The nose has the shape of a pyramid made of bones and cartilage, covered on the outside with leather, and on the inside lined with mucosa. Under the skin there is a thin layer of muscle, responsible for the wrinkling of the skin at this level and the dilation and constriction of the nostrils.
The nasal bones resemble a roof, which continues to the bottom with triangular cartilage, and between them, on the midline is the septal cartilage.
The Purpose Of The Operation
Rhinoplasty aims to improve the appearance and proportions of the nose, whose shape is altered either hereditary or post-traumatic or as a result of previous operations.
In addition, nose reshaping can improve breathing when there is nasal obstruction due to structural abnormalities of the nasal pyramid.
As with any cosmetic surgery, it is very important to know the changes desired by the patient and his expectations to be consistent with the surgical possibilities of modeling the nose.
Aesthetic Rhinoplasty Aims To:
- reducing the size of the nose;
- removing the hump and obtaining a straight or slightly concave back;
- narrowing of a broad or bulbous tip;
- raising the tip of the nose;
- rounding a too sharp tip;
- narrowing of too wide nostrils;
- removal of asymmetries and deviations.
Reconstructive Rhinoplasty Aims To:
- correction of congenital malformations of the nose;
- correction of post-traumatic deformities;
- nose reshaping after removal of tumors.
What Preoperative Investigations Are Needed
Blood tests usually only require routine investigations to attest to the patient’s health.
- The radiograph of the facial mass will provide details about the architecture of the nasal pyramid.
- Sometimes, in case of a significant alteration of the shape of the nasal pyramid or in case of associated nasal obstruction, a CT or MRI may be required.
During the preoperative consultation the surgeon will follow the following aspects:
- It will evaluate the shape and dimensions of the nose in relation to the other elements of the face and the ideal proportions. A nose may appear large in a patient with an underdeveloped chin and as a result, in such a case it is wiser to increase the chin (increase the projection of the chin) instead of reducing the nasal pyramid.
- It will evaluate the angle formed by the nose with the upper lip, which ideally should be 90 degrees for men and over 90 degrees for women.
- You will notice the symmetry of the nostrils and the position of the dividing wall between them (nasal septum), as well as any respiratory disorders.
- It will evaluate the quality of the skin at the level of the nasal pyramid, because the thicker it is, the less it will mold over the small osteo-cartilaginous support, limiting the changes obtained by the operation.
- Will take photos and measurements regarding the current size of the nose,
- It will assess the patient’s health and obtain information about his medical history. Last but not least, the doctor will recommend preoperative investigations (blood tests, imaging investigations, ENT consultation) and will adjust or stop the administration of drugs that increase the risk of bleeding (aspirin, oral anticoagulants, natural medication, etc.).
- He will recommend quitting smoking at least 2 weeks before the operation.
The more pronounced the dysmorphism of the nasal pyramid, the more dramatic and obvious the changes will be after the operation.
When The Operation Is Indicated
Rhinoplasty is a strictly individualized operation, and as a result cannot be practiced to satisfy someone else’s desires or to copy an ideal image.
It Is Indicated When:
- the patient has reached adulthood (over 18 years) and the elements of the face have completed their growth;
- health is good;
- the patient’s expectations are realistic.
In certain situations it is not possible to obtain the desired results in only one operator time. Sometimes minor corrections are required to get the final aesthetic look.