Before & After

This 23 year-old young lady consulted me following previous rhinoplasty surgery elsewhere. She felt that the correction of her nasal hump was incomplete and this resulted in a drooping of her nasal tip with an unattractive profile view. Comprehensive septorhinoplasty was undertaken to modify the dorsum of the nose and alter the position and dimensions of the nasal tip relative to this. The arching of the nostrils was present before surgery and this can only be corrected with more extensive composite grafting of tissue from the ears. If not undertaken in the first instance this can always be carried out as a secondary procedure if desired.

This 21 year-old lady had undergone nasoseptal surgery previously elsewhere, and had suffered a complication which resulted in a collapse of the structural septum of her nose and a significant septal fistula – a so-called saddle nose. This affected her self-confidence greatly and she was referred to me for secondary reconstruction. This involved complex reconstructive surgery including the use of cartilage graft from her rib and ear, but these interventions were worth it and she now has a stable nose with good breathing and beautiful facial harmony.

This 23 year-old professional young lady was referred to me by one of my former patients who had undergone nasal surgery under my care. She disliked her nasal hump and whilst excessively reducing her nose would not be in fitting with her ethnic appearance, a spare roof preservation approach was utilised to provide a harmonious result with a smooth dorsum and better nasal proportions. This resulted in a good functional and aesthetic outcome with no concerns regarding external scarring.

“Dr Gore is an incredible surgeon…. Thanks to his incredible work I now love my nose; it has been life changing in terms of confidence and I can finally take profile photos without feeling embarrassed”. This 18 year-old’s primary concerns were her marked dorsal hump and the large size of her nose. Morphing her initial photograph gave a surgical guide of what to aim for. She wanted to turn over a new leaf before starting university – so a date was found after her A’levels were finished. An ultrasonic Piezo technique enabled reduction and reconstruction of the bony skeleton with a strong stable result. In this case the morphed plan and the final result are nearly identical. Such lovely words from her #iwantgreatcare review!

This 24 year-old man disliked his nose proportions and consulted with me about rhinoplasty surgery. His principal concerns were his marked dorsal hump and his very deep radix – the area at the top of the nose between the eyes. These issues were corrected with structural rhinoplasty and the addition of radix augmentation using spare cartilage (crushed to maintain a smooth contour) and a soft tissue smoothing layer. This has produced a masculine, but more appealing nose with which the patient is rightly delighted.

“You’ve given me my perfect nose!” – and what a transformation with preservation rhinoplasty. The power of rhinoplasty surgery is astonishing when you consider how much the difference a nose can make to a face. As well as undergoing spare roof preservation rhinoplasty surgery using ultrasonic piezo technology, she had lost some weight, and both factors combined led to a radical change in her appearance. Her primary concerns were her nasal hump and lack of nasal definition in profile view. This was a perfect case for spare roof preservation rhinoplasty surgery. Preservation of the dorsal structures aims to give a perfectly smooth dorsum without any of the contour irregularities that traditional structural approaches may incur, whilst more traditional sidewall infractures lead to a controlled harmonious narrowing of the nasal bones.

This 57 year-old healthcare professional was referred to me by a colleague following previous surgical excision of a vascular anomaly on her nasal tip and resurfacing with a full-thickness skin graft. Normal skin grafts do not work well in the setting of the nasal tip for reasons of colour, contour and texture mismatch. A more definitive reconstruction was planned using a paramedian forehead flap over multiple stages. To achieve the perfect contour an additional intermediate stage was recommended but this has ultimately borne fruit and resulted in a good nasal contour that is difficult to distinguish from normality. In a patient-facing role this is of particular importance to her and has re-established her confidence in social and professional contexts.

This 44 year-old man from overseas was recommended to see me by a plastic surgery colleague to consider definitive nasal reconstruction following cocaine use. His case was particularly complex due to the nature of the injury that had occurred and the hostile nature of the tissues in his mid-face. Such defects can only be reconstructed with multi-stage surgery but how many stages are involved can be unpredictable. In this case significant tissue loss from the first operation due to unanticipated smoking resulted in significant additional stages being required to get to the point of an acceptable reconstruction from an aesthetic and functional perspective. This patient showed particular resilience in the setting of some surgical challenges and we are both delighted that having started this difficult process we were able to see this through to the end with a nose that he can proudly face the world with.