Nose: Rhinoplasty Surgery

Why Do I Want to Change the Shape of My Nose?

Thousands of individuals in the United States each year undergo nasal surgery to reshape the appearance and shape of the nose. Unfortunately, the nose is located in the center portion of the face and so any small abnormal characteristic is easily visible. Therefore it is no surprise that nasal surgery or rhinoplasty is performed so often. Nonetheless, rhinoplasty is a significantly satisfactory procedure that helps individuals achieve greater self-esteem and personal satisfaction.

Common Causes of Nasal Deformity

There are quite a number of reasons for outer characteristic nasal deformity and abnormality.  These include, but are not limited to, inherited genetic abnormalities, ethnic characteristics, neoplastic related deformities, congenital defects, infection, and most commonly trauma.  With the increased instance of contact sports in the United States there is equal increase in the propensity for nasal trauma with associated nasal deformity.

What is Rhinoplasty Surgery?

Nasal surgery (rhinoplasty) is probably the most common procedure that facial plastic surgeons perform today. Every year nearly a half-million Americans seek consultation for treatment of underlying internal and/or external nasal deformities. The goal of the rhinoplasty procedure is to reconstruct, reshape, and reform the outer most portion of the nose marked by malposition, deformity and deficiency. Cosmetic rhinoplasties are performed to improve subtle changes, ethnic, or familial characteristic flaws. Reconstructive rhinoplasties, on the other hand, are performed to correct nasal deformity secondary to neoplastic disease, infection, trauma, and congenital defects.

The Underlying Goal

For the majority of individuals seeking improvement for nasal aesthetic concerns, significant success is achieved with rhinoplasty. Improvement is the underlying goal; however perfection or changing one’s nose to look like a movie star’s is an unreasonable aspiration. 

Making the Decision for Rhinoplasty

So many individuals contemplate rhinoplasty, and the decision is quite easy.  A common sentiment is that the obvious deformity needs to be corrected. Nonetheless, it is very important to have realistic expectations for nose recontouring. The overall goal is to improve the aesthetic characteristics and to make the nose fit better with one’s own unique physical facial characteristics. Having a nose that is proportional and in-line with the rest of the face is instrumental in determining the reshaping and design of the nose. The decision in an individual is based on internal motivations and should not be dependent upon family member’s or friend’s suggestions that surgery be performed. 

The Rhinoplasty Procedure

Rhinoplasty is done on an outpatient basis with intravenous anesthesia or general anesthesia. The procedure lasts approximately one hour to an hour and a half.  Generally, the incisions are made inside the nose, and on occasion incisions are made along the lower portion of the nose between the nostrils called the columella.  Quite often internal structural abnormalities are also corrected during the rhinoplasty, which includes correction of a deviated septum.  Internal structural improvement via septoplasty entails straightening and redirecting the cartilage and bone so as to provide better airflow through the nose and ultimately better nasal function. 

The upper portion of the nose is mostly bony and the middle one-third and lower one-third are mostly cartilaginous. Cartilage recontouring in the lower two-thirds is performed concurrent with restructuring of bony deformity in the upper one-third. Sculpting, morselization, chiseling, as well as other techniques are employed to nicely contour the shape of the nose to provide the desired result.

Areas of Concern

Commonly a bump on the nose, also called a dorsal hump, is treated quite successfully. Other common abnormalities include asymmetry, wideness, lumpiness, and an undesirable profile. It is through the expert re-sculpting and trimming of prominent cartilage and bony structures, which results in the natural non-irregular profile and appropriate contour. 

An additional area of concern is the droopiness of the nose, also called “tip ptosis”.  “Rotation” is performed during rhinoplasty to achieve resolution of the droopiness and to restore the nose to an elevated and more youthful position.

Rhinoplasty(nasal surgery) - Before	Rhinoplasty(nasal surgery) - After

Also See: Endoscopic Sinus Surgery, Nasal Septoplasty, and Chronic Sinusitis