A 25-year-old female presented with a nasal septum deviated towards the left, affecting both her nasal airway and the external appearance of her nose. Clinically assessed as a left-sided septal deviation with an associated dorsal irregularity and an under-supported nasal tip, the condition had been long-standing and had not improved with conservative measures. Dr. Harikiran Chekuri at Redefine Clinic performed a combined septorhinoplasty with dorsal augmentation and tip support under general anaesthesia. The procedure was completed in 2 hours, and the patient tolerated it well with no post-operative complications.

PATIENT PROFILE

The leftward deviation of her nasal septum had been present since her teenage years, and over time it had begun to affect more than just her breathing. She noticed persistent difficulty breathing through the left nostril, particularly at night and during physical activity, along with a visible asymmetry in the bridge and tip of her nose that she had grown increasingly conscious of in photographs and in person.

She had relied on nasal decongestant sprays and home remedies for years, but these only offered temporary relief from the congestion and did nothing for the external irregularity of her nasal profile. A prior ENT consultation had confirmed the septal deviation but had only discussed functional correction, without addressing the dorsal and tip concerns that bothered her aesthetically.

She researched rhinoplasty surgery in Hyderabad and came to Redefine for a consultation. She wanted a single procedure that would correct her breathing difficulty, straighten her nasal profile, and give her nasal tip better definition and support, without needing a separate surgery for each concern.

WHAT WAS ASSESSED DURING THE CONSULTATION

A thorough clinical and investigative assessment was conducted before any surgical recommendation was made:

• Physical and endoscopic examination: confirmed septal deviation towards the left with mild airway compromise on that side.
• Dorsal profile assessment: dorsal irregularity and mild deficiency noted, indicating the need for dorsal augmentation to achieve a smooth, well-aligned bridge.
• Tip assessment: nasal tip found to be under-projected with weak structural support, requiring reinforcement for a stable, well-defined result.
• Skin and cartilage evaluation: skin thickness and septal cartilage reserve assessed as adequate for grafting purposes.
• Anaesthetist assessment: patient reviewed and cleared for general anaesthesia prior to scheduling.
• Surgical markings documented: midline reference, septal deviation, dorsal augmentation zone, and tip support points marked prior to surgery.
• Patient goals confirmed: improved nasal airflow, a straight and well-aligned dorsum, and a supported, well-projected tip in proportion with her facial features.
• Follow-up schedule discussed: splint removal review, two-week review, and long-term follow-up for final results confirmed.

WHY SEPTORHINOPLASTY WITH DORSAL AUGMENTATION AND TIP SUPPORT WAS CHOSEN

• A leftward septal deviation with an associated dorsal irregularity and weak tip support requires correction of the internal structure and the external profile together. Septoplasty alone would have improved breathing but left the visible asymmetry uncorrected.
• Septorhinoplasty was chosen over isolated septoplasty because it allows the septum to be straightened and, where suitable, septal cartilage to be reused as graft material for dorsal augmentation and tip support within the same operative session.
• Dorsal augmentation was performed to smooth the nasal bridge and correct the profile irregularity created by the underlying deviation.
• Tip support, achieved with structural grafting, was added to reinforce a previously under-projected and poorly supported tip, giving it definition and long-term stability.
• Performing all three components in a single 2-hour session under general anaesthesia allowed for one coordinated recovery period rather than staged procedures.

Pre-operative photographs and surgical markings documented the left-sided septal deviation, the dorsal irregularity, and the under-projected tip, along with the planned correction zones.

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• Patient positioned supine under general anaesthesia. Surgical markings reviewed and confirmed by Dr. Harikiran Chekuri before incision.
• Septal access achieved and the deviated cartilage and bone carefully repositioned and straightened to restore the midline alignment of the septum and improve the nasal airway.
• Adequate septal cartilage preserved during correction, with a suitable portion harvested for use as graft material for dorsal augmentation and tip support.
• Dorsal augmentation performed by placing the harvested cartilage graft along the nasal bridge to correct the profile irregularity and achieve a smooth, well-aligned dorsum.
• Tip support achieved with structural cartilage grafting to reinforce projection and definition, correcting the previously weak and under-projected tip.
• Nasal skin and soft tissue redraped over the corrected framework and incisions closed in layers with fine sutures.
• External nasal splint applied at the end of the procedure to protect and stabilise the corrected structure during initial healing.
• Total operative time 2 hours. The septorhinoplasty was completed without complication. The patient tolerated the procedure well and recovered from general anaesthesia uneventfully.

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Recovery progressed smoothly following surgery. Initial swelling and mild bruising around the nasal bridge and eyes were expected in the first few days and reduced steadily over the following weeks. The nasal splint was retained through the initial healing period and removed at the first follow-up visit with Dr. Harikiran Chekuri, at which point the improved alignment of the dorsum was already visible. Breathing through the left nostril improved noticeably once the initial post-surgical swelling within the nasal passage subsided. At the two-week review, Dr. Chekuri noted a smooth and well-aligned dorsal profile, with the tip showing improved projection and definition compared to the pre-operative appearance. The patient confirmed that both her nasal airflow and the external appearance of her nose had improved in line with her expectations.

Feedback recorded at the follow-up visit at Redefine, Hyderabad.

★ ★ ★ ★ ★ 5.0

Verified Patient (Name withheld for privacy)

“I had struggled with breathing through one side of my nose for years, and I was also self-conscious about how uneven my nose looked in photos. Dr. Harikiran explained that both concerns came from the same underlying deviation and that they could be corrected together. The recovery was easier than I expected, and once the swelling settled I could already tell my breathing and the shape of my nose had both improved. I am glad I did not wait any longer to get it fixed.”

Profile: Female, 25 years, Hyderabad

Procedure: Septorhinoplasty with Dorsal Augmentation and Tip Support, Redefine, July 2026

Doctor: Dr. Harikiran Chekuri, Redefine

Note: Due to privacy regulations, the patient’s name is not displayed. This review has been shared with the patient’s written consent.