Patients often come because they like to talk about the shape of their nose. Rhinoplasty is a procedure to reduce and enhance the shape and appearance of the nose and often times I will have a pretty young woman in her 20s who says I inherited my father’s nose, I have got this big Italian nose or whatever. So then we talk specifically about what they would like to do and the most common things that we do are if you have a hump here is we lower the hump. If the tip is very wide and broad, we can refine that. If the nose is long, we can shorten it and rotate it up a little bit. If the nose is very wide, we can narrow what we call the alar bases, but there are several things that we can do. It is a three-dimensional structure when you reduce the hump, then sometimes you need to narrow what we call the bony vault and when you reduce and refine the tip it makes the entire nose look better. So there are several parts to it and often we need to spend you know 20 to 30 minutes talking about these various things, but in the right patient who has a significant nasal deformity it can dramatically enhance their facial appearance and definitely be worthwhile. The other type of patient that I sometimes see for rhinoplasty is a 45-year-old male who says, “You know, I used to be a professional baseball player and I broke my nose four times. Can you just move it back to the middle of my face,” and I say, “I can help you.”

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