Nose jobs are gaining in popularity for many reasons. Among them are greater awareness of possibilities, openness to cosmetic surgery and social media.
Thanks to social media such as Facebook, Twitter, Instagram and chat apps that allow you to attach images and mass text, many people today are becoming more concerned about their appearance, and about having the “perfect” look. This means different things to different people, and can revolve around one feature or a combination of them.
Seeking that perfect nose
When it comes to noses, desiring the ideal can mean undergoing a rhinoplasty – cosmetic nasal surgery – for any of several reasons including straightening a crooked nose, reducing the size of a large nose or nasal hump, raising the nasal bridge, reducing flared or fleshy nostrils or creating a more pointy or upturned tip.
The objective is to emerge with a more well defined and shapely nose with improved projection that gives the face a more 3D appearance.
This request is not restricted to adults. Recently, a 12-year-old girl who had undergone a rhinoplasty made the news.
In general, most surgeons would perform rhinoplasty on patients who have reached skeletal maturity, usually at age 16 and above. If surgery is done before a patient has stopped growing, complications can arise as the nose continues on its natural development path, possibly altering the result of the rhinoplasty.
For those who wish to simulate the appearance of a rhinoplasty, fillers are sometimes used as a temporary measure that gives the patient time to get used to a new look before committing to the actual surgical procedure.
Fillers, though, cannot address the full spectrum of nasal augmentation that is possible surgically. For instance, fillers cannot narrow a broad nasal tip or alar base. The alar is the fleshy bottom part of the nose which joins the cheek.
Nasal filler injections have also been known to result in dreadful complications such as blindness and skin necrosis or loss. I have managed a few patients who present with unnaturally broadened radix – the root of the nose between the eyes – from repeated and excessive filler injection by their physicians.
I prefer a comprehensive open rhinoplasty to produce a more projected and well-defined nasal tip, elevated dorsum, and to achieve slight lengthening of the columella. The tip projection and lengthening is achieved with a piece of cartilage from the nasal septum. If this is insufficient, rib cartilage is used for optimal results. Rib harvest increases surgical duration and requires general anaesthesia. In Korea, cadaveric cartilage is used instead of rib harvest to save time.
The nasal tip is narrowed by increasing the tip projection and suturing the lower lateral nasal cartilages. A piece of conchal cartilage from the ear is laid over the nasal tip to give it a nice rounded contour. Occasionally, alar reduction is necessary to narrow the alar base.
Sutures over the columella are removed after one week. Post- operative bruising lasts for about two weeks. Most of my patients return to work within one to two weeks. The residual swelling subsides gradually. The final result is appraised after three to six months. A young patient especially may be affected by unkind comments from friends and relatives during this time. Family members should be ready to provide emotional and psychological support post-surgery.
Most patients are happier after surgery. Some of them even opt to undergo a functional rhinoplasty procedure at the same time, such as correcting an existing nasal blockage or correcting structural problems that cause chronic congestion and breathing problems.