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The nose is the central feature of the
face, and therefore, a primary focus for aesthetic facial
plastic surgery. The original concept of rhinoplasty was to
reduce large noses. Today, our understanding of nasal anatomy
has given us more control over nasal shape. The classic "turned-up,
pinched" noses are a thing of the past; finesse rhinoplasty
is a direct result of our experience with the "turned-up"
noses.
Rhinoplasty is one of the highest art forms
in plastic surgery, demanding artistic, functional and technical
expertise. Broadly speaking, rhinoplasty can be divided into
these eight categories:
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1. Aesthetic - to improve the
appearance
2. Functional - to improve
breathing.
3. Primary - original
or first
rhinoplasty.
4. Secondary - revision of previous
surgery can be minor or major,
functional or aesthetic.
5.
Reduction - to make the nose
smaller.
6. Augmentation - to
make the nose
larger. This is usually done for low
bridges
or poorly-defined tips.
7. Closed - no external incision on
the nose, the most commonly
performed method. | |
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8. Open
- a small incision is made between the nostrils to allow better
visualization of internal structures, necessary for certain
nasal problems.
Rhinoplasty is obviously a complex subject,
one that demands skill, interest, and experience on the part
of the surgeon. The "15 minute nose job" is a thing
of the past.
The initial consultation establishes rapport
between patient and physician. The patient's vision, along
with desired and possible outcomes will be thoroughly discussed.
Sometimes all that is necessary is to de-emphasize the nose,
allowing other facial features to stand out. At times, analysis
of adjacent structures such as the chin, cheeks and forehead
may greatly influence one's perception of the nasal problem.
This is best accomplished through careful review of the patient's
preoperative photographs and pre- and post- operative photographs
of other patients with similar anatomy. Two or more consultations
are often necessary. The goal is an open and realistic exchange
of ideas between doctor and patient.
Once aesthetic goals have been established,
the surgeon must determine what can most successfully (from
an aesthetic and functional point of view) achieve what has
been outlined. This typically involves the employment of a
number of surgical techniques in order to realize the harmonious
balance of facial features desired. This may involve reduction
of cartilage or bone, addition of cartilage (usually from
the septum or ear), or simply a change in shape of the existing
nasal structures using sutures. The desired result must be
accomplished through architecturally stable and functional
techniques. The nose should both look good and function well.
Nearly all surgeries can be performed on
an outpatient basis. Postoperatively, recovery is rarely more
than uncomfortable. Bruising is typically present when osteotomies
(repositioning of nasal bones) are required and generally
lasts 7-14 days. Preoperative homeopathic oral medication
and postoperative ointment can greatly reduce the duration
of the bruising. The nasal splint, which is used to minimize
postoperative swelling and help support the nose during healing,
is removed about 5 days after surgery. Camouflage makeup can
be applied immediately after its removal. Packing, if required,
may usually be removed at home the following day.
Click Here to Look at Before & After Pictures 
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