Hi there, Dr. James Southwell-Keely here. Welcome to my case studies. The procedure is rhinoplasty. This lovely patient presented complaining of a small hump on the top of her nose and a fairly broad ill-defined tip. If we screen down to the frontal view, you can see what she means. She was otherwise fit and well and presented no problems as a surgical candidate. So after a detailed assessment and workup, we proceeded to the operating theater.

The surgery entailed making an incision in the columella of the nose, which is the strip of skin that exists between the nostrils here. This then allows me to access the underlying bone and cartilage of the nose by elevating the skin off those underlying structures. If we scan through to a postoperative view, you’ll see that I’ve been able to shave down that small hump and give the side profile of the nose a more appealing appearance and better balance. We then screen down to the frontal view. You can see how I’ve attended to the tip in improving its definition and overall improving the balance of the nose.

In reducing the small hump she had on the top of the nose, I’ve had to make cuts in the bone on either side in order to narrow the nose through the mid portion. I then use some cartilage to accentuate the dorsal, or the top of the nose, and to reinforce the tip. At the conclusion of the surgery, she had sutures placed in that columella incision and a splint that wrapped over the top of the nose. There was some minor postoperative bruising and swelling which usually settles within the week. She came back to see me at the one week postoperative mark for removal of the columella sutures and then again at the two week post-operative mark for removal of her splint.

I tell all of my patients that it takes a good 12 months to see the final results of a rhinoplasty operation, but instantly you see a change in the shape of the nose for the better and over the ensuing months you see a gradual improvement towards that 12 month mark. She’s happy, able to return to exercise within six weeks, and the images we see today in the postoperative setting are at about the nine month postoperative mark.

If you have any questions regarding rhinoplasty, please feel free to reach out to me. Lovely speaking with you today. Take care and bye for now.