This patient had a dorsal hump but also notice that her radix, or starting point of her nose, was too low. A mistake would be to remove just the nasal hump, resulting in a nose which is too low and a definite stigma of a previous rhinoplasty. A radix graft was placed to slightly alter the nasal starting point.

The nasal tip in this patient was ptotic, or weak in support and hanging. This gives her the appearance of a long nose on lateral view. A "tongue-in-groove" technique was used in combination with a columellar strut to provide the patient with adequate rotation and projection.

An endonasal approach was performed, a closed rhinoplasty. The endonasal rhinoplasty is considered a "lost art" by some surgeons in that very few surgeons can obtain predictable outcomes in a long term basis with this technique. Only certain noses can be approached with an endonasal technique. The benefit of the endonasal technique is avoidance of a scar at the base of the nose, or columella and decrease in swelling. This patient is seen 3 weeks after surgery and had no bruising and minimal swelling.

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More patient photographs can be seen in Dr. Shah's office.