Patient Photos

Male to Female Facial Feminization Rhinoplasty

This Seattle facial feminization rhinoplasty patient came to Thomas Lamperti, MD looking to begin the process of facial feminization surgery. Besides wanting to reduce the overall size of her nose she also wanted to improve her chronic nasal congestion problems. The patient reporting having many prior nasal fractures which results in a crooked nose and poor breathing. The patient had a very broad, bulbous tip along with wide nasal bones and a bridge hump. Additionally, the patient had a deviated nasal septum, which was even noted on the patient's base view. This indicated a caudal septal deviation that required more complicated reconstructive techniques to repair. Dr. Lamperti performed an open septo-rhinoplasty to address these issues. As the first step he reconstructed the patient's deviated septum, creating more even nostrils and much better nasal breathing. Next, Dr. Lamperti removed the patient's nasal hump. Given the desire for a more feminine appearance a more appropriate supratip break was also created. Controlled bone fractures, also called osteotomies, were used to narrow the wide nasal bones. To refine the patient's bulbous tip a cephalic trim and dome binding sutures were used to narrow and flatten the convex lower lateral cartilages. The tip defining points were also narrowed using sutures as well. Due to the patient's relatively thick skin there were some limitations as to how more smaller Dr. Lamperti could make the patient's nose. The main concern is that the thick nasal skin would not adequately redrape after surgery leaving the patient with a less refined, amorphous nose. In the 6 month after photos you can see how a less masculine nasal appearance is seen. The nose is less big and wide overall and there is no longer a prominent bridge hump. The tip is also less prominent and bulbous. You can also see how the columella is straighter on base view following septal reconstruction. The patient also reports that she is breathing much better since having her surgery.