says Dr. Miller, though changes in proportions can sometimes make it appear smaller. It also can’t fix a crooked nose.
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