Patient complains
The patient was concerned about the size and shape of her nose, which she perceived as disproportionately large and wide relative to her other facial features. On clinical examination, the nose showed a generalized hypertrophy of the nasal pyramid — both in width and in projection — with a nasal dorsum marked by a prominent hump that broke the continuity of the profile. The nasal tip was drooping, accentuating the apparent length of the nose and creating a heavy appearance that also visually reduced the prominence of the upper lip. The combination of excessive width, a dorsal hump, and a drooping tip gave the nose a dominant presence on the face, unbalancing the overall facial proportions.
The Treatment plan
The case required a comprehensive reduction and reshaping of the nose — not an isolated correction. Addressing only the hump or only the tip, without simultaneously intervening on the width of the nasal pyramid, would have produced an incomplete and potentially mild result. Planning targeted three simultaneous objectives: removing the hump for a clean profile line, narrowing the nose to reduce its visual width, and elevating the tip — with the direct effect of improving the visibility of the upper lip and proportioning the nasal length.
The closed technique ( closed rhinoplasty) was chosen as the optimal approach for this type of case: it allows full access to nasal structures without external scarring and offers precise control over modifications, with a more comfortable recovery.
Surgical Technique
The procedure was performed exclusively through intranasal incisions (closed rhinoplasty), with no visible external scar. All components of the problem were addressed simultaneously:
- Removal of the dorsal hump: the profile hump was resected in a controlled manner, creating a straight and harmonious profile line proportional to the rest of the face.
- Narrowing of the nasal pyramid: the excessive width of the nose was reduced through intervention at the level of the nasal bones and lateral cartilages, narrowing the frontal projection of the nose and creating a more elegant shape.
- Elevation of the nasal tip: the tip was repositioned upward, reducing the drooping appearance, proportioning the total length of the nose, and improving the visibility of the upper lip — an important aesthetic detail that transforms the overall expression of the face.
Result
The nose now presents a reduced and well-proportioned volume, with a narrower and more beutiful shape from the front, a clean profile without a hump, and a correctly positioned tip. The elevation of the tip has improved the visual relationship between the nose and the upper lip, balancing the overall facial expression. The result is significant but natural — the nose no longer dominates the face, without looking operated on or standardized.
