- Bridge/Dorsum – Shaped by nasal bones
- Nasal Sidewalls – Upper lateral cartilages
- Nasal Tip – Shaped by mobile catrilages
- Nostril Reduction
Many patients from San Francisco and Oakland who consult Dr. David Mabrie for nose surgery have had some history of a nasal fracture which may have caused an enlarged hump, or nasal deviation. Even patients with no history of trauma to the nose may have concavities along the sides of their nose which make the nose appear deviated or make a hump look larger on one side than the other. It is very important to identify these concavities or contour irregularities before surgery, because if not recognized, the hump may be treated, but the improvement is limited because the concavity is still present.
Nasal fractures occur when the nasal bones are traumatically broken and result in a cosmetic deformity. Nasal fractures ideally can be treated 7 to 10 days after the initial injury. After 5 to 7 days, the swelling has decreased enough to evaluate the actual shape and contour of the nose. The fracture should be repaired before 3 weeks, when the bones start to heal. After 3 weeks, nasal fractures should be repaired 3 to 6 months later when the bones are stable enough to treat. Repairing nasal fractures at that time usually involves osteotomies (very controlled breaks in the bone to mobilize the fragments and straighten them as much as possible).
Concavities of the Nasal Sidewall
Concavities or contour irregularities of the nose happen for a variety of reasons, often not known by the patient, including a remote injury, growth irregularities in the underlying bone or cartilage, or previous rhinoplasty. They may be treated during nose surgery in San Francisco using the patient’s own cartilage as a graft. The cartilage is taken from the septum or from the ear in a manner that does not significantly alter the appearance of the ear and then placed under the skin to improve the contour. Alternatively, dermal fillers may be placed in the nose non-surgically in the office.
Deviations of the Nose
Deviations are caused by either growth irregularities or trauma and may be accompanied with a septal deviation. The patient may have impaired breathing as a result. In this case it is prudent to have the septum treated at the same time. With a background in otolaryngology (head and neck surgery) in addition to facial plastic surgery, Dr. Mabrie is specially trained to treat both functional and cosmetic deformities of the nose.
Dr. David Mabrie
For more than a decade, Dr. David Mabrie has been perfecting his technique for optimizing facial beauty with dermal fillers. He is the only facial plastic surgeon in San Francisco whose practice is focused entirely on injectables.