Rhinoplasty — Dorsal hump reduction and tip refinement

Before (left), after (right). A prominent dorsal hump and a wide, undefined tip. Open rhinoplasty reduced the hump and refined the tip cartilage for a straighter profile, keeping the airway function intact.

This case needed structural work, not just a tip trim. Open rhinoplasty gave direct access to narrow the tip with a conservative cephalic trim of the lower lateral cartilages plus transdomal and interdomal sutures, then a columellar strut graft from the septum held the new projection. The dorsal hump was reduced and the resulting open roof closed with lateral osteotomies to narrow the bony vault, with spreader grafts protecting the airway in the process. A minor alar reduction matched the base to the refined tip. Dr. Khaled Ghalwash, Alexandria.