Surgeon: Dr. Batniji
Location: Newport Beach, Ca
Procedure Detail: This 16 year old female presented with an interest in changing the shape of her nose. Specifically, she desired removal of a dorsal hump (bump on the top of the nose), increased rotation of the nasal tip, and more definition of the nasal tip. During the consultation and review of her photographs, Dr. Batniji noted collapse of the middle part of the nose on the left, thus resulting in nasal airway obstruction and a “c” shaped deformity on frontal view. Using digital imaging software, Dr. Batniji demonstrated the benefit of chin augmentation (chin implant) as well as neck liposuction in order to balance the relationship between the nose and chin. Dr. Batniji performed the following:
- Neck liposuction.
- Chin augmentation with a composite Gore-Tex coated silicone chin implant.
- Laser turbinectomy/turbinoplasty to reduce the size of hypertrophic (enlarged) inferior turbinates, thus improving her ability to breathe through the nose.
- Septoplasty to straighten the nasal septum, thus improving her ability to breathe through the nose.
- Rhinoplasty via an external approach.
- Left spreader graft to address left internal nasal valve collapse. The left upper lateral cartilage was found to be detached from the dorsal septum, resulting in depression of the left middle third of the nose and subsequent “c” shaped deformity to the nose on frontal view. By placing a spreader graft, Dr. Batniji reconstructed the internal valve and straightened the nose.
- Right auto-spreader graft to maintain the integrity of the right middle nasal vault and right internal nasal valve.
- Dorsal hump reduction (profileplasty) with osteotome to address the bony dorsal hump; a rasp was then used for subtle refinement of the bony nasal dorsum. Cartilaginous dorsal hump was removed conservatively. The upper lateral cartilages were preserved to further maintain the integrity of the middle nasal vault and internal nasal valve.
- Caudal extension graft to slightly de- project the nasal tip, increase tip rotation, and provide tip support.
- Suturing techniques to improve definition of the tip cartilages (lower lateral cartilages).
- Tip graft with septal cartilage to provide subtle refinement to the nasal tip; Dr. Batniji covered this tip graft with morselized cartilage to soften the appearance and provide a natural result.
- Bilateral lateral crural grafts to strengthen the alar sidewalls and provide natural contours to the nasal tip.