The Dorsum
Nasal - Dorsal Angle Augmentation Using Custom Designed Silastic “S” Implant

More information about the following areas of rhinoplasty surgery: Tip, After Surgery

Requested Change: Dorsum
Most often patients request that their dorsum be more pronounced.

From the lateral view or profile, the dorsum appears low or flat and the nasal frontal angle is depressed in the African American nose. Because the tip of the nose is underprojected, the tip often blends with the dorsum. The procedure requires that the surgeon be skilled in anatomy of the nasal tip and dorsum and understand the differences in the black nose as well as how to achieve the desired change. A surgeon must add dorsal height and add cartilage structure to give the tip more height because of the lack of structural support. This can be accomplished in a number of ways: Dr. Slupchynskyj can either use prosthesis (SLUPimplant) or the patient’s own cartilage harvested from a donor site such as the ear to create a projected nasal frontal angle and raised dorsum.

PROBLEM: Flat Dorsum; Depressed Nasal Frontal Angle

CORRECTION: Add dorsal height

CORRECTION: SLUPimplant™

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The TIP

Requested Change: Nasal Tip
Most often patients request that their tip be "less flat and with smaller nostrils.”

The tip of the African American nose is characterized by a soft, round, and broad shape. The tip has little of no cartilage support. The projection of the tip of the nose is low or flat and the tip often blends in height with the dorsum. The nostrils are often wide or flared. Additionally, the alar rims also flare at the cheeks creating greater curvature. Finally, the skin is thick and full of soft fatty tissue which obscures the underlying structure of the nose and contributes to the soft round appearance of the tip.

Because of the lack of structural support and the condition of the skin, contouring the tip of the African American nose is complicated. The procedure requires that the surgeon be skilled in anatomy of the nasal tip and understand the differences in the black nose as well as how to achieve the desired change. In order to contour the tip of the nose and narrow or reduce the nostrils (nares), Dr. Slupchynskyj must remove soft tissue and fullness from the tip and add cartilage structure. Dr. Slupchynskyj can use the patient’s own cartilage from the outer ear to repair a defect in the septum of the nose or to create a new tip graft, or he can even use cartilage from to septum to create a tip graft.

PROBLEM: Narrowing of Nostrils

CORRECTION: Bulbous Tip

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Nose cast and nose sutures

After Surgery a nasal splint is placed to protect the new shape as the tissue heals. 5-7 days after surgery the splint is removed. Sutures around the nasal alar are removed at the same time. Sutures (stitches) are seen where the the vertical and horizontal areas of the nose are reduced or reshaped.

Here we can see the tip of the nose before and right after surgery. The new tip is seen immediately.