Why does rhinoplasty surgery not allow my nose to be made as small as I want?
I want rhinoplasty surgery to make my nose a lot smaller, but my surgeon tells me I can't get have a size reduction as dramatic as I want. I am frustrated and don't understand why I can't have the little nose I want.
Asked by: Anonymous
Answers (3)
Any nasal reduction surgery has certain limitations. The goal of surgery should be to create an aesthetically pleasing nose which still has good function (i.e. you can breathe out of it). To do this, a certain size of the nose must be maintained. In addition, the basic structure of the nose must be maintained. It is impossible to completely reduce the size of bone and other supporting structures of the nose and still maintain nasal shape and function.
Facial Plastic Surgeon
There are anatomical structures of the nose which limit the extent of modification; nasal bones, upper lateral cartilage and lower lateral cartilage. The nose must balance between these three structures. Thus, an extremely large nose cannot be made to be a short little flat nose. To achieve a well balanced and natural looking nose, all three structures must come together in a three-dimensional fashion to look great. Sometimes the amount of reduction permitted to establish this balance is less than what a patient may envision.
With rhinoplasty, form must not supercede function
Facial Plastic Surgeon
We always appreciate patients who present to us having done some homework on their own because it lets us know that they are really preparing for their surgery and, more importantly, because it allows us to spend more time in really discussing the available surgical options.
We find a lot of our patients, men and women, present with exactly this question and the answer largely depends on each particular patient’s anatomy.
Sometimes, patients present with a large hump, which makes their nose look large, and you will often see these pictures on surgeons' websites because, in reality, though they are the most dramatic results, they are relatively easier to accomplish. Occasionally, these patients also have smaller chins, and a chin implant goes a long way in balancing their appearance.
The more difficult cases are those patients who like the overall shape of their nose but feel like their whole nose is just too large. In these cases the tip, middle third of the nose and bridge all have to be reduced equally. While we can and often do exactly this procedure for our patients, it is important in these cases to be very cognizant of skin thickness.
In those patients who have thick skin, we caution that while the nose can be made smaller, it should still maintain definition and refinement. In our patients with thick skin, we always let them know that if we attempt to make the nose too small the tip can lose its shape and appear amorphous. So while we make the nose smaller, we stress the importance of tip definition and refinement.
Finally, and perhaps most importantly, we must remember that the primary function of the nose is to help in breathing and this function is critical. Unfortunately, a lot of times with all the mass media exposure to airbrushed pictures, we are exposed to images of people who are not real and to noses that cannot be reproduced without causing problems in breathing. And it is for this reason that at Profiles, we always admonish that Form must not supercede Function.
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