NOSE JOB WITHOUT SCARS?

N O S E  J O B  W I T H O U T  S C A R S ?  

By

 

 

Dr. Steven B. Hopping

Past President of American Academy of Cosmetic Surgery
Cosmetci Surgeon

 

American Academy of Cosmetic Surgery Hospital

 

 

 

Aesthetic Rhinoplasty is the surgical procedure that aims to correct the form of the nasal pyramid in a way that a better adequacy of facial beauty to the cosmetic rules consensually most acceptable in each time and place can be achieved.

The goal always is to improve the appearance and function of the nose.

Physiognomic alterations, like a nose that appears too large for the face, a hump on the nasal bridge when viewed in profile, a nose that seems too wide when viewed from the front, a tip that droops, plunges, is thickened or enlarged, nostrils that are excessively flared, a nose that is off-center or crooked or even a previous injury that has left the nose asymmetrical, are some of the most frequent problems mentioned during the consultation for Rhinoplasty.

Various techniques that can increase or decrease the nasal bridge, reduce the size or width of the nose, narrow the nostrils, change the angle between the nose and upper lip or reshape the tip can be addressed dependently each case and desire. The whole shape of the nose can be changed in a way that it will be adjusted to your face based on studies of your profile and frontal view. Details such as the curve, the width or the projection of your nose will be discussed.

Each patient has to understand that the nose is a very important structure centrally located at the face. It is a mark of human physiognomy. Every disproportion in the face is extremely perceptive and difficult to hide.

Main goal of this surgical procedure is to create a nose that is artistically as close as possible to each society’s beauty concepts which are influenced every time by ethnic cultural characteristics and fashion.

Most of all in every case the nasal physiological function must be always maintained or even become better, the form and symmetry must be proportional of the general facial contour and in any way the nose should be considered as an esthetic unit isolated and independent.

Any surgical procedure that alters the morphology of the nose will produce a permanent change in its physiology and in patient’s psychology as well. Thus accurate diagnosis of the particular deformity in each case is of vital importance as it will determine the operative technique.  Thorough pre operative evaluation is fundamental for the correct diagnosis of each deformity and local anatomical changes. No standard technique is applicable to all deformities. Each case is different and must be treated as so.

Most modern day rhinoplasties are performed via intranasal incisions. The incisions are placed inside your nose and if needed at the crease laterally in order to reshape your nostrils. Also if your nose needs to be built up in some areas, this can be done using nasal (septal) cartilage or perhaps bone or cartilage from another site as ears or rib.

External Rhinoplasty, Open Roof Rhinoplasty or Exorhinoplasty are all terms for the same procedure, the Open Rhinoplasty. The difference from the previously mentioned Closed Rhinoplasty is that it is performed through an extra external incision placed at the columella from which you can unfold the whole skin nasal cover so that the internal structural support (bony and cartilaginous) of the nose can be seen and altered.

In my opinion should not be performed so often as we usually notice, especially in the Middle East region, as it stigmatizes the patient with a scar. In some cases this external scar might be less evident, but a scar is always a scar. When something can be delivered otherwise with comparative results I cannot see any benefit sacrificing the nose.

Furthermore the magic in Aesthetic Plastic Surgery is to be able to perform all the procedures through small incisions in sites that can be very well hidden, covered and camouflaged.

It still remains a valuable procedure but for difficult cases especially for complex nasal tip problems, where a lot of detailed work must be done molding the cartilagenous supporting system, as the disadvantages are usually the increased post operative healing period, which means that the nose will stay swollen for a longer period and sometimes might end up being hard with an altered shape due to excessive fibrosis, the increased performing surgical time and the worst of all, the uncovered outside apparent incision.

Anesthesia for every kind of Rhinoplasty can be local with intravenous sedation for minor cases or general, depending on the emotional status, age, physical status, patient’s choice and the extent of the procedure.

One night stay at the Clinic and follow ups for two weeks when the nasal splinter and the tapes will be removed is obligatory.

Final results will be achieved after 6 months.

 

Dr. Steven Hopping, Cosmetic Surgeon