Rhinoplasty: The Centerpiece of the Face
Rhinoplasty, or nose surgery, is one of my favorite operations. It is literally surgery of sub millimeters. Patience, precision, and attention to detail are the keys to beautiful, long lasting results. But my approach might be different than many other plastic surgeons. When I evaluate the nose, I don’t think of it as an independent unit on the face. The nose is one subunit of the entire face including the chin and mid face. Therefore, when I operate on the nose, I like to evaluate the chin projection and mid face projection so that all three are in balance. A balanced face is important to frame a beautiful nose. And a beautiful nose is the centerpiece of a beautiful face.
When we look at the nose, we actually measure it in our minds to its base at the mid face and its relation to the chin. Therefore, I often include facial fat grafting at no additional cost with my rhinoplasties to balance the mid face with the nose. Surprisingly, sometimes patients who want a nose job don’t really need one. I’ve corrected large noses by augmenting the chin and mid face with fat and small chin implants. The result is often a more balanced face and a rejuvenated, younger face.
Part of the aging face is actually seen in the nose. Young noses are thinner and perkier with an obtuse angle from the lip to the nose. As we age, the nose tends to widen and drop. Combination fat grafting to the face and rhinoplasty is a very powerful combination to take years off both a man or woman’s life.
The picture below on the left is BEFORE rhinoplasty and fat grafting. As we age, our faces lose fat. Gaunt faces look old. Young faces are full of volume. Areas highlighted are areas that fat was injected into. This includes the midface (blue), premasseteric region (yellow), and the cheek (white contour).
There are no external incisions on her face. The nose surgery was performed with incisions hidden inside the nose. The nose was tilted, shortened, and refined. Fat was taken from her ‘love handle’ where she didn’t want it, and injected into her face through the corner of the mouth. Below is a complete set of BEFORE and AFTER pictures:
