Here is a young patient who has a very specific look for a modeling campaign. He presents with a nasal fracture and a congenital knob to the nose. He has never had previous surgery and is seeking to improve his breathing, maintain his nasal shape, and keep his look but with a slight change to the appearance of his nose. This patient, like many of my patients, depends on their face for their career.
The key for me is to understand what the patient wants, what is necessary for his career. Sometimes we actually go over photographs, talk to the photographer, agent and really make sure every person is involved in the decision making process. Ultimately, the “look” is determined by the patient, but he can make a much more informed choice when he has input from people whose opinion he trusts. Together, the patient and I determined what our surgical goals were.
In his case, to straighten out his nose his nasal bones needed to be broken in a special manner. Many unsatisfied rhinoplasty patients I have seen from outside surgeons break nasal bones in the same manner for male and female patient alike. Rhinoplasty must be tailored to the patient and this will sometimes create an overly narrowed feminine appearing nose.
In addition, this patient has slight deviation throughout his nose. However, while more invasive procedures are indicated for some patients, this patient has a specific look and really wants minor changes to his nose.
The knob on the patient’s nose bothers the patient a little and he desires improved symmetry.
In addition, he has a severe septal deviation. A big portion of his case is to improve his breathing. Changing just the outside appearance in his nose is not enough.
For his case, an endonasal approach, finesse rhinoplasty was performed with specific osteotomies and septal repositioning and a restructuring of his right lower lateral cartilage.
His postoperative pictures represent improvement in his deviation His nasal tip knob is improved as well. Overall, he retains his appearance and looks like himself, but just improved. I can not stress how many of my patients tell me they want to look like themselves but just improved.
After his operation, his work as a model continues in numerous successful national print campaigns and runway work. Here is one example of photograph taken six months after surgery. The photo ad was in numerous magazines.