How Do Rhinoplasty Surgeons Know What Will Fit?

Every patient and every rhinoplasty is unique -- there is not a "one size fits all" nose. For the nose to look natural it must adhere to some basic proportions, but it must also be in balance an harmony with the patient's other facial features.
Most rhinoplasty surgeons now use computer imaging to review and analyze the patient's own photos. The patient's photos can be morphed to simulate the surgical changes. Recently, 3D rhinoplasty imaging has become available. This allows the surgeon and the patient to view the nose from any angle and make simulated changes in 3D (see link below).

Rhinoplasty is an art. Knowing what will fit your face comes from experience, surgical skills, training, and knowledge. There are many different angles and measurements, but surgeons rarely perform these calculations. A surgeon's before and after portfolio can give you an idea of what he is capable of, especially if he has before and after photos of a patient with similar nasal anatomy to you.

Rhinoplasty, along with other cosmetic procedure are considered a real art. So when I look at a patients nose there are landmarks and specific relationships that I look at to see what is IDEAL. Now having said that, it is needs to be assessed what is the patient trying to achieve.
A combination of what you want and what is ideal for this particular face will lead you to nice result. Make sure that your plastic surgeon is board certified by american board of plastic surgery.
Good luck.

 This is the reason you should see an experienced rhinoplasty specialist. This is an art and you have to make sure the surgeon has the same "taste" as you. The best way of doing this is to look at his actual work--Live post operative patients with a similar problem to yours.

Hi Mark,
Rhinoplasty is an art. One of the giants of rhinoplasty surgery, Eugene Tardy, MD, called rhinoplasty "the most difficult of all facial plastic surgeries".
What makes it a difficult surgery is blending the aesthetic sense of beauty and proportions skillfully to achieve what best "fits" the individual face after having made the proper diagnosis and creating a precise surgical plan. As with other facial cosmetic procedures, you want a physician with "the eye, the hand, and the heart" (see web reference below)
Leonardo da Vinci studied the human face and his mathematically ratios have withstood the test of time. Rhinoplasty surgeons have these proper proportions in mind when they operate on the nose.
Computer imaging pre-operatively helps give both the patient and the surgeon an idea of what "fits" for the patient, but ultimately it is the artistic ability of the surgeon to sculpt the nose on the operating table that achieves pleasing rhinoplasty results.
Good luck and be well.
Dr. P

The way that a Rhinoplasty surgeon "knows" what fits your face comes from experience and in depth knowledge of facial anatomy, physiology as well as facial aesthetic. All the things you mention should be considered in every rhinoplasty consultation along with a number of other considerations like cartilage shape, strength and external issues such as ethnicity. I like to use computer imaging for both the patient and me. Imaging helps simulate potential results, it also gives a pretty good idea of how the new nose will fit your face.

There are many factors taken into account when performing a rhinoplasty. Size and shape of the face and head must be considered, as well as features of the nose such as the width of the tip, the bridge, and the nostrils. All of these factors need to be in balance. There is an artistic component in addition to technical and scientific skill in creating an excellent looking nose that matches and balances with the facial proportions. There is also a tremendous amount of experience that goes into planning and executing a rhinoplasty procedure to create a well-balanced nose that does not look like it has been operated on and fits well with the face.

As a facial plastic surgeon, I am particularly thrilled by this question!

Rhinoplasty combines all the artistic skills and experience to create the best result for the patient. There are some rules too! The facial plastic surgery literature has some guidelines based on aesthetic principles or "rules of beauty."

There exist average angles and measurements that help create a guideline to how the nose appears on the face. Combining this knowledge with artistic skill and experience will give you the best result.

This can all be discussed with you during your consultation and illustrated using computer imaging.

Great question and best of luck!

Nothing beats seeing a computer generated image of the surgeon's prediction of what he can accomplish.
His depiction is based on size and shape of nose and that of your face. Also, the relationship of the nose to the adjacent structures. He must also consider skin quality, strength of cartilage. And, the internal structures, such as the nasal septal architecture.
Be sure to check out the doctor's results by viewing the doctor's before and after collection. That is very important; you need to see the doctor's art form.
Finally, be sure the doctor is comfortable with your case. Some noses are tougher than others.