Rhinoplasty: Case Example- Reduction and Augmentation of the Nose

Nuances of Profile Management- The Radix

Rhinoplasty: Case Example 1- Reduction and Augmentation of the Nose

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Case Examples

Case 1

A 27-year-old female presented requesting reduction of her dorsal convexity (Fig. 7). Profile analysis revealed a deep radix, over-projected rhinion and normal tip projection. A deep supratip depression created the illusion of an over-projected tip.

Surgical correction included augmentation of the radix and caudal dorsum in the area of the supratip depression and reduction of the rhinion. A double layered septal cartilage graft was positioned at the radix and a single piece of septal cartilage was inserted as a small onlay graft in the supratip area of the cartilagenous dorsum. One and a half years postoperative views are shown in Fig. 7.

Alignment of the nasal profile in relationship to a properly positioned radix, rhinion and nasal tip produced a balanced nasal profile. Tip projection was not altered; however augmentation of the caudal dorsum lessened the supratip break which had the effect of reducing the apparent tip rotation and creating the appearance of less tip projection. This case illustrates the visual phenomenon of accentuated height of the rhinion caused by a deep radix and an excessive supratip depression.

Preoperative photo before augmentation with reduction rhinoplasty.

Figure 7A- Rhinion reduced 1.5 mm. Figure 7B- Nasion augmented with septal cartilage graft.

Before and after photo of a reduction rhinoplasty with augmentation and radix graft.

Figures C-H: Preoperative and 1.5 years postoperative photographs.


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