The goal in a rhinoplasty procedure is to conserve the nose using an incremental surgical approach to make a nose, well, look like a nose. Nothing more and nothing less. Watch Dr. Robert Caridi in the operating room explain in detail the process of a conservative rhinoplasty procedure, or nose job, of a male patient at Westlake Plastic Surgery.

See before and after rhinoplasty photos

This patient was seen in the office on several occasions for consideration for cosmetic rhinoplasty. He expressed a desire was for a hump reduction, narrowing and shortening of the nose, and improvement in the tip complex. Patient presented with a large and long nose, strong lower lateral cartilages, a relatively straight septum, mild to moderate turbinate hypertrophy bilaterally, and wide nasal bones in the mid vault area.

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This procedure is completed under general anesthesia provided by our board-certified anesthesiologist. After being induced under general anesthetic, standard prep and injection of the nose was performed. A stairstep incision was designed in the most narrow portion of the columella. The nose was opened followed by a rim incision and an angled scissor dissection that is included in the degloving of the tip complex. Exposure of the nose extends over to the nasal dorsum. The lower lateral cartilages were strong and relatively symmetrical. Bilateral mucoperichondrial tunnels were created using a Joseph elevator. Separation of the upper lateral cartilages from the midline septum was performed followed by a reduction of the cartilaginous and bony dorsum using a straight scissor and rasp, respectively. The lower lateral cartilages were reduced leaving a 7 mm strip and several sutures were then used to secure the tip complexes to each other. The edge of the cartilaginous septum was then trimmed through a right-sided approach. Trimming of the lower lateral cartilages was performed adjacent to a prominence in the submental region. A 3 point suture was then placed to improve the angle of the tip complex as well. The tip complex was then advanced on the septal angle area and secured with a suture. A bilateral percutaneous infracture was then performed with a marked improvement of the dorsal lines and the width of the nose.
Relationship between the nose and the tip complex was evident before closure of the nose was performed. Contoured Telfa pads with bacitracin were placed on either side of the midline septum secured on the outside of the nose with a heavy, nonabsorbable suture. Standard splint and dressings were applied to the nasal complex and removed 7 days later as seen in the video.
The risks include, but are not limited to bleeding, infection, hematoma formation, scar deformity, contour deformity, pain, paresthesias, numbness, asymmetries, dissatisfaction with results, chronic edema breathing obstruction issues additional procedures additional cost and a host of other potential downsides.

The patient is seen two months after his procedure for a follow-up assessment. He expresses no breathing obstructions and is very happy with his result. He did have swelling in the nasal tip complex which is normal. It should be noted that swelling in the nose takes up to two years to fully minimize. Patients should allow this time to pass before they see the final result.

There you have it! Another successful rhinoplasty procedure by Dr. Caridi at Westlake Plastic Surgery in Austin, Texas!

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