A Rhinoplasty is an operation to improve the appearance of the nose. It can also be used to improve breathing. A successful Rhinoplasty requires careful preoperative planning. Each part of the nose, including the dorsum (or “bridge” of the nose), the tip, the nostrils and their relationship and proportions to each other must be carefully analyzed. The effect that a manipulation of one part will have on the appearance of another must be predicted and calculated. Rhinoplasty is truly a combination of art and science.

A rhinoplasty can be performed in one of two ways. Our preferred approach is the “Closed” approach. Another approach is referred to as the “Open” approach. Both are valuable techniques. Each has its advantages and disadvantages. The choice of which approach to use depends on the findings during an examination. Ultimately, the goal is to create a natural and aesthetically pleasing and balanced result.

Closed Approach

A “Closed” approach refers to a technique of Rhinoplasty in which no external incisions are made. All incisions are made within the nose. The advantage of this approach is that no external scars are created. All scars remain hidden with this technique. This is our preferred method of Rhinoplasty.

Most people seeking Rhinoplasty will be good candidates for the closed approach. This is because most individuals will have great improvement in the appearance of their nose with changes to the dorsum (“bridge”) of the nose, and minor changes to the tip of the nose. The closed approach is successful in treating these areas.

The closed approach can also be used to treat minor breathing difficulties.

If an individual needs major revision of the tip of the nose, more complex manuevers to the dorsum of the nose, or has major breathing difficulties, the “Open” approach is a better option.

Open Approach

An “Open” approach refers to a technique in which a small incision is made across the “Columella” (which is the small bridge of tissue between the nostrils leading up to the tip of the nose). The incision is designed so that when it heals, it is inconspicuous. Furthermore, when someone is being viewed at eye level, this part of the nose and the scar are generally not visible.

The open approach is preferred when major changes to the tip of the nose are needed. It is also useful when complex work needs to be done to the dorsum, or “bridge” of the nose. In addition, if a patient has major breathing difficulties, the open approach will be a better technique to use.

The choice of technique will depend on what is found on a careful examination. A thorough discussion of each technique will be conducted during the consultation.

Results

This patient requested an improvement in the appearance of her profile. She was unhappy with the “bump” on her nose. She wanted an improvement that looked very natural. As you can see in the “After” pictures, the appearance of the nose is significantly improved. Her profile is straight. The “bump” is no longer present. Her nose is also more narrow and defined when viewed from the front. The overall result is very natural looking. The improvement in the appearance of her nose compliments the other pretty features of her face.

The patient below complained about the appearance of her nose. In particular, she was unhappy with the “bump” on the nose. A thorough analysis of her face was performed. This patient has many aesthetically pleasing features. The balance and proportion of the features to each other are ideal. However, the presence of the bump on the nose was detracting from her natural beauty. This bump was disturbing the harmony between the different features of the face. Performing a rhinoplasty not only improves the appearance of the nose, but also can improve the entire appearance of the face. The “After” picture shows the results. We refined the tip of her nose. We also removed the bump on her profile. These small changes restored balance to her face. The beautiful features she already had are now more obvious. The bump is no longer detracting us from her natural beauty. In addition, there is nothing about her appearance that would suggest she has had a “nose job.” Our goal is to create great results which look completely natural.

The patient below requested improved definition of the tip of the nose. She also requested a less wide nose. The “After” pictures were taken only one month after surgery. Note that the tip of the nose is slightly more defined. Also note that the nose is less wide. The changes are subtle and very natural looking. The appearance of the nose is designed to maintain balance and harmony throughout the face.

This patient felt that her nose was “too large” for her face. We performed a rhinoplasty and septoplasty through a “Closed” approach. We straightened her septum and returned it to the middle of her nose, as you can see in the last two pictures of this series. We also reduced the fullness of the tip of her nose. In addition, we narrowed the width of her nose. This can be seen in the frontal views of her nose. We also lowered her nose and reduced the amount of projection of the nose from the face. As you can see in the “After” pictures, her nose is now slightly smaller and does not project as much from her face. She already had many pretty features. The rhinoplasty served to restore balance to her face and accentuate the beauty she already had.

This patient requested we only show his nose for his privacy. He felt that the tip of his nose was too large and was not defined. He did not want major changes to his profile. He also wanted a natural looking result. we performed his surgery through a “Closed” approach. We removed excess cartilage from the tip and used sutures to carefully shape his tip. We also narrowed the width of the nose. We did not change his profile significantly. As you can see in the “After” pictures, the tip of his nose is much more narrow and defined. The whole nose appears less wide. The appearance of the nose is improved. His result is very natural looking. We always work very hard to achieve what each patient wants.

The patient below had a slight bump on the nose on a profile view. The tip of her nose was also slightly wide and not well defined. We reduced the bump on the nose and straightened her profile. We also removed excess cartilage from the tip of her nose and sculpted the cartilage to give her a more narrow and defined tip. Her result is very natural looking. The result also accentuates the beauty she already had.

This patient was unhappy with the “bump” on the nose on profile view. She requested a more straight profile and aesthetic appearance of the nose. The “After” view shows a more straight profile, correction of the “bump,” or dorsal hump, and a more aesthetic look to the nose.

The patient below requested a refinement in the appearance of her nose. In particular, she wanted the nose to be slightly more narrow from the front view. She also wanted the tip to be smaller. Notice in the “After” picture how the nose is more narrow from the front view. The tip is also smaller and more defined. The picture of the nose from the angle shows an improved profile and less fullness of the tip. Notice also how natural the nose looks. There are no “tell-tale” signs of rhinoplasty. Creating natural looking results is very important to me and is something we strive for in every rhinoplasty we perform.

When we analyze a face, we examine each of the features and assess the relative proportions. Usually, a change in one feature will enhance the overall appearance of the face by reestablishing balance. Often, subtle changes in multiple features can be synergistic, creating an overall greater improvement. In some cases, performing a rhinoplasty, chin augmentation, cheek reduction, cheek enhancement or any combination of the above may dramatically improve the harmony among the features of the face. If you are interested in this, please request more information during the consultation.