They seemed to pursue natural-looking surgery. At my first consultation, they recommended osteotomy plus hump reduction and septal cartilage harvest, followed by nasal-tip angle adjustment; for bulbous-nose correction, they recommended partial alar excision and cartilage suturing. Because osteotomy felt burdensome, at a follow-up consultation I showed photos of the nose I wanted and explained the look I was aiming for. They said that, if I wanted to pursue that look, osteotomy could also be done with a closed approach, so we should hold off on it. They seem flexible and to tailor consultations to patients' needs. Seeing that they leave 1.5 cm of septal cartilage when harvesting it, they seem to prioritize safety. Many other places said costal cartilage was necessary, but here they said they generally proceed using septal cartilage first and use ear cartilage if it is insufficient. I am making my final deliberation about whether to have surgery here.
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