Rhinoplasty is one of the most challenging cosmetic surgery procedures and requires a special degree of skill even among experienced plastic surgeons. The nose is most prominent facial feature and often defines a person's physical identity.
Most patients requesting this procedure have always been concerned about the appearance of their nose and may be considering cosmetic surgery for the following reasons:
- To correct or reshape their "inherited" nose which is too large or too pudgy. They would like it to be more refined.
- To correct a nose that may be crooked due to an old injury.
- To improve the appearance of their nose from a previous operation.
- To correct a deviated septum that may be causing difficulty breathing. The septum is the structure separating the two nasal passages. It may be skewed to one side, blocking the passage of air. There are other structures, on the sides of the nasal passages called turbinates. In allergic individuals, these are frequently enlarged and can also cause obstruction.
It sometimes surprises people to learn that a rhinoplasty is not like sculpting clay. On the inside, the nose is a delicate framework of cartilages and bones which make up a structure like the frame of a house. The skin is draped across it like the roof. Changes to the outside appearance of the nose are made by adjusting the underlying framework. Experienced surgeons are cautious not to take out too much of this support system, because this may cause parts of the nose to collapse, producing a deformity that is difficult to correct.
The ideal nose appears natural, not "perfect".
All of us have seen people on TV or at the movies who have had "nose jobs" with a result that looks artificial and unpleasing. In most cases, this is due to overtreatment. An enhanced nose with a natural appearance that compliments the face is much better than one that draws attention to itself and looks operated on.
Most people understand how important it is for the nose to be harmonious with the rest of the face. Very few people today are looking for a cute "button nose". Nor do they wish to have a concave nasal dorsum that looks like a ski jump. An overly narrowed nose looks out of place on a wide face. Ethnicity is an important consideration too. An overly-reduced nose in a Hispanic or African-American patient looks out of place. We all know some popular examples of that!