Rhinoplasty: Knows & Knows Not About the Nose

And it Keeps Getting Bigger

Your nose, like your ear, continue to grow throughout life.  The tip generally enlarges and for most people drop.  Thus, when it comes to rhinoplasty in adults, improving nasal appearance can be a powerful rejuvenating procedure when the nose is reduced and tilted. That is, rhinoplasty can make a man or woman look younger, particularly when combined with a lip lift, ear lobe reduction, and face lift.

Liquid Noses & The Non-Surgical Nose Job

There are several ways to improve nasal appearance. One is with the use of fillers.  Products like Restylane, Juvederm, and Radiuses can fill areas of the nose to improve symmetry to camouflage a “hump”.  The second is with surgery.

The Surgery

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Rhinoplasty surgery can come in two flavors: open or closed techniques.  The open technique is performed with a small incision in the middle of the columella.  For most people, this leaves a virtually invisible scar.  The closed approach is performed with all incisions hidden within the nose.  Both approaches have advantages and disadvantages. The main advantages of a closed approach is the absence of a potential visible scar on the columella.  However, scars are almost always not visible.   The bigger advantage of the closed approach is less post-operative swelling.  While there can be persistent swelling in the tip of the nose for up to a year with an open approach, a closed approach may shed a few months off this course.

The two biggest advantage to an open approach is one,  visibility. The second is the ability to do complex tip refinement.  However, this point is often debated among plastic surgeons. Many do feel that if a lot of tip work needs to be performed, an open approach is the appropriate one.

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However, most surgeons will have a “preferred” approach.  Bias exists among surgeons as to what is the “better” surgery: “To open or not to open”, that is the question.”  Some surgeons will perform either open or closed rhinoplasty depending on the aesthetic goals of the patient.  Others subscribe to only one technique. Meaning, some only  do open rhinoplasty. And some only do closed rhinoplasty. Of course, some do do both.

+ & – in Rhinoplasty

Rhinoplasty often reduces noses, but it can also include “addition”.  When we think of a nose job, we often visualize a big hump being “shaved” down. Or ski slopes in women.  Many times this is indeed the goal or result.  However, not all noses are too big and not all women desire ultra-feminine ski sloped noses.   Noses can be too small, or “under projected”.  Or, the nose can start off “too low” and look like a “beak”.  In such cases, cartilage is often used to build up the nose and essentially make it larger.  In fact, sometimes rhinoplasty will combine both additive and subtractive techniques to make one part bigger and another part smaller.

The Frame

The nose is the centerpiece of the face.  The cheeks and chin are the “frame”.  If you were to purchase an $8,500 painting, would you hang it on the wall as-is? Or would you “accessorize” the art by adding a beautiful frame?  Sure, some people are into the more raw look with paintings hanging on walls without frames.  But frames add beauty to the art in a synergistic fashion.  Similarly, enhanced cheeks, lips, or chins (when appropriate) will make the nose prettier. It  often even makes the nose “smaller” when proportions are balanced in the face.  It’s essential to have the nose examined in the context of the entire face to achieve optimal results.

 

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