The Seattle Rhinoplasty Center
The rhinoplasty surgery, the procedure itself, Dr. Portuese performs the rhinoplasty or revision rhinoplasty through a closed technique. He does not perform the open rhinoplasty technique, which tends to have more swelling, edema, and a longer recovery. All the incisions are placed on the inside of the nose and there is no incision placed across the columella. This technique offers the exact same exposure to the nose for all the structural cartilage grafting that may need to be performed on the more complicated and revision-type rhinoplasties. During the rhinoplasty procedure itself, the specific changes are made which were agreed upon between the patient and Dr. Portuese. Irregularities of the nose such as a hump or wide nose or wide tip are all addressed at the time by narrowing the tip by removal of cartilage, or sometimes when a bulbous tip is present, the tip cartilages are sewn together. Crooked, fractured, and broken noses are all realigned by resetting the nasal bones. Asian noses are typically refined on the tip and then augmented the bridge by either cartilage grafts or synthetic Silastic implants. Large projecting noses can be de-projected for a better aesthetic, pleasing profile, and occasionally a chin implant may be placed underneath through incision in the submental area for augmentation and better facial balance and structure.