Noses are an unusual part of our anatomy. They sit in the centre of our face and are generally noticed on our face mostly because of their position in that important triangle made by our nose and our eyes.
They are designed as a structure through which we breathe and smell. This means that they are essentially features on our faces which have a projecting external shape and a convoluted shape on the inside to detect odours as we breath in and to humidify the air at the same time. They are not designed for an aesthetic purpose.
Noses come in a variety of shapes and sizes. Women’s noses are generally thought to be more petite than men’s noses. This is in the context of female facial characteristics as opposed to male characteristics which are generally larger and thicker set.
Ethnicity plays a significant part in the shape of our nose. Middle Eastern noses, Asian noses, European noses, Aboriginal or Islander noses are all distinctly different variations on a theme.
They also seem to change as we grow older, obviously the cute button nose of our childhood changes through youth to a more defined adult nose and adult noses do seem to change progressively with time.
For some people the nose can present a problem. That problem may be one of function, it may be one of appearance or it may be a combination of both.
The most common functional problems relate to the airway. These can be simple but disturbing problems like hay fever causing blockage of the nose through to more complex and persistent problems such as distinct anatomical narrowing of the airways. The narrowing can be so severe to result in a virtual inability to breathe through the nose.
The sense of smell is more rarely a cause for concern but there are individuals who suffer the condition of Anosmia and who are therefore unable to distinguish different odours.
Trauma is a common cause of problems to the nose. Most of your facial bony structure is fairly solid, but the nose is much less so in that the bones are thinner and there is a substantial component of the nose made of cartilage. This means that trauma can easily bring about a distortion of your nose both in its external appearance and its airway.
The other reasons that a nose can be a problem for any individual relate to its shape and size.
Many people are concerned about the size of their nose and in particular what they refer to as the “dorsal hump”. People are concerned about the shape of the tip, the width of the nose and how much the tip hangs down.
Some people find the size of their nose disturbing in relationship to the overall size of their face. Usually this is a problem where your nose appears too large in the respect to the proportions of the face.
To correct anatomical deformity of your nose where it affects the breathing or the appearance of the nose, surgery is the only real solution.
Where your problem is purely one of airway restriction, surgery can be performed to straighten the septum (septoplasty) of your nose or to reduce the size of the bones which sit inside your nose and whose job it is to humidify air as it is breathed in. This sort of surgery is generally performed by Specialist Plastic Surgeons or Ear Nose and Throat Surgeons.
Where the external appearance of the nose is a concern, surgery is most often performed by Specialist Plastic Surgeons. Plastic Surgery to correct the shape of your nose is called “Rhinoplasty”. This may mean alteration to the bone, the cartilage, the skin or even all three.
Rhinoplasty is commonly performed as an open rhinoplasty where there are cuts inside your nostrils and a small cut across the tissue between the nostrils to allow open access to the underlying skeleton of the nose, or as a closed rhinoplasty where the incisions are essentially the same but without the cut across the lower part of the central piece of tissue.
Surgery to correct the shape of the nose may involve removal of the dorsal hump by fi ling it down or removing it using a scalpel, a saw, and a chisel. Occasionally pieces of cartilage or other splinting material are placed into the dorsum of your nose to build the dorsum of the nose up. The tip of the nose is often reduced by removing some of the lower cartilage. Similarly, it is also often reshaped or built up at the very point of the tip to give the tip a subtle prominence over the dorsum of your nose. Occasionally your nose requires narrowing by using a chisel to fracture the lateral nasal bones inwards.
There is a myriad of minor variations that can be carried out during a rhinoplasty to optimise the affect. Indeed, rhinoplasty is one of those operations where a certain amount of surgery is performed and the nose is then resembled and reassessed before further surgery continues. This process might be carried out a number of times during the operation.
After your operation whether it be for septoplasty, a rhinoplasty or a combination of both, your nose is usually packed and there is usually an external splint applied to your nose. These dressings will stay on for a variable period, which may be as long as two weeks. The post-operative period can be stressful but to be able to breathe more easily through a nose which you like the appearance of, is a very pleasing outcome.
The nose is one of the areas of cosmetic plastic surgery where I fi nd it can be exacting to meet the expectations or desires of the patient. For this reason, I feel it is very appropriate that patients do have realistic expectations of the operation. It is important that patients are able to accept that their nose is very individually their nose and it may not be possible to achieve Michelle Pfeiffer or Ryan Gosling’s nose in their instance.
I think rhinoplasty is one of the most intricate, challenging and enjoyable operations in the spectrum of Cosmetic Plastic Surgery. It has been an absolute delight to perform rhinoplasties on patients and see how happy they are. In some cases, it absolutely changes their self-esteem, their breathing ability and indeed their life.
Dr Newton’s knowledge and experience will
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right procedure for your body.