Rhinoplasty, the Gift That Keeps Giving

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There are two general categories of aesthetic procedure, those that recreate your look by correcting aging features, and those that change your look by altering inborn features for improved aesthetics.   Among the latter, rhinoplasty is the flagship procedure. By beautifying the central feature of your face, you benefit daily for the rest of your life in many interactions and situations. Rhinoplasty is a delicate surgical procedure, best performed by highly skilled surgeons with excellent equipment.  Enhancement may be significant with only millimeters of change. The human eye is very sensitive to slight adjustments of angle and proportion.

Interested men and women should seek advice from well trained and appropriately certified surgeons. In the United States, this includes either a surgeon certified by the American Board of Plastic Surgery or perhaps a “facial” plastic surgeon with a library of “before and after” photos demonstrating a track record of successful results. The procedure should be performed in the safest possible environment, at an accredited free-standing ambulatory surgery center or office operating facility. Patients should not hesitate to challenge surgeons regarding credentials. The qualified surgeon works hard to provide the best circumstances for his or her patients, and is usually proud to show evidence of certifications achieved.

There is no single method or technique of rhinoplasty. For each individual, the procedure is adapted in scope and magnitude to accomplish goals established by patient and surgeon in advance. The result should not be left to the surgeon’s discretion, and should not in any way be a surprise to the patient. Changes to the nose are agreed upon in advance. Both the precise change and the degree of change are discussed, and preferably, simulated by two dimensional drawing or three dimensional software.   Although there is always an element of unpredictability, the surgeon must be confident that he or she can approach the agreed upon result.  Swelling resolves and healing progresses during several months following nose re-shaping.  Final appearance should match ethnicity, enhance other facial features, and appear naturally in harmony with the remaining facial contours. For example, rhinoplasty performed on an Asian or Hispanic individual should not create a nose that appears distinctly caucasian.  Size of the nose influences perception of the entire face.  For example, reduction in nasal size enlarges apparent size of surrounding features, such as eyes and lips, promoting femininity.  Diminishing size of a single component of the nose, such as the tip, enlarges apparent size of adjacent parts, such as the nasal base.

The younger the age at which rhinoplasty is performed, the longer the patient experiences resulting benefits. Because facial growth is not complete until late teens, rhinoplasty should be deferred until age 16 or later for women, and 18 or later for men.

Steve Laverson, MD, FACS
Diplomate, American Board of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgeons
Article by
San Diego Plastic Surgeon