Facial Cosmetic Surgery by J.A. Bartlett MD FRCS (C), specializing in Rhinoplasty and Facial Rejuvenation

Rhinoplasty Surgery

Every year over half a million people in North America who are interested in improving the appearance of their nose seek consultation with a facial plastic surgeon such as Dr Bartlett. Whether it be the nose you inherited or a change related to aging or an injury, nothing has a greater impact on how a person looks than the size and shape of the nose. Because the nose is the most defining characteristic of the face, a slight alteration can greatly improve one's appearance.

Before and After Pictures of Dr. Bartlett's Patients

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Endonasal (closed) rhinoplasty. This patient demonstrates the most common request in rhinoplasty. She underwent removal of the hump, both cartilage and bone. The tip was also made somewhat sharper. On the frontal view before surgery, the top of the nose is too narrow relative to the bottom. A more balanced frontal view was achieved with surgery.
Endonasal (closed) rhinoplasty. Entire nose made smaller with removal of very prominent bony and cartilaginous hump.



Endonasal (closed) rhinoplasty. Bony and cartilaginous hump removed, entire nose lowered closer to face and tip rotated upwards.



External (open) rhinoplasty. This patient had marked over projection of the tip and a prominent hump primarily comprised of cartilage. Significant resections of several components of the tip cartilages were necessary to move the tip closer to the face. This is best done through an external rhinoplasty approach.

Endonasal (closed) rhinoplasty. This patient had a moderate bony and cartilaginous hump deformity with normal tip position. The cartilaginous and bony hump was removed and the tip was refined slightly.


Endonasal (closed) Rhinoplasty with Chin Augmentation. Patient underwent removal of bony and cartilage hump and upward rotation of nasal tip. Often patients requesting rhinoplasty also benefit from augmentation of the chin to enhance the profile further. A chin implant was placed through the mouth with no external scars.
External (open) Rhinoplasty. This patient had a moderate bony and cartilage hump. In addition, the entire nose was over projected from the face. The hump was removed and the entire profile of the nose from the eyes down to the tip was deprojected (moved closer to the face). This is best done with an external rhinoplasty approach.
Endonasal (closed) Rhinoplasty. This patient had a prominent bony and cartilaginous nasal hump deformity. On the preoperative photo one can also see tension on the upper lip ("pulled out" from the face). The hump was removed and the entire nose moved closer to the face. The lip position improved along with these changes to the nose. The tip has also been rotated upwards slightly and refined i.e. made sharper.
Augmentation Rhinoplasty. This patient underwent augmentation of the nasal profile using a Gore-Tex implant.



External (open) Rhinoplasty. This patient had an unusual issue with collapse of the tissues lateral to (at each side of) the tip of her nose. This was treated surgically with placement of cartilage taken from the inside of her nose which was then placed atop her tissues in this area. On the profile you can also see that she had a very mild convexity or (nasal hump) which was lowered. In addition, the nasal tip was rotated upwards slightly and refined.
External (open) Rhinoplasty. This patient had multiple issues. She had a nasal hump but also a saddle deformity (i.e. above the tip was a deficiency of cartilage). Through an external rhinoplasty the hump was lowered and the tissues above the tip augmented using the patient's own cartilage. On the front view one can appreciate a narrowing of the tip. This picture was taken just one month following external rhinoplasty and further tip narrowing will occur as the tissues heal.
External (open) Rhinoplasty. This patient had a very prominent bony and cartilage hump deformity and over projected nasal tip. The hump was lowered and the entire nose including tip was deprojected (moved closer to the face). This is best done with multiple techniques using an external rhinoplasty approach. The nasal tip was also refined.
This patient simply underwent removal of nasal hump. Picture taken 2 months post-op. No tip refinement was done but one can see very significant improvement with this simple procedure.


Rhinoplasty Consultation

Dr Bartlett likes to have a thorough discussion of your goals and expectations of cosmetic nose surgery. Skin type, ethnicity and age are important factors to be considered. Since there is no one ideal in cosmetic nasal surgery, the goal is to improve the nose esthetically, making it harmonize better with other facial features.

Use of state of the art computer imaging enhances your evaluation. This enables you to set a reasonable goal; a nose that you like which is also surgically possible using the various techniques that Dr Bartlett employs. We wish to ensure you are seeking rhinoplasty because you want it, not to please others. Also our patients understand that rhinoplasty may improve their profile, not give them someone else's.

Selection of Pre and Post operative pictures of Dr Bartlett's patients

Rhinoplasty Before & After

Rhinoplasty Before & After

Cosmetic Nose Surgery Before and After

Before and After Rhinoplasty Photos

The above patients have relatively thin skin and thus with rhinoplasty a sharper tip can be achieved.

With thicker skin, it is difficult to get as sharp a tip but also with this skin type it may not be desirable.

Nasal Surgery Before and After

Before and After Rhinoplasty Photos

The above patient has a more challenging issue with the entire nose being overprojected i.e. further out from the face than desired. The goal of rhinoplasty was to lower the entire nose. Because of the degree of reduction necessary, this was done with an external rhinoplasty approach. This involves a small incision at the base of the nose. Notice the marked change in the size of the nose while still maintaining a natural look to the nose. The tip cannot be made as angular or sharp as the patients illustrated above on account of a greater skin thickness. This is not a drawback however as a sharp nasal tip would not match her overall features and skin type.

External Rhinoplasty

External Rhinoplasty

Marking indicates position of incision for external rhinoplasty. This heals extremely well with no evident scarring.

Endonasal Rhinoplasty

Before and After Rhinoplasty Photos

The above patient was mostly concerned about the hump on her nose and in fact the tip did not have to be set back as much as the previous patient. The changes were therefore achieved all through internal incisions- i.e. endonasal rhinoplasty.

In some rhinoplasty patients , there is not a desire to make the nose smaller but rather augment or increase the size of the nose as can be seen with the next example.

Nasal Augmentation

Nasal Augmentation

The above patient underwent augmentation of the bridge of the nose. This can be done with a variety of materials but generally involves placement of a graft of your own cartilage or at times use of a synthetic implant such as goretex. ®.

An important part of the evaluation includes analysis of your chin. People who want rhinoplasty to make large noses smaller often may benefit from balancing the profile with augmenting what may be a ‘weak' chin as a weak chin may make your nose look more prominent. This is referred to as chin augmentation surgery.

Rhinoplasty with Chin Augmentation

Before and After Rhinoplasty Photos

Above patient has undergone chin augmentation in conjunction with rhinoplasty.

Rhinoplasty Surgery

› Rhinoplasty Overview

› Consultation

› Pre & Post operative pictures

› Rhinoplasty FAQs

 

Please contact Dr Bartlett's office at 604-273-4360 or via email or confidential online inquiry to obtain more information on Rhinoplasty surgery or to schedule a personal consultation with Dr Bartlett.

 

        I was so delighted with the results from my rhinoplasty surgery. Dr. Bartlett's outstanding care, professionalism and expertise makes it a pleasure to recommend him to anyone considering facial cosmetic surgery!"
- N.R, Rhinoplasty Patient