Summary: Rhinoplasty remains one of the most popular facial plastic surgeries year after year. Nose surgery can enhance facial harmony and the proportions of a the nose, but each nasal deformity requires a different approach to surgery.
The nose is one of the most distinctive facial features. It literally stands out from your face — especially when there’s something not-quite-perfect about it.
Many people feel that their noses are too long, short, wide, or some other characteristic, and that’s why rhinoplasty is one of the most common plastic surgery procedures in the U.S. each year. The ideal outcome of any rhinoplasty procedure is to have a result that balances with your other facial features.
If you have ever considered rhinoplasty, use this quick guide to the most common nasal deformities to learn what types of techniques are often used to remedy them.
What it looks like: Many rhinoplasty patients hope to address a dorsal hump, or that bump that along the bridge of the nose. The hard structures of the nose are made of a combination of cartilage and bone. When a person has larger or more prominent nasal bones at the upper base of the nose, this can give the nose a beak-like shape. When the hump is found lower on the bridge, this is usually because there is a significant amount of cartilage. Most dorsal humps are made up of a combination of both bone and cartilage.
How to fix it: Dorsal hump reduction is a very common rhinoplasty technique that involves reshaping or removing parts of the nose structures. In some cases, only cartilage needs to be gently shaved to reduce the bump’s appearance, while other times the surgeon needs to make small, strategic breaks in the bones called osteotomies to achieve the desired look.
What it looks like: A disproportionately long nose can overwhelm an otherwise attractive or proportional face. A lengthier nasal bridge is common amongst some ethnicities, including Native Americans, Middle Eastern groups, and those from southeastern European countries. A long nose is often has a longer columella, or the flesh between the nostrils. The length of your columella influences the projection of your nose.
How to fix it: Many longer noses need only a conservative rhinoplasty to help dramatically improve how the nose complements the rest of the face. Surgeons often shorten the septum, or the cartilage that separates the 2 nostrils, and rotate the nasal tip cartilages. Many men seek rhinoplasty for this reason, as a slightly smaller nose can give them a more youthful appearance and help them stay competitive in the workplace.
What it looks like: Some noses have a prominent, fleshy tip commonly referred to as a bulbous tip. A bulbous tip has 2 common causes: a large amount of soft, fleshy tissue, as commonly seen in those of African descent, or prominent lower lateral cartilages, as seen in some Caucasian ethnic groups.
How to fix it: A bulbous tip comprised of primarily soft tissue is often quite broad and full. By trimming or removing a portion of this tissue, the surgeon can help refine the nose.
For those with prominent lower lateral cartilages, a surgeon can perform a lower lateral cartilage cephalic trim. During a cephalic trim, the surgeon removes a portion of the cartilage to give the patient a more streamlined profile.
What it looks like: A ptotic, or droopy, nasal tip can be caused by trauma, aging, or genetics. Because the nasal structures often collapse with age, droopy tips are most commonly associated with the aging process and can make patients appear older than they are.
How to fix it: To elevate and slightly upturn the nose, the surgeon can rotate the nasal tip cartilages upward. This helps combat any droopiness of the nose and gives the patient a more youthful appearance. Sometimes additional cartilage is needed to give the nose stability. While many patients have sufficient cartilage in the nose, in some cases the surgeon may harvest cartilage from the ear, the ribs, or the sternum for additional support.
Scarring: One of the major concerns of many patients before rhinoplasty is whether they will have any obvious scars. According to Orange County plastic surgeon Dr. Timothy D. Miller, most rhinoplasty surgeries can be done using a “closed” approach. This means that the incisions are hidden within the nostrils. In an “open” approach, the incision is across the columella. Whether your surgery would be an open or closed approach depends on the type of procedure being performed and the preference of your surgeon. However, even in an open approach, the incision across the columella is very small and discreet.
Downtime: Patients are often curious how long they can expect to be out of commission following a rhinoplasty. The majority of patients are on pain medication for 1 to 2 days after surgery and feel ready to go back to their everyday activities after about a week, although bruising and swelling lasts longer. Most surgeons recommend limiting more strenuous activities for a total of 4 to 6 weeks.
Determining your details: It is highly recommended that you schedule a consultation with a board-certified plastic surgeon. Most plastic surgeons offer complimentary consultations or apply the consultation fee to the cost of your procedure. At this appointment with a qualified specialist, you can learn more about your precise nose type and what can be done to meet your cosmetic goals.