Nose Reshaping (Rhinoplasty)
Overview
Nose reshaping (Rhinoplasty, or a ‘nose job’) is an operation to change the shape or size of the nose.
A lot of people are unhappy with the size and/or shape of their nose. The nose is central to facial balance and many people opt for surgical nose reshaping, or rhinoplasty, in an effort to find a more harmonious alignment of their features. Sometimes the problem can be more to do with the position of the chin or jaw, but patients tend to focus their dissatisfaction on the nose.
While surgical techniques are advanced, there are limitations as to how much the nose can be altered.
Outcomes depend on the size of the nose, the condition of the skin and the age of the patient. The most important thing is that there is clear communication between a patient and a surgeon about what is wanted and what is achievable. Patients should also bear in mind that surgery alone will not solve any emotional or social problems they may attribute to their nose or to their appearance generally
COSMETIC REASONS
Most people who dislike their nose have concerns about the bridge or the tip. At the bridge, or dorsum, people often complain about having a hump. Meanwhile, people who want to change the tip often see this part of the nose as being too wide, round, blobby, beaked or lacking in definition. Some people also dislike the length of their nose.
MEDICAL REASONS
Other patients may opt for a rhinoplasty because of an injury to the nose, whereby the nose may be broken or bent following an accident of some kind. Others may have functional breathing problems relating to the nasal airways. In these cases, surgical interventions would be considered reconstructive, whereas for the majority of nose operations the surgery is classed as cosmetic.
Nose operations are most commonly carried out to:
Alter the hump at the bridge of the nose
Reshape the tip of the nose
Alter the length of the nose
Alter the width of the nose
Alter the width of the nostrils
Restructure and reposition the nose after an injury
Open up the nasal airways to help breathing.
A nose reshaping operation is either performed from inside the nostrils- this is referred to as a closed rhinoplasty; or else by making a small cut on the nose and elevating the skin – known as an open rhinoplasty (shown in this image).
The precise nature of the operation will vary depending on the area of the nose that is being treated.
BRIDGE (OR DORSUM)
If the bridge of the nose is being operated on, the surgeon removes the bone and cartilage that is causing ‘the hump’. The nose may then be broken to allow the remaining pieces of bone to be moved closer together, resulting in the narrowing of the nose.
TIP
When the tip of the nose is operated on, the cartilage that makes up the tip-support needs to be partly removed or reshaped. This is done through the nostril, or by making a small cut in the bit between the nostrils (known as the columella) in an open rhinoplasty.
LENGTH
A surgeon can adjust and reduce the central structure of the nose, known as the septum, to help shrink the tip and reduce the overall length of the nose. Adjustment to the tip cartilages also helps adjust nasal length.
WIDTH
By breaking and repositioning the side nasal bone, a surgeon can also reduce the width of the nose and achieve a narrower appearance.
ADDITIONAL RHINOPLASTY
Surgeons can also add to the nose using cartilage grafts from the septum or, occasionally, silicone implants, in what is called an additional rhinoplasty. This type of operation is used to build up a ‘flat’ bridge or tip. The above techniques can also be used to straighten and refine a nose that has been broken through injury, and to relieve breathing difficulties.