The Profile View in Rhinoplasty: Insights and Techniques

This post is dedicated to the profile view, also known as the “lateral view” or “side view,” which is arguably the most popular angle for rhinoplasty before and after photos. One of the most common reasons for seeking rhinoplasty surgery is to reduce a dorsal hump, a change best viewed in profile. This classic rhinoplasty operation is prominently featured on every rhinoplasty surgeon’s website and social media and is in many ways the quintessential rhinoplasty operation, often showcasing dramatic changes. In this post, I will review different philosophies, issues, and techniques specific to sculpting the nasal profile.

Assessing Patient Preferences

The first step in discussing the profile with a patient is understanding their preferences for their desired nose shape. Many patients have spent considerable time exploring social media and surgeon websites, studying before and after profiles. They usually have a clear idea of the changes they want and can articulate these preferences well. I ask patients to describe the changes they seek—for example, some may want subtle adjustments, possibly retaining a smaller residual hump, while others desire a more pronounced, scooped-out look, akin to a “Barbie” nose.

Personally, I prefer a more natural look, with a straight or slightly convex or concave dorsum, which I believe ages better. I advise patients against an excessively low bridge, as it can lead to complications such as saddle nose deformity and inverted-V deformity.

Understanding the Anatomy

The dorsal hump consists of bone in the upper part and cartilage in the lower part. This distinction is crucial for bridge reduction techniques, as different methods are required for bone and cartilage. The connection between the bones and cartilage is a critical support area. Lowering the bridge too much can disrupt this connection, leading to nasal collapse. Maintaining a straight profile minimizes this risk.

One innovative technique to address this is ultrasonic rhinoplasty, which uses a device to cut and shape bones while preserving cartilage integrity. This technique offers precise control when shaping the bridge. However, even with ultrasonic devices, it is best to avoid creating an excessively low bridge.

Managing Expectations

When you see an Instagram post showing immediate results of a hump reduction, remember that the bridge will lower significantly over time—typically 5-10%—due to swelling reduction. A nose that looks “perfect” in these photos may no longer appear the same a year later. Surgeons must judge the appropriate level of reduction despite the swelling.

Conclusion

These nuances highlight just one common aspect of rhinoplasty surgery. If you’re considering rhinoplasty, please feel free to reach out to our office to schedule a consultation!