Featured Case


Before	After

Before	After

Before	After

The current Featured Rhinoplasty Case Example was chosen because of the many complexities involved with her surgery.This is an otherwise healthy young lady who desired reshaping of her nose due to several areas of concern. She had no prior surgery on her nose.

One of her main concerns was the asymmetry involving her nasal tip. The right side of her tip was relatively flatter compared to the left side, which itself was much pointier than normal. This was particularly evident on her lateral view where the nasal tip appeared excessively pointed. In addition, her nasal tip was projected excessively far from her face, or overprojected.

Furthermore, she had concerns with the shape of the columella region. The columella refers to the soft tissue that is situated vertically in between the nostrils. Ideally, the columella contributes to a soft contour that curves downward in between the nostrils, which are themselves slightly arched in the opposite direction on each side (see photo of relatively ideal columellar contour). In this particular case, the patients columella was retracted upward, or hidden. This contributed to the appearance of a poorly defined and even flattened nasal tip as seen from the front view.

Dr. Hilinski performed an open septorhinoplasty along with a temporal fascia graft to achieve the changes noted. Her nasal tip was completely disassembled and rebuilt to reflect a more pleasing shape. This involved use of multiple cartilage grafts intended to extend the septum anteriorly, which helped to push out the columella. Once this was accomplished, the tip was made more symmetric with use of specialized sutures and placement of additional cartilage grafts. The nasal tip was then deprojected, or brought closer to her face, and rotated slightly to help achieve better balance and proportion. Finally, a fascia graft was placed over the bridge and nasal tip to help minimize chances of visible contour irregularities that can show thru thin skin like she had.

The end result nearly 12 months following surgery is demonstrated here. Notice overall improvement in her tip shape and size. The columella is now more appropriately positioned as are the nostril arches along each side. Her tip is now more symmetric with a more feminine contour. The tip has also been rotated and deprojected and now appears less pointed as seen best on the profile view.

Dr. Hilinski's office in San Diego, CA is conveniently located near the following: