Septal Extension (Septal Cartilage) + Alar Reduction + Nasal Tip Refinement + Nasal Bone Osteotomy & Narrowing

Treatment details: Septal Extension (Septal Cartilage) + Alar Reduction + Nasal Tip Refinement + Nasal Bone Osteotomy & Narrowing

A nose is rarely improved by correcting one element in isolation. Narrowing the bones without supporting the tip leaves the tip looking heavier against a slimmer bridge, and lengthening the tip without narrowing the base widens the appearance from the front. Septal cartilage was chosen as the graft material because it is straight, rigid enough to hold projection, and taken from within the same operative field, so no separate donor site is needed. The alar base was reduced on both sides after the tip position was set, since the width that needs removing changes once the tip is projected. One month is early for a nose built this way. What is visible here is the settled bone position, not the final definition of the tip.

Cutting and repositioning the nasal bones causes bruising around the eyes, which is at its worst in the first three to five days. A splint is worn over the nose for about a week. As the swelling settles, a visible step or unevenness along the bridge can appear, and this is one of the most common reasons for revision surgery. Cartilage is taken from the septum (the wall between the nostrils) to use as the graft. Harvesting it carries a small risk of a hole in the septum (septal perforation) and can affect airflow. Narrowing the bony part of the nose can also narrow the internal nasal valve, the narrowest point of the airway, which can make breathing through the nose harder. Numbness of the tip is common and usually settles over several months as sensation returns. The scars at the base of the nostrils from the alar reduction stay pink for several months before fading. Bleeding, infection around the cartilage graft, and prolonged swelling of the tip are all recognized complications. Avoid contact sports, and do not rest glasses on the bridge of the nose, for six weeks.