African-American rhinoplasty

Abstract

Dr. Guyuron: The first patient is a 25-year-old woman who would like to correct the imperfections in her nose (Figure 1). Dr. Griffin, what flaws do you see in this nose? Bahman Guyuron, MD Figure 1 This 25-year-old woman has voiced no specific complaint but is seeking improvement in the appearance of her nose. Dr. Griffin: Her radix is a little high, but she may be happy with it. She has a very strong dorsum. She has poor tip projection, and I would certainly address that problem. Her columella-labial angle is less than 90 degrees; with more tip projection, she would also improve this already relatively good angle. From the basal view, I can see that she needs alar base resections to bring the base of her nose into balance. Her nasal tip needs a columella strut as well as tip grafting. I am glad to see that, overall, her skin is not oily and appears to be in very good condition. Steven M. Hoefflin, MD Dr. Guyuron: Dr. Hoefflin, what aesthetic problems do you see? Dr. Hoefflin: She has a full nasion and a lengthy, strong bridge. She has an acute nasolabial angle and I would probably graft this area. She has some excessive alar widths and I would perform an alar reduction. She would benefit from a projecting conchal peapod tip graft.1 I would also consider talking to her about a chin implant. Anthony C. Griffin, MD Dr. Guyuron: Dr. Stal, how would you approach this patient? Dr. Stal: I agree with everything that has been said. She has lower lateral cartilages that tend to diverge. If you resect too much of her cephalic lower lateral cartilages or cause them to diverge at an inappropriate angle, you may precipitate external valve collapse. She has a high radix and a …