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Today, we'll be discussing rhinoplasty surgery for the over-projected, droopy-tip, and a poly-beak. The goals of surgery are to provide a smaller, cuter, more feminine nasal appearance. My gracious patient is asleep with general anesthetic. Two benign nevi are marked for shave biopsy after the conclusion of rhinoplasty. The mark along the nasal sidewall indicates the anticipated amount of bridge lowering.

Exposure of the lower lateral cartilages reveals exaggerated curvature along the entirety of the medial crus, where it meets a strong, over-projected lower lateral cartilage. Repair will involve division of the lower lateral cartilages at their domes. Suturing the medial crura together, lowering the medial crural complex, along with lowering the anterior projection of the lower lateral cartilages.

A columellar strut is placed in a pocket between the medial crura and with sutures in two locations. You can see the de-projected and contoured lower lateral cartilage at a level slightly higher than the medial crural post. This is her appearance near the end of surgery, after additional septal shortening, dorsal reduction, and osteotomies were performed. After closing her incisions, nostril narrowing was performed, and lastly, the shave biopsy.

Rhinoplasty Deprojection

Doctor Eric Joseph discusses and demonstrates rhinoplasty deprojection.

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