Cosmetic Rhinoplasty

Cosmetic nasal surgery – sometimes referred to as a ‘nose job’ or plastic surgery of the nose – covers any surgery intended to refine or improve the shape of the nose or eliminate defects the patient may find disturbing. Surgery to remove a hump is one example. A saddle depression requires the opposite treatment; instead of reducing the bridge, we raise the profile. Bulbous nose tips or excessive tip projection – a drooping nose tip, sometimes called a ‘Polly beak’ – may require ‘tip rotation’ to create the right proportion between the top lip and the bottom, protruding angle of the nose. Large nostrils can distort an otherwise attractive profile.

How we approach surgery, whether we use the ‘open’ or closed’ approach depends on the complexity of the procedure. The closed approach is intra-nostril surgery; the surgeon works through the nostrils (slightly distended for surgery). Closed surgery is generally quicker and less costly, and the preferred way of approaching simple surgery on ‘virgin’ (first surgery) noses. The Nose Clinic does simple hump removals using the closed approach. We sometimes also adopt the closed approach to repair the septum (the diving wall between the two air channels).

More complex surgery requires the surgeon to make a tiny incision at the base of the collumella (the pillar between the nostrils). He then partially raises the skin/tissue of the nose as one would open the bonnet of a car, to expose the delicate anatomy of the nose tip, adjoining nostrils and tissue cartilage on either side of the nose. It gives the surgeon more ‘working space.’

MENTOPLASTY

There is no point in refining the shape of a nose if the result does not harmonise with the face and align pleasingly with the chin. If the patient has a receding chin – the nose/chin proportions don’t align – we would suggest a chin augmentation (mentoplasty) to strengthen the chin. Mentoplasty is a simple procedure usually done at the end of nose surgery. The surgeon uses a pre-shaped soft silicone mould inserted onto the tip of the chin through a tiny incision on the inside of the mouth to increase the projection of the chin in relation to the nose. The effect on the face is immediate – a balanced and pleasing result that a nose refinement alone, would not have achieved.

COMBINED SURGERY

If a patient asks us for functional surgery and a cosmetic nose refinement, we approach this as a single operation; quite unlike the traditional manner of handling this dual form of surgery. Here, two surgeons preside over the procedure, one to repair the air channels of the nose (an ENT specialist) and another, to actually shape the nose (usually a general cosmetic surgeon). They work as a team. Besides being more expensive it introduces a dilemma. If the result is disappointing, who takes responsibility for the poor result?

For information on the ‘Ideal Nose‘ click here.  For ‘Functional Surgery‘ click here.