Is It Possible to Contour One Side of Nose Cartilage While Maintaining a 'Blended Look'? (photo)

    The closed obviously avoids the scar.  Removal of tip cartilage has less variability than the placement of a graft.  Sanding makes sense as does the cartilage graft.  If the scoop does not bother you, then no cartilage graft necessary.  The female nose tends to look more scooped out than a male nose, but that is, of course, your decision.

First, thank you for the photos. You mentioned several treatment options recommended by different surgeons but you didn't mention your specific concerns about your nose. It's more important to hear what you like and dislike about your nose. Do you have a clear idea of what you want your nose to look like? Make a wish list and then go to the surgeons and ask each one how they would address your surgical goals. The surgical plan should match what you are trying to accomplish. There may be more than one treatment plan that can help you achieve your goals and it's critical that you feel comfortable with both the surgeon and the plan.

Best Wishes

Spreader grafts are placed on the concaved side of the midthird of the nose when there is a differential in the profile.  If there is a severe convexity to one side, then shaving the high side down to match the concaved side will also be performed in addition to the spreader graft.  Spreader grafts are a patients own cartilage, harvested from the internal portion of the nose and placed along the bridge line to improve the profile and symmetry.  Repair of a deviated septum itself will not effect the outside portion of the nose and is simply performed only for improvement of airflow dynamics through the nose.  Both of these procedures can be performed through closed rhinoplasty techniques.

The most important issue is understanding what you don't like, and having a clear understanding of the 'goal'. Each surgeon will have their bias, though we sometimes find adding a cartilage graft to the side of the nasal bone very hard to blend. The skin is thin and with touch and glasses the laid on or added graft just might be a bother. We like the idea of the graft over the dip in the bridge (if that is the look you are drawn to) and fracture (with septum straightening) to reduce the deviation in the nose. Closed or open can both work.

Hi.

Just going by your pictures, I would vote with surgeon #1.  But, believe me, this is not the right way to decide what to do.