The nasoseptal L Strut is the foundation of aesthetic and functional rhinoplasty. The septum serves as the foundation of the nose and has many implications in rhinoplasty. The septum is at the top of the architectrual hierarchy of the nose. Where the septum goes, so goes the nose. Dr. Kim uses photos and detailed explanation to demonstrate the role of the septum inside the nose.

What do predictable rhinoplasty results rely on? Nasal tip base stabilization is a technique in structural rhinoplasty where the tripod, instead of relying on scar contraction to find its final position it relies on graphing.  For example cartilage would be placed between the inner limbs of the tripod, the tripod released from its connection to the septum and resutured onto a midline anchor point to set the tip to the correct position. This mobilization and fixation creates a much more predictable outcome.

Nasal tip sculpting is another aspect of tip surgery.  Traditional techniques would rely on destructive methods of creating that form.  The tip should remain strong and well balanced with a triangular face and appropriate proportions.  Don’t always think of reductive surgery.

The middle vault is the part of the bridge that resides in the central portion of the nose, it often needs to be altered in order to make the area straighter or reduce a hump on the nose. The middle vault is a very important area in regards to structural rhinoplasty. Most commonly problems happen when removing a hump on the nose, which is often an excess of cartilage. If nothing is done except to let the body heal on its own an inverted v often occurs if the central portion of the nose isn’t supported. Sometimes the hump isn’t removed and a better option is to mask the hump by placing cartilage above it. Dr. Kim illustrates the video with actual before and after photos of patients.

Nasal tip position – weakening the nasal tip support can lead to an unpredictable tip position.

Thin skin vs. thick skin in rhinoplasty. The difference of thick skin and thin skin in rhinoplasty is very important to understand. With thick skin it is better to expand the nose and create a contour that stretches the skin envelope so that you can see the changes. With thin skin there is more flexibility in making a reduction but any changes will be revealed through thin skin. Thin skin contracts over time. There is a continued progression of skin changes after surgery.

The nasal septum serves as a structural wall that holds up the nose.

The L strut must be strong by the end of the surgery. Structural rhinoplasty aims to prevent L strut problems by keepint the L strut strong.

Dr. Kim discusses the specific anatomy of the nose. The structural elements of the nose include the nasal septum, nasal bones, upper lateral cartilages and the lower lateral cartilages.

Dr. Kim discusses the techniques in structural rhinoplasty that are designed to avoid difficulties and complications during rhinoplasty surgery.

Dr. Kim walks you through a seven part series that describes the structural approach to rhinoplasty.  Dr. Kim uses the transformation of Michael Jackson’s nose as an example.

Watch as Dr. Kim describes the risks of artificial implants during rhinoplasty.

Watch as Dr. Kim explains digital morphing and transforms Barbra Streisand and Owen Wilson right before your eyes.