Our beautiful patient from AZ is seen 5 months following revision rhinoplasty. After her first surgery, she was bothered by her overprojected tip, hanging columella, and severe right nasal obstruction. You can see a smaller, straighter, and less distracting nasal appearance. Her deviated nasal septum was corrected, and she required a right spreader graft, and a right lateral crural strut graft to improve her nasal appearance and airway.
Our lovely 25 year old patient is seen here one year after functional and cosmetic revision rhinoplasty surgery. Our patient had 100% left nasal obstruction due to a severely deviated nasal septum that was not addressed at her first surgery. She had one of the worst deviated nasal septa we have seen in over 23 years! She was also bothered by her crooked nasal appearance and droopy nasal tip appearance. You can see a straighter, more natural looking, and better breathing nose that blends in.
“Dr. Joseph gave me my life back. After a failed rhinoplasty at only 17 years old I spent 7 years waiting for the right time and the right doctor to fix it all. I had a severely deviated septum and couldn't breathe out of my left nostril at all. I had multiple ENTs tell me I had nearly 100% blockage on my left side. From the front my nose appeared crooked and had a bump on one side and a very noticeable indent on the other. I hated almost every picture that was taken of me because this "v" shaped nose showed up even more in certain lighting. I knew a functional and cosmetic revision rhinoplasty was inevitable but I was traumatized from my first experience with a different doctor in New Jersey. After spending countless hours researching and having consultations with other doctors I knew Dr. Joseph was the doc for me. He knew my case was going to be difficult and shared with me that I had one of the worst deviated septums he had ever seen but he was confident he could improve my breathing and the aesthetics of my nose. I trusted him and he truly exceeded my expectations. My breathing is nearly perfect and he turned a VERY ugly nose into something beautiful and more importantly he restored my confidence. ”
Our beautiful 29 year old patient is seen photographed 1 year following functional and cosmetic revision rhinoplasty surgery. When she came to our office, she was bothered by her nasal appearance and breathing after previous rhinoplasty performed elsewhere. She was mostly bothered by a persistent bulbous and droopy nasal tip appearance, and by a persistent dorsal hump. Her airway was compromised by narrowed internal nasal valves on both sides and a persistently deviated nasal septum. Her revision rhinoplasty consisted of nasal narrowing, hump removal and tip rotation. We used spreader grafts to repair her internal nasal valves, and we performed septoplasty - these maneuvers were to improve her nasal airway. An extended shield graft was used to maximize tip support and tip definition with her thick skin type.
Our beautiful 51 year old patient is seen 7 YEARS following tertiary revision rhinoplasty surgery. Tertiary means that two other surgeons operated on her nose before we did. She had repair of a persistently deviated nasal septum, and was provided a straighter and less distracting nasal appearance. Seven years after her surgery, you can see that she looks un-operated and she is breathing very well.
Our beautiful 23 year old patient is seen one year following functional and cosmetic revision rhinoplasty surgery. Her first surgeon removed a dorsal hump, but he failed to correct her wide, over-projected, and droopy nasal tip appearance. Her breathing became worse after her first rhinoplasty. Her repair consisted of tip de-projection, rotation and narrowing for a less distracting nasal appearance. Her breathing was improved by placing spreader grafts since her internal nasal valves were narrowed. We also reduced her turbinates to further improve her airway.
An over-projected nasal tip is one that sticks out too far. In our experience over 22 years, we cannot overemphasize the importance of dividing the lower lateral nasal tip cartilages to have maximal control of tip configuration. We treat the nasal tip as a tripod. Two of the tripod’s limbs are the right and left lateral crural tip cartilages, and the third limb is the sutured medial crural complex, typically with a columellar shoring strut graft. Dividing the tip cartilages may allow the greatest flexibility for reconstructing a nasal tip appearance to be pleasing and unoperated in appearance.
© 2025 Eric M. Joseph, M.D. Telephone: (973) 325-1155
22 Old Short Hills Road, Suite #112 Livingston, NJ 07039