Historically the most common method for performing rhinoplasty was to reduce its overall size. While this is still often the case, today more emphasis is placed on achieving a well-balanced nose that fits harmoniously with the other features of the face, ethnicity, and size of the individual. The most common complaint in people who wish to undergo nasal reshaping is that their nose is too ‘big’. More accurately, the size of their nose is disproportionately too large for their face. Specifically, one or more of the following may be too large: nasal length, nasal width or nasal projection (how far the nose sticks out from the face). In addition many people with big noses tend to have a ‘hump deformity’ of the nasal bridge. State of the art reduction rhinoplasty aims to reshape the nose rather than simply remove underlying structure so that it does not change drastically over time and become pinched or non functional. During reduction rhinoplasty it is important to pay attention to other unattractive features that need to be improved such as asymmetry, nostril shape and tip definition.
The ideal nose has subtle features which make it attractive. Even if the length, width and projection are acceptable, other elements will influence nasal aesthetics. Important considerations include tip definition, contour irregularities, asymmetry and the brow-tip nasal aesthetic line. A well defined tip is adequately narrow with properly positioned tip-defining points and has appropriately shaped and sized lobules with smooth contours. A poorly defined tip is either too wide, boxy or bulbous. A poorly defined tip is usually the result of thick skin or weak underlying cartilages. In such cases it’s best to create a more robust framework that can “push out” against the skin to provide greater definition. Nose surgery in Beverly Hills can help correct these issues.
Following surgery to remove cancer or occasionally following facial trauma, the nose may be left severely disfigured due to the lack of tissue that has been removed or lost. Reconstructive rhinoplasty refers to surgery required to restore tissue that is absent or has been damaged beyond repair. Tissue replacement is usually thought of in terms of replacing the three layers of the nose: 1) the outer skin-soft tissue envelope including skin, subcutaneous tissue and fascia, 2) the middle foundation layer or bone-cartilage framework and 3) the inner mucosal lining. Surgical repair requires the use of grafts and flaps from various parts of the body to restore the missing component tissues. The overall reconstructive process typically requires multiple staged surgical procedures. Again, both the surgeon and patient need to understand the limitations in the final outcome that such deformities are associated with.