The Perfect Nose

The nose, a prominent facial feature, usually determines the overall attractiveness of one’s face. A nose that is unattractive, misshapen or out of proportion, whether seen in frontal or profile view, will distract the looker from an otherwise beautiful or handsome face.

A perfect nose would be one which looks good by itself and complements other facial features. The nose is an essential element in defining the balance of your overall facial look. Most people want to bring the size and shape of their nose into better symmetry with their face. They want a nose that compliments their other features rather than dominating their appearance.

Modern aesthetic or cosmetic rhinoplasty is a surgery that aims at improving the appearance of the nose for a natural look. Statistics reveal that amongst both men and women, rhinoplasty surgery takes a slot among other popular plastic surgeries.

In simple words, rhinoplasty refers to plastic surgery that facilitates to better the function of the nose or improve the appearance of a person’s nose. It is termed reconstructive surgery when the surgery is done to improve the nose function. When surgery is used for aesthetic purposes, it is termed cosmetic surgery.

What is Rhinoplasty?

As a cosmetic procedure, Rhinoplasty can make great differences not only in the balance of facial features, but most especially in a person’s self-esteem that creates total confidence. The aesthetic enhancement that a rhinoplasty surgeon can make include altering the tip or bridge of the nose, decreasing or increasing the size of the nose, and narrowing or changing the shape of the nostrils. The meaning of rhinoplasty is, literally, shaping the nose. It is a surgery that is designed to enhance or change the contour of the nose.

There are generally two types of rhinoplasty, differentiated by the way the surgeon accesses the interior of the nose. Initially, the surgeon begins the procedure by either making an incision inside the nose, where the bone and cartilage support structure of the nose is accessed through, this is called closed rhinoplasty. Another approach is making an incision across the columella, the thin strip of tissue that separates the nostrils, is called the open rhinoplasty. You may have to talk to your doctor to help you decide which of these nose surgeries will be best for you.

With equal importance, a nose that is always blocked makes breathing more difficult and uncomfortable. Rhinoplasty also improves the breathing passages that reduce nasal stuffiness and sinus headaches. The procedure involves correcting the deformities of the nose by removing, re-arranging or re-shaping bone and cartilage.

Effects of Rhinoplasty

Appearance can be improved for those people who are dissatisfied with the shape and size of their nose. An unacceptable appearance of the nose may occur because of inherited nasal shape or acquired deformities may occur as a result of trauma. Functional improvement of breathing difficulties can also be accomplished through septoplasty (correction of deviated septum), or reduction of excessive tissues (turbinates) inside the nose. Rhinoplasty will create a more pleasing look and also boost your self-confidence.

Candidates for Rhinoplasty

Both men and women are candidates for Rhinoplasty, assuming that facial and nasal growth is complete, and especially if they have any of the following symptoms:

  • Your nose appears too large for your face.
  • There is a bump on the nasal bridge when viewed in profile.
  • Your nose seems too wide.
  • The tip of your nose appears to droop or plunge.
  • The tip of your nose is too thick or enlarged.
  • Your nostrils are excessively flared.
  • Your nose is crooked or off-center, or has changed its shape after an injury.
  • You have difficulty breathing through one or both nostrils.

Ideal patients should be realistic about their ideas on how their nose should look like. Patients seeking a subtle, natural improvement that appears harmonious with their other facial characteristics are usually the most satisfied.

Your Consultation

BHMG’s Certified Surgeon will take your medical history and ask you questions regarding your general health, especially if it relates to your nose. You will be asked to point out features of your nose that you wish to improve and will perform a gentle examination of the nose, in addition to assessing the skin quality, size and shape of your nose in relation to your other facial features. Photographs and digital images will allow you and our surgeon to evaluate the appropriate procedures that will give you the best results. There are times when other procedures like Chin Augmentation or Lip Enhancement may help in achieving a more pleasing appearance and profile.

The Rhinoplasty Procedure

Rhinoplasty is usually performed under IV sedation or general anesthesia.

Below are the different types of Rhinoplasty Procedures

Open Rhinoplasty

In open rhinoplasty, it permits the surgeon the least restricted access to the cartilage and bone of the nose but is also more likely to cause scarring. The incision across the columella makes it achievable for the doctor to lift the skin off the tip of the nose and have a better view of the nasal structures, make a wide variety of corrections including repositioning and reshape the cartilage very precisely according to what the patient and the surgeon have agreed upon.

During the healing process, the incision leaves a very small, almost unnoticeable scar on the underside of the nose.

Closed Rhinoplasty

Closed Rhinoplasty is also called the endonasal rhinoplasty. This technique is called “closed” in a sense that the nose does not need to be opened using an external incision to access internal structure.

The main advantage of having a closed rhinoplasty technique is that there is no visible scarring after the surgery since the incisions are made inside the nose and is totally invisible after the procedure which makes it more favorable for the patient to have this as an option.

Incisions in this operation are made inside the nostril, while it may not offer quite as much freedom to the surgeon; the closed rhinoplasty surgery still allows plenty of reshaping potential. In other cases, an artificial implant is the best way to give the patient the nose appearance he or she desires.

Rhinoplasty with Alarplasty

Alarplasty is the procedure to reduce the width of nostrils and alar base to match proportionally with the overall contour of the nose and be in perfect symmetry. The surgical technique varies on the shape of the nostrils and nasal proportion to the whole face.

Alarplasty is a conventional procedure that is performed in the same time as rhinoplasty if the alar of the patient is so much wide and needs reduction, the doctor will consider that which case needs to be performed or not.

Alarplasty / Alar Trimming

The type of procedure for the aesthetic significance of the nose that the patient will require varies and depends on the size of the nose is a great concern for the patient. Alar trimming is usually performed on a patient with a wide nostril and flaring alar lobule. This procedure will improve the contour and definition of your nasal alar lobule area and alar trimming is frequently requested by oriental patients.

Infracture

In the perspective of a rhinoplasty, an Infracture is the movement and restructuring of the nasal bones. To reduce the width of the nose, the bones and attached cartilages needed to be moved medially (inward), creating a narrowing of the nasal bridge.

This is intended to improve the aesthetic appearance of the nose within the overall structure of the face. For patients that have a dorsal hump or crooked nasal dorsum, they would need infracture rhinoplasty to straighten and smoothen the bridge of their nose.

Rhinoplasty with GORE-TEX Implant

GORE-TEX implants are highly recommended for rhinoplasty operations. GORE-TEX implant is an advanced subcutaneous augmentation material (SAM) made of microporous ePTFE (expanded polytetraflouroethylene). It was discovered in 1958 and approved by the Food and Drug Authority (FDA) in 1975; this was initially and effectively used for heart and pulmonary valve operations for its strength and biocompatibility.

Professionals say that, these GORE-TEX implants are highly recommended for any minor or major nasal correction operation or surgery. If required, revision rhinoplasty became an easy task with GORE-TEX implants.

The procedure for the GORE-TEX implants is same as natural tissue grafting. After giving anesthesia, a small incision is made to the nose to reach underlying cartilage and bones. Then according to the requirements of the patient, the surgeon will reshape your nose by removing part of cartilage, or by removing bones, or by adding bridge or tip implants. After rhinoplasty operation, the patients are allowed to go home. Their nose is given a protective covering by support. This whole covering will help the patient in getting new shape, and therefore, improves the recovery process. You might have to keep a nasal support or some gauze to give support to your weak nose.

Oftentimes reviewed as the best and the finest implant by many nasal surgery experts, GORE-TEX’s soft consistency allows it to blend well to the contours of the nose thus providing a natural-looking nose lift as if one is born with it. More important, it is safe with nil case of rejection. The patient usually resumes its normal activities without any worry of the implant as this maintains the flexibility of the nose. Once healed, few months after the operation, the patient can still engage in contact sports such as volleyball, scuba diving, and the likes. Aside from that, the patient doesn’t have to worry of heat exposure since GORE-TEX implant can stand a wide range of temperature.

GORETEX permits growth of human tissues into its empty spaces within it helping fasten the implant in the treated area. This natural and hasty growth of tissues within and through the implant allows our bodies to heal it as something not foreign, something which a hard implant like silicone is not capable of. The good information is that GORE-TEX implant’s pliability and durability makes it suitable and effective even for complicated reconstructions and corrections of damages caused by surgery using silicone implant.

Cartilage Graft

Implants are classified by their source of origin; autologous grafts or autografts are harvested from the same patient, homografts derive from a donor within the same species, xenografts originate from another species, and alloplasts are manufactured from synthetic or semisynthetic materials.

Autografts gratify many of the requirements of the ideal nasal implant. Their advantages are several: No disease transmission or biocompatibility issues, low rates of infection, resorption, rejection, and extrusion, favorable graft–host interactions, and minimal inflammatory response elicited. The greatest restrictions of autografts hinge on the limited quantity of available tissue and the morbidity associated with tissue harvest.

Regardless of their limitations, autografts continue the gold-standard material for nasal implantation and the one against which all other materials are measured. Cartilage, bone, fascia, and skin may be harvested and used as autografts. Each of these tissues exhibits unique characteristics that may be applied favorably, depending on the needs of the nasal surgeon in a given reconstructive case.

Recovery

After surgery, a lightweight external splint is applied to maintain the new shape of the nose and to protect the nasal bones, if they have been fractured and narrowed. This splint is removed within a week. Internal nasal splints may be inserted at the time of surgery to protect the septum. These are removed within a week. There is always some stuffiness of the nose, especially when work has been done on the nasal septum.

It would generally take about 1 to 2 weeks for a patient to recover. Normal activities can be resumed within 2 to 3 weeks time.

Pain is minimal and is controlled with medications. Bruising may occur around the eyes, but will fade within a few days. Discoloration usually disappears within a couple of weeks.

Risks

Complications are usually infrequent and minor when Rhinoplasty is performed by a qualified plastic surgeon. As with any other procedure, there is always a possibility of complications such as infection, nosebleed, or a reaction to the anesthesia. You can minimize your risks by following your surgeon’s instructions both before and after surgery.

Post-surgery, small burst blood vessels may appear as tiny red spots on the skin’s surface. These are usually minor but may be permanent. As for scarring, when Rhinoplasty is performed from inside the nose, there is no visible scarring at all. When an “open” technique is used, or when the procedure calls for the narrowing of flared nostrils, the small scars on the base of the nose are usually not visible. Other scars near the bridge of the nose can come from sculpture of the nasal bones from an external approach.

Rarely does a second procedure occur. Though a corrective surgery may be required, for example, to correct a slight deformity, the procedure is usually minor. Such cases are unpredictable and happen even to patients of the most skilled surgeons.

FAQs

Who is a good candidate for Rhinoplasty?

Any man or woman can undergo Rhinoplasty as long as he or she is in good health and has realistic expectations on the procedure.

How should I prepare for the consultation with a surgeon?

Be prepared to answer any question regarding your medical history and get ready to point out what features you wish to improve. It would be helpful if you provide photographs that will allow you and your surgeon to evaluate the appropriate procedures needed.

Is Rhinoplasty done for cosmetic reasons only?

Aside from enhancing your facial appearance, Rhinoplasty can also improve your breathing passages in order to reduce nasal stuffiness and sinus headaches.

Will there be obvious scars from the procedure?

During the procedure, only small incisions will be made so the resulting scars will be hidden in the natural skin fold at the base of the nose. And there is no visible scarring when Rhinoplasty is performed from inside the nose.

How long is the recovery period?

Normally, it would take about 1 to 2 weeks for a patient to recover from Rhinoplasty. You can go back to work and resume other normal activities within 2 to 3 weeks.

What can the surgery change in me?

Rhinoplasty can change your individuality in terms of aesthetic purpose by giving you more self confidence and assurance in your well being. It changes your nose size in relation to the other facial structures, nose width, at the bridge, nose profile, with visible humps or depressions on the bridge, nasal tip that is large or bulbous, drooping, or too upturned, nostrils that are large, wide or upturned and nasal asymmetry and deviation.

Is this procedure really right for me?

The decision to go through rhinoplasty is extremely a private one. Only you, in consultation with your surgeon and your closest friends and family, can make that important decision. Any surgery, be it for reconstructive or aesthetic purpose, should fulfill your individual approval and satisfaction, and should not to flatter someone else’s desire or to try to fit any sort of supreme ideal image.

It should be a particular decision you have to make for your uniqueness. For many patients, the increase in confidence, self esteem, and self-assurance after a successful rhinoplasty can be truly life-changing, making rhinoplasty a worthwhile and rewarding experience for patient and surgeon alike.

Am I a Candidate for Rhinoplasty?

Both men and women are candidates for Rhinoplasty and it is a good option if your facial and nasal growth is complete (15 years of age or older), you are physically healthy, stopped from smoking and if you have specific, but realistic goals in mind for the development of your appearance and for your health improvement.

Ideal patients should be realistic about their ideas on how their nose should look like. Patients seeking a subtle, natural improvement that appears harmonious with their other facial characteristics are usually the most satisfied.

Assuming that facial and nasal growth is complete, candidates can have any of the following symptoms:

 

  • Your nose appears too large for your face.
  • There is a bump on the nasal bridge when viewed in profile.
  • Your nose seems too wide.
  • The tip of your nose appears to droop or plunge.
  • The tip of your nose is too thick or enlarged.
  • Your nostrils are excessively flared.
  • Your nose is crooked or off-center, or has changed its shape after an injury.
  • You have difficulty breathing through one or both nostrils.

 

What are the essential facts about the safety and risks of nose surgery?

The decision to have nose surgery is extremely private and you’ll have to decide with the help of your trusted surgeon, if the benefits will fulfill your goals and if the risks and potential complications are acceptable. Your plastic surgeon and/or staff will explain in detail the risks associated with surgery. You will be asked to sign consent forms to ensure that you fully understand the procedure you will undergo and any risks or potential complications.

In any desire to undergo a reconstructive or aesthetic surgery, don’t just dwell on the positive. You should also give watchful consideration to both the potential risks of surgery and to the appropriateness of your expectations. Ideally, no surgeon can produce an anatomically perfect nose, it is best to think in terms of cosmetic improvement, rather than absolute excellence.

At its greatest, a skillful surgeon can only achieve near-perfection, and that significant task requires a fateful combination of artistic talent, technical skill, strong cartilage, forgiving skin and a little providence.

Surgical risks are present in all patients, but youth, nourishing general health, a patent complexion, clean living and an otherwise healthy nose tend to favor a satisfactory outcome. On the other hand, remember that all surgeons utilize a scalpel, not a magic wand.

All rhinoplasty outcomes, even remarkable ones, have persistent flaws to a greater or lesser degree, and even an accomplished rhinoplasty surgeon cannot guarantee pure perfection under any circumstances.

What can I expect during the surgery?

Be prepared to discuss and answer honestly any question regarding your medical history and get ready to point out what features you wish to improve. It would be helpful if you provide photographs that will allow you and your surgeon to evaluate the appropriate procedures needed.

You may prepare by taking note of the important questions that you have to ask your surgeon like:

  • Why you want to have the surgery, your expectations and desired outcomes
  • Medical conditions, drug allergies and previous medical treatments
  • Use of current medications, vitamins, herbal supplements, alcohol, tobacco and drugs
  • Previous surgeries

How should I prepare for the consultation with a surgeon?

The actual rhinoplasty surgical procedure is typically performed as an outpatient procedure and it takes between one to two hours depending on the case of the patient. If you are having reconstructive work done, or you are having a more complicated procedure, the surgery may take somewhat longer. The plastic surgeon can specifically tell you what to expect during the surgery so it is very important to make guided discussion during the consultation with your surgeon.

What should I expect during my consultation?

The success and safety of your nose surgery depends very much on your complete truthfulness during your consultation. You’ll be asked a number of questions about your health, desires and lifestyle.

Your surgeon may also evaluate your general health status and any pre-existing health conditions or risk factors, examine and measure your face, take photographs for your medical record, discuss your options and recommend a course of action on reshaping your nose, discuss likely outcomes of a nose surgery and any risks or potential complications, what to do and not to do before and after the surgery, and also the type of anesthesia that will be used during the surgery.

Is Rhinoplasty done for cosmetic reasons only?

Aside from enhancing your facial appearance, Rhinoplasty can also improve your breathing passages in order to reduce nasal stuffiness and sinus headaches.

Will there be obvious scars from the procedure?

During the procedure, only small incisions will be made so the resulting scars will be hidden in the natural skin fold at the base of the nose. And there is no visible scarring when Rhinoplasty is performed from inside the nose.

Is there anything I have to do before the procedure?

Before the procedure, the surgeon will have to ask you to get laboratory testing or a medical evaluation, which will be discussed to you during your consultation and also take certain medications or adjust your current medications. You should also stop smoking well in advance of surgery. Avoid taking aspirin, anti-inflammatory drugs and herbal supplements as they can increase bleeding Some of the special instructions you will receive will cover:

  • What to do on the night before and the morning of surgery
  • The use of anesthesia during your nose surgery
  • Post-operative care and follow-up

Your plastic surgeon will also discuss where your procedure will be performed. Surgery of the nose may be performed in an accredited office-based surgical center, outpatient or ambulatory surgical center, or a hospital.

Rhinoplasty Philippines
Do I need assistance after the surgery?

If your nose surgery is performed on an outpatient basis, be sure to arrange for someone to drive you to and from surgery center and to stay with you for at least the first night following surgery.