1 month before and after pictures of my wonderful patient who underwent a Rhinoplasty. This is an incredibly wonderful patient of mine that underwent some changes to her dorsum and nasal tip to enhance her look while improving her breathing. She is still 1 month out and still has some swelling that will only continue to improve!
This young female patient that had a revision rhinoplasty with Dr. Mourad using her own rib. She came in 9 years after a primary rhinoplasty with another surgeon in New York City. She complained about her nose looking “deformed and unnatural”. The photo on the left shows her before photo. As you can see, she has asymmetry of her nasal tip. A functional and cosmetic surgeon Dr. Mourad looks at the “tip defining points”. These can best be appreciated by the reflective white light points at the tip. In her photo on the left, you can see that the patient’s right light point is higher then her left point. This was because her nose was twisted, with malformation and poor positioning of her cartilages.
Many years ago, when she had her original surgery, they removed cartilage that caused asymmetrical scarring and positioning of the cartilages as the years wore on. Over time, her nose began to droop looking unnatural. In her after photo on the right, you can see that her tip points are symmetric, with symmetric casting of light and shadows. Using her rib through a minimally invasive approach and access through a 1.2 cm incision, Dr. Mourad was able to recreate the natural contours of the nose. This photo is only 1 month after surgery, with still some swelling that should come down with time.
Do you ever feel like your nose is weak and collapsing? Like you have an inability to pass air? The nasal cartilages and bones can weaken over time, collapsing, causing feelings of congestion and inability to breathe. Sometimes the collapse is so severe it is present at baseline. This can be detrimental to your overall health and well being.
The patient pictured here couldn’t breathe because of collapse of his right nostril. Through an ethnic rhinoplasty this patient’s crooked nose and breathing could be fixed without any external incisions, minimizing pain and post operative swelling.
The patient is a 16-year-old female patient presented to Dr. Mourad for concerns with nasal breathing obstruction. She also complained of the appearance of her nose. The photo on the left demonstrates her preoperative view. She stated she did not like that her “tip was so big”, in addition to complaining of her tip “drooping.” The evaluation revealed the patient to have a bulbous tip. Dr. Mourad met with the girl and her family many times to help understand her complaints and understand her and her families expectations. After careful discussions with the family, she decided to undergo a closed rhinoplasty. This minimally invasive rhinoplasty, allowed for the patient to undergo the necessary modifications that maximized her outcome without compromising her future development. The photo on the right demonstrates a more refined and narrower tip, that is straight, without the “bulbous appearance” seen in the left photo. Her tip is also at a higher position, more elevated, and less droopy then seen in the preoperative photo. Her breathing is also improved after Dr. Mourad corrected her nasal airway obstruction internally.
This is a 41-year-old female who presented 1 year after rhinoplasty with complaints of 100% nasal blockage and unnaturally appearing nose.
Left Photographs: This photo shows her at presentation to Dr. Mourad’s office 1 year after her initial surgery. The black arrows show that she had an excessive amount of her nose removed externally, causing significant scarring and contracture. This scarring narrowed her nostrils and contributed to her inability to breathe. The blue arrows show that her nose has incomplete breaks in her nasal bones causing nasal valve collapse, further making her breathing worse. In the lower picture, the purple curved arrow also shows that she has a “droopy” tip that hangs low. The deformity is also from excessive resection of the internal structures of the nose. The blue star in the photo on the profile view also shows that the previous surgeon had left a bony hump, that also was made to appear worse by the droopy tip.
Right Photographs: This is a patient 1 year after surgery once the final healing has settled in. The purpose of the surgery was to restore her ability to breathe. The patient underwent a complete nasal reconstruction using her own rib. The orange arrow shows that her nasal tip was restored to a more natural, “higher”, position, no longer with a deforming “droopy” look. Her nasal tip has smoother contour. Her ability to breathe has been completely restored with improvement in her nasal valve structures.
This case demonstrates a 57-year-old woman that presented to Dr. Mourad after septal perforation secondary to a nasal surgery with a different surgeon many years before. Her complaints were nasal crusting, frequent infections, and bleeding. She attempted to use humidifying measures including ointments, humidified air, and nasal saline, which did not resolve her symptoms. The perforation is larger. The photo on the left demonstrates the 1.5 cm perforation as seen through the left nostril. Her repair required the use of a regional flap, using a right-sided Pedicled Inferior Turbinate Flap. The photo on the right demonstrates the immediate repair of the perforation intraoperatively.
The above case demonstrates a 45-year-old woman that came to see Dr. Mourad who developed a hole in her septum secondary to cocaine use. The photo on the left is a photo into the left nostril that demonstrates the 1.2 cm perforation which is located in the front portion of the septum. Her symptoms included noisy breathing, frequent nasal crusting, and bleeding. She also suffered from frequent sinus infections. The picture on the right demonstrates an intraoperative view of the repaired perforation, immediately after the repair. This perforation was repaired using a left-sided local flap (link to local flap). The technique used was an Anterior Ethmoid Artery Pedicled Flap. This technique uses rearrangement of tissue within the nasal cavity to close the hole in the septum. She has mild swelling in the area that will resolve with time.