Long, wide nose with wide, drooping tip on thick skin

Rhinoplasty on a long, wide nose with wide, drooping tip on thick skin, by Dr. Gerbault:

Refining an overall wide and long nose with a rather thick skin is one of the most difficult things to succeed in rhinoplasty. The nasal bones must be accurately reshaped to make the bone pyramid narrower without pinching it. In this case, the bony cartilaginous junction is very prominent, making a marked hump on the oblique views.
The cartilages of a wide and drooping tip should not be weakened when the skin is thick, otherwise they will create a polly beak difformity. A good tip support is then essential to refine the tip and prevent it from droping when smiling or over time.
Structural ultrasonic rhinoplasty allows this precise reshaping without compromising bone and cartilage stability, even strengthening the latter thanks to the buried grafts support.
At 6 days, no bruises, just a little edema. At more than 3 months, the refinement is already clear from the front and profile. The nose is shorter and the tip remains well-supported.

Angular nose with hump and bulbous tip on thin skin

Rhinoplasty on angular nose with hump and bulbous tip on thin skin, by Dr. Gerbault:

Correcting adverse contours is one of the most complicated things to do in patients with thin skin. The correction must be as perfect as possible because every defect will be visible sooner or later.
Ultrasonic rhinoplasty smoothed the previously visible bone contours, corrected the humps and lowered the profile line.
The repositioning of the tip cartilages made it possible to refine it in a natural way without cartilage resection and the frequently consecutive operated look.
Structural ultrasonic rhinoplasty thus reshapes the nose in a gentle and precise way without breaking the bones or cutting the cartilage significantly: the structure of the nose and its supporting role are preserved.
The result is shown at 18 months with a natural overall refinement of the nose without any camouflage grafts used.

Rhinoplasty on a slavic nose with a round and bulbous tip and a hump, by Dr. Gerbault:

Slavic noses often have common characteristics: a thin skin, a mild hump, somewhat wide nose bones and especially a bulbous tip.
The correction combines an ultrasonic rhinosculpture of the nasal pyramid without breaking the nasal bones with the tip reshaping by repositioning the cartilages without cutting them.
The result is shown at 3 months, with a global and natural refinement of the nose.

Rhinoplasty on nasal hump with broad tip, by Dr. Gerbault:

Some noses look massive and thick because the skin is rather thick, and the cartilages are soft: these patients want a thinner and more elegant nose.
The use of structural rhinoplasty processes is essential to achieve this desired finesse. Cartilage grafts are taken on the nasal septum to support and strengthen deficient cartilage structures. Patients are warned that the nose will always remain stiffer. Beware, the classic techniques of cartilage trimming with a poor tip support can give significant deformations in these cases: piggy nose, retraction of the alae, even shorter and massive nose.
Three months after a structural ultrasonic rhinoplasty, we can appreciate the overall refinement of the nose, especially the lower part, despite the edema that still exists. In these cases, time is on the patients side, as the refinement is even more significant in the months that follow.

Rhinoplasty on big tip and small hump, by Dr. Gerbault:

Correcting too wide and round tips is difficult when the profile line is nice.
It’s the case for this young girl who has very mild hump on the profile, but who complains about a too round and wide tip, with the bottom of it too bulging.
An ultrasonic rhinoplasty treats the hump and lower slightly the profile line without breaking the nasal bones.
The tip is treated with cartilaginous sutures and supported through small hidden grafts to maintain the result.
The result is natural and subtle, but with a real refinement 1 year after the surgery.

Rhinoplasty in Paris on hump and wide ill defined tip on a thick skin nose, by Dr. Gerbault:

Nose refinement on a thick skin is difficult: the nose must be reshaped with ultrasonic structural rhinoplasty to achieve a natural refined nose without the rhinoplasty stigmata.
On this young woman, bones and cartilages have been reshaped without breaking or trimming anything.
With ultrasonic rhinoplasty, there’s truly little bruising on day 6 post op and patients can resume a normal social life.
The result is shown at 3 months with a natural overall nose refinement.

Primary rhinoplasty on thick skin of the Indian type, by Dr. Gerbault:

A significant refinement of the nose is possible even on thick skin, if the appropriate rhinoplasty techniques are used.
This young woman was asking for a treatment of her hump and her too wide tip, to achieve a smaller and cuter nose.
She had a structural ultrasonic rhinoplasty with an overall reshaping of her nose without breaking nasal bones.
The result is early (3 months) but already significant.

Bulbous and wide tips lacking definition are a real challenge when the skin is thick. They need very specific techniques for a global balanced refinement.
Structural ultrasonic preservation rhinoplasty.
She went back to work 6 days after the surgery: no one noticed that she had a rhinoplasty.
She came back at 2 months postop, delighted by the result and happy that everyone found her prettier without knowing what had happened! This is what all the patients say when the final result is natural.

Young woman complaining about a wide nose with an asymmetric hump.
The tip is wide and is lacking definition.
There’s also a septal deviation.
Ultrasonic structural rhinoplasty realized during the live surgery day of the IMCAS – ISAPS end of January 2019.
Result at 3 months post-op with a noticeable refinement of the nose and a hump correction.

To have a thick skin , a wide tip lacking definition with very weak cartilages lacking support: it’s a difficult situation to achieve a good result in nose aesthetic surgery.
For this patient, there’s also an alar cartilage malposition, increasing the bulbous appearance of the tip. It even worsens when the patient smiles ecause of the lack of tip support.
In this case, a highly structural rhinoplasty reinforcing all the parts of the nose with cartilaginous grafts is the only way to significantly refine the whole nose. It’s combined with n ultrasonic rhinosculpture to refine the bony vault.
The result is still early at 3 months post op, and the nose will keep on refining in the next months.

Patient having an asymmetric hump more significant on the left side, with a septal deviation.
The tip is also asymmetric with a more concave appearance on the left side.
Ultrasonic structural rhinoplasty for nose symmetrization, with ultrasonic septoplasty : The septum is straightened, the bony vault is symmetrized with ultrasonic rhinosculpture.
The cartilages are also symmetrized with cartilaginous sutures.
The result is shown at 6 months.

Structural rhinoplasty for refinement.

Primary rhinoplasty on thick skin.
Wide nose, wide and dependent tip.
Reinforcement of the support of the base of the nose achieved through structural rhinoplasty.

Primary Rhinoplasty, Broad Tip