Patient Photos

Boxy and Bifid Tip Rhinoplasty

This Olympia rhinoplasty patient consulted with Thomas Lamperti, MD regarding her desire to achieve a more refined, narrow nose along with improving her chronic nasal obstruction and recurrent sinus infections. During the initial consultation Dr. Lamperti noted that the patient had a wide boney upper nasal bridge along with an overly rounded, boxy, bifid nasal tip. The patient also was interested in narrowing her nostril width conservatively as well. The patient's internal nasal examination also showed that she had a significantly crooked nasal septum and a sinus CT scan indicated narrowed sinus openings contributing to her recurrent sinus infections. Dr. Lamperti performed an open septorhinoplasty and sinus surgery to correct the patient's septal deviation and sinus drainage blockage. He also smoothed down the patient's bridge creating a more feminine appearance. To narrow the nasal bones a combination of lateral and intermediate osteotomies were placed. Additionaly, Dr. Lamperti refined the patient's tip by performing a cephalic trim and placing dome binding sutures. He narrowed the patient's wide, boxy tip defining points and effaced the bifidity in this area by placing an interdomal suture to narrow the distance between the nasal domes. Lastly, Dr. Lamperti performed a conservative nostril reduction using a Y-V advancement technique in which the nostrils were moved inward 3 mm on each side. In the 14 month after photos you can see how the patient now has a very natural, but refined appearing nose with a more narrowed overall appearance. You can also see how her tip no longer has its original bifidity and has nice smooth transitions from the tip to the ala and bridge. Importantly, the patient's nasal breathing and recurrent sinusitis symptoms are greatly improved.