The patient is a 29 year old woman who noted that her nose was too large for her face. She wanted her “nose job” to appear natural and didn’t want anyone to see any tip-offs that she had had surgery. The patient also wanted a nose that would blend in with her facial features. There were no breathing problems. She complained of the bump on her nasal bridge but had no other issues except for the overall size.
Rhinoplasty Surgery
At the patients procedure which was performed under general anesthesia, a closed rhinoplasty was done to take down the “bump” on the bridge of the nose. The upper part of the nose was also narrowed to go with her new smooth bridge profile. The nasal tip was shortened and slightly narrowed to match the patient’s fine features. The patient returned the next day and the small packs that were placed in the nostrils were removed and the splint was kept on another five days. When the splint was removed, the patient could see her new bridge and was very happy. She also was able to see at this early juncture that the tip was less prominent but starting to match her face.
Rhinoplasty is Facial Plastic Surgery
We perform rhinoplasty to usually make the nose smaller and to refine its shape but it has to come into alignment with the other features of the face. For patients with longer and finer facial features, a short nose that is broad at any point will clash and the nose will therefore, become obvious. Since we do rhinoplasty to de-emphasize the nose, making the nose different from the face makes it more obvious.
Tip Projection and Rotation
If the nasal tip was recessed, i.e. made to stick out less, that might also clash with her fine features and long nose and the nose might appear too dainty. Likewise, this patient is also tall and rotating the tip upward would have unnecessarily shortened the nose and created more nostril show, which would take away from the beauty of the nose. So in this patient, minimal tip changes were made with the exception of simply refining the very tip of the nose to lend beauty.
The Nasal Bridge
The nasal bridge is the part of the nose that proceeds from the brow to the tip. Historically, the bridge had been completely or almost completely removed which left what we now call a “sky slope”. That gave the ability to make the nose much smaller and was seen as feminine. The current standard for rhinoplasty is that the bridge should be either straight of slightly bowed. This allows for some decrease in the size which allowing the nose to also be narrowed. Also, by limiting the amount of bridge that is removed, patients can maintain some ethnicity to their nose if they so wish.
