Getting The Natural Rhinoplasty Look

Rhinoplasty, also known as nose-shaping surgery, is a common plastic surgery procedures of the face. By changing the shape of the nose, one's entire face can have a different look. While rhinoplasty has been around since the beginning of early surgery, modern nose reshaping techniques create results that are more natural and can hold their shape over time.

Historically, rhinoplasty surgery was associated with after surgery appearances which were 'overdone'. This type of reductive rhinoplasty produced noses that were short with up-turned tips(pugnose appearance) and with low bridges. Even if the nose did not appear this way immediately after surgery, this appearance developed months or years later. This nasal appearance was the result of removing too much of the natural structures of the nose. Dropping the bridge of the nose too much (bone and cartilage)and lifting or shortening the nasal tip too much (cartilage) weakens the underlying support of the nose. As time goes by after surgery, scar tissue forms and shrinks, pulling the nose downwward and in creating a sunken unnatural appearance. It may look too small, too upturned, or too narrow and pinched at the tip.

The importance of maintaining as much of the support of the nose is better appreciated today. The nose is like a house, the framework must be maintained to keep the roofline intact. Contemporary rhinoplasty is more of a rearrangement of the framework structures with only small removals of cartilage or bone. In this way, the nasal dorsum (line along the bridge to the tip) remains smooth but at a good height, the end of the nose is lifted but not too high, and and the nasal tip is narrowed but is not made into a single point.

Besides less cartilage and bone removal, the natural rhinoplasty makes use of adding support through cartilage grafts as necessary. Supporting the tip of the nose through strut grafts, using small hand-carved grafts to improve tip shape, spreader cratilage grafts in the middle of the nose to open up breathing, and actually increasing the height and line of the nose through onlay or radix grafts are some of the methods by which the nose can be builtup and strengthened. These cartilage grafts are usually acquired from the septum of the nose (which may be simultaneously straightened) or from the back of the ear.

Natural rhinoplasty methods utilize the concepts of nasal tissue preservation, artful alignment of the different areas of the nose, and skillful manipulation of small nasal elements. It is usually best done through an 'open approach' with a resultant indetectable scar across the columella. (strip of skin between the nostrils) Natural noses fit each patient's face more proportionately and never have that 'operated' appearance. While tedious to perform, I find the long-term results rewarding and the need for secondary revisional surgery reduced.