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Female patient complaining of a large nasal tip. She also feels that her tip hangs too low and her nostrils are too elevated.

Procedure: Open rhinoplasty with septal graft with lateral crural overlay to deproject the nose, tip narrowing sutures, alar rim grafts, shield graft, radix graft and osteotomies.

Comments: The reason why this patient feels that her tip is too big and her nostrils are elevated is that her nasal tip cartilages are vertically-oriented instead of being more aligned along the nostrils. To prevent post-operative nasal obstruction, either the cartilages have to be repositioned or placement of alar rim grafts. The after photos are 7 months following the surgery and the frontal and base view reveal the dramatic difference.

Los Angeles and Beverly Hills rhinoplasty patients.

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