There are many variables in nose surgery. So, we have put together an article to explain the nose anatomy, common nose shapes and problems, and a glossary of words that you should know. This will not only help you better explain your desires to your surgeon, but it will also help you better understand what can and cannot be done.
How your nose looks is very important when talking about aesthetics and beauty. Every nose is a different shape and many of us are not happy with how ours looks. Rhinoplasty is a surgical procedure that aims to reshape the nose to improve how it looks.
Nose jobs require a very skilled surgeon to achieve the perfect result. Your plastic surgeon needs to take a lot of factors into consideration when operating, since each nose is different, and each patient wants a different look.
First, the surface anatomy which describes the visible parts of the nose without the structures that form it on the inside. The visible anatomy of the nose includes:
•The Radix: The highest point of the nose, directly in between your eyes.
•The Dorsum: Also called the bridge. It’s the part of the nose that runs from the radix to the tip of your nose.
•The Columella: The straight column between your two nostrils
•The Alae: These are the side boundaries of the nostrils. Each side is called “Ala” and the plural is “Alae”.
Underneath the surface anatomy (as explained above), there’s bone and cartilage. This is what gives the nose its shape. We can divide the nose vertically into 3 parts. The upper third is formed by the nasal bones. While the middle third by the upper lateral cartilages. And, the lower third from the alar cartilages:
•Nasal bones: These bones are not very hard, and are usually shaved during rhinoplasty to form the desired look. The nasal bones give the bridge of the nose its shape and projection.
•Upper lateral cartilages: Cartilage is a type of firm tissue that’s much softer than bone. It starts right below your nasal bone, in the middle third of your nose. You can try to feel it yourself (it’s the soft compressible part). These cartilages keep the nostrils widely open, and if they’re weak, your nose can have a “pinched” appearance
•Alar cartilages: These are very important as they give your nose tip its appearance and are usually manipulated during rhinoplasty. These cartilages underlie the tip of the nose, the columella, and the alae.
•Nasal septum: This is the wall that runs in the middle and separates the right and left nasal cavities from each other. You’ve probably heard of the term “deviated septum”, which refers to a problem in the nasal septum.
Rhinoplasty can be done for a variety of cosmetic and medical reasons. Here’s a list of the possible problems that might make you consider having a nose job:
DORSUM PROBLEMS
The dorsum, also known as the bridge of the nose is the region extending from the radix to the tip. The ideal dorsum should be a straight line with minimal curvature. Some common dorsum problems include:
•Large dorsal hump: This is when the dorsum projects excessively and is curved to the outside, causing a hump. It’s a common problem that is caused by enlarged nasal bones and cartilages.
•Wide nose: This can mean that the nose is wide at any part: the upper dorsum (dorsal bridge), middle dorsum (dorsal base), the tip, or the nostrils. You might feel that your nose is wide at any of these locations in a way that’s not proportional to the rest of your face.
•Under-projected dorsum: Usually associated with an under-projected nasal tip (explained below). An under-projected dorsum is one that is short and does not project enough outside the face.
•Saddle deformity: This usually happens after over-correction of a large dorsal hump, when too much tissue is shaved off. The dorsum appears like a “ski-slope”, with an inside curvature.
TIP PROBLEMS
The tip is made of alar cartilages. This supports the nostrils from the sides and gives the tip projection in the middle. Some nose tip problems include:
•Droopy tip: This is when the tip is pushed downward. This is commonly caused by a large nasal septum that pushes the alar cartilage down causing a droopy tip.
•Over-projecting tip: Also called “Pinocchio Nose”. Refers to when the tip projects too much outside the face, usually as a result of large alar cartilages.
•Under-projecting tip: This is when the nasal tip does not project enough away from the nose. It can be associated with an over-projecting dorsum (hump), or an under-projected dorsum.
•Bulbous tip: When the nose tip is either too large or wide.
•Boxy tip: When you look at the nose from below, it should resemble a triangle with the tip of the nose as the top corner, and the alae as the sides. If the nose appears as a rectangle, it’s said to have a boxy tip.
ALAR PROBLEMS
The alae are the sides of the nostrils. Some of the problems with the size and projection of the alae might include:
•Wide alae: This is when the alae project sideways too much, making the nostrils look wide sideways.
•Notched alae (nasal flaring): This is when the alae notch above their normal position so that the columella appears from the sides, giving a “snarl” appearance.
•Asymmetric alae: When the right and left side of your nostrils are asymmetric.
OTHER NOSE PROBLEMS
•Deviated nose: This is when the nose has deviated to one side of your face. This happens if you have a deviated septum, deviated nasal bones, deviated tip, or deviated upper lateral cartilages. Each of these problems requires a different surgical approach
•Airway obstruction: If you have trouble breathing through your nose, something might be blocking the way. This might be; a) A deviated septum b) Enlarged turbinates c)Or another problem that your specialist surgeon can diagnose.
There’s the open rhinoplasty and there’s the closed rhinoplasty. These are two different techniques that surgeons can utilise when performing a nose job. Our surgeons have experience using both these techniques to deliver excellent aesthetic results, and they might combine the two to achieve the look you desire. Each technique has its uses in specific situations and can provide certain advantages over the other technique.
The open technique is mainly chosen when the problem is in either the tip or alae. A small incision is made in the skin of the columella (between your nostrils) and the excess tissue is taken away. The remaining tissue is then redesigned to achieve the desired shape. After which, the skin is closed, and usually, no visible scarring is left after healing.
The closed technique is chosen when the problem is mainly in the dorsum (bridge) of the nose. A small incision is made inside the nose to perform the surgery, and the skin is left untouched.
Dr. Sheetal Londhe Monteiro Plastic surgeon in Pune who offers rhinoplasty with excellent results. She has done Master class in Rhinoplasty from London.
She will discuss your concerns with you and try to learn what it is that you don’t like about your nose. Then she will explain how they can help make your nose more aesthetically pleasing and more proportional to the rest of your face.
After surgery, you can expect some discomfort, swelling, pain, congestion, and bleeding for the first week. However, this will get better as the days pass, and should not last more than a week or two. You should know that full recovery might take a long time, and your nose will not settle into its final shape until at least a few months have passed.
It’s important that you have realistic expectations about what the surgery can achieve as well as the shape of your new nose. Hopefully, your surgeon will do his/her best to give you the beautiful nose you’ve always wanted and you’ll be very happy with the overall improvement in your facial aesthetics.
Before and After Photos of Nose Surgery of real patients with real results. If you would like to see before and after photos you can visit Clinic with appointment
Above all, always choose a proficient cosmetic surgeon e.g., Dr. Sheetal Londhe Monteiro to yield maximum results.