I wanted to post a plastic surgery blog entry focusing on rhinoplasty imaging as it relates to achieving realistic results in nose reshaping. This particular San Diego rhinoplasty patient had suffered trauma to the nose when he was actually stepped on after falling to the ground. As you can see on his frontal rhinoplasty view, he had severe trauma to the bridge of his nose with collapse. You can see his frontal view looks ‘washed out’ – meaning, he has very poor shadowing on both sides of his bridge. In addition, you can appreciate that his nose was collapsed asymmetrically, or differently on both sides.
Imaging in Rhinoplasty
We consulted with him in our San Diego office regarding reconstructive rhinoplasty surgery, which included a discussion of cadaveric rib cartilage grafting. Using a computer imaging program, we provided him with a visual idea of what his nose might look like following nasal reshaping surgery. Below are his preoperative rhinoplasty photos and the corresponding imaged view of what his nose might look like after nose reshaping. This imaging represented rebuilding his bridge back up and repositioning his nasal bones to their original orientation. On his side view you can see just how much his bridge was collapsed. With the computer imaging program, we were able to demonstrate visually how rebuilding his bridge back up might look following rhinoplasty.
Computer Images From Rhinoplasty Consultation
Actual nose preoperatively on left side, computer imaged/enhanced photo on right showing possible changes with planned rhinoplasty or nose job surgery.
Reconstructive Rhinoplasty With Rib Grafting
I ended up taking this patient to surgery and performed a complex open reconstructive septorhinoplasty. As part of the nasal reshaping process, I also performed a cadaveric rib grafting procedure. This was needed to rebuild his bridge height and restore and more normal looking nose.
Actual Rhinoplasty Before And After Photos
Here are his before and after rhinoplasty (nose job) photos. As you can see, we have now restored a more symmetric frontal view of his nose with improved shadowing. His nose no longer looks flattened across the front. On his profile view, rhinoplasty has provided restoration of a masculine profile view through elevation of his bridge height. Also compare his true post-rhinoplasty result with the computer imaged rhinoplasty photos shown above. As you can see, his actual rhinoplasty results are better than what we imaged in his rhinoplasty consultation before surgery. This is, in fact, my goal with all rhinoplasty patients. My personal approach to the rhinoplasty consultation involves ‘under-imaging’ and ‘over-delivering’ in terms of the nasal reshaping process. I would much prefer to show you computer images that are sufficiently enhanced to make you satisfied as a rhinoplasty patient, yet realistic and achievable. If you are content with the surgical goals using a computer image that is under enhanced, you should then be even happier when the actual rhinoplasty results surpass the anticipated imaging. This particular San Diego rhinoplasty patient is a prime example of our routine use of computer imaging in nasal reshaping surgery.
