History
Ms KW is a 27 year old who had never liked the appearance of her nose. She felt that it was too big for her face and wanted the prominence of her hump reduced. She also had trouble breathing through both sides of her nose at night. She thought she may have previously fractured her nose as a child.
Ms KW came to see Dr Robinson with the goal of improving the breathing through her nose as well as improving the appearance of her nose.
Pre operative assessment
Ms KW had a promence to her nose in the upper and mid third of her nose. The tip of her nose was also bulbous. When examining her nose with a nasoendoscope she had a deviation of her septum to the right as well as having large inferior turbinates.
Intraoperative procedure
Ms KW had an external rhinoseptoplasty and turbinoplasty. The general steps of the procedure were as follows:
- Hump reduction using rasping techniques to reduce the prominence of her nose
- Combination osteotomies with infracturing of nasal bones to reduce the broadness of the upper third
- Bilateral cantilevered spreader grafts to provide definition as well as support to the mid third of the nose
- External septoplasty with removal of the bent portion of her nose
- Bilateral lateral crural turn in flaps to reduce the bulbosity of the tip of the nose as well as improve the breathing through the nose
- Bilateral turbinoplasty using endoscopic techniques
- Domal and interdomal sutures
Post operatively
Ms KW had an uneventful post operative recovery and was extremely happy with her result. This is reflected in her rhinoplasty outcomes evaluation score and nasal obstruction symptoms evaluation score.
NOSE Questionnaire
This score evaluates breathing through the nose. The lower the number the better the breathing through the nose. Ms KW went from a score of 9 to 2.
Rhinoplasty Outcomes Evaluation Questionnaire
This score evaluates the cosmetic appearance of the nose. The higher the score the better the results. Ms KW went from a score of 10 to 19.