Third Quarter 2008, Volume 22, Number 2

Changing the focal point of your face — your nose

IN THIS ISSUE

Reflection and realism ensure benefits beyond the obvious

Changing the focal point of your face — your nose

Ask the Surgeon / Health Tip / What’s New

Implants advance and provide enhancements

Take a good look at your nose in the mirror. Are you aware of the various ways you could improve the appearance of your nose? From minimally invasive skin peels to improve skin tone to rhinoplasty (nose surgery), there are many ways you can improve the function, symmetry, shape, and skin of your nose.

Improve the function
A surprising number of people have difficulty breathing through their nose and choose to suffer unnecessarily. A functional rhinoplasty can address this problem. Nasal obstructions may be caused by a crooked septum (cartilage and bone that divides the nose into two air chambers), by enlarged internal structures, or by weak sidewalls of the nose.Your facial plasticsurgeon can improve your ability to breathe by adjustingand supporting the inside of your nose.This type of surgery may be covered by your insurance company since symptoms making the surgery necessary and appropriate cannot be controlled by medication.Be sure to check.

Correct the symmetry
Your facial plastic surgeon will evaluate your nose from several different angles. From the front, the nose should lie within parallel lines drawn down from the inner corners of the eyes to the nostrils. From the base, the nasal tip should appear triangular and the nostrils should be symmetrical in shape and size. In order to bring the nose into better balance, your surgeon may employ several techniques of adding, removing, and refining. The benefit of returning symmetry to the nose has a tremendous affect on the overall appearance of the face.

Refine the shape
Patients may be surprised to learn that their small imperfection can be improved by a non- surgical option. Injectable fillers can be used to provide more definition to the top and sides of your nose. This provides immediate results with no recovery time. The disadvantage is that the results are not permanent, with fillers lasting between three months to two years depending on the substance. Implants made of a synthetic sponge-like material can augment parts of the nose and offer long-lasting results. Changes that are more extensive will require underlying bone and cartilage to be rearranged, removed, or added.

Common questions regarding changing the shape of the nose include over-projection, bumps, saddle nose, and width. How much a nose sticks out, or projection, can be reduced by removing cartilage from the tip of your nose. A bump on the nasal bridge (dorsum) can be reduced by using a file-like instrument to shave off and smooth down the excess bone. For some cases, it may be necessary to create controlled breaks in nasal bone to achieve simple bump reduction. The skin easily re-drapes and adheres to the new shape of the nose.

When the middle of the nose is too close to the face this is called a saddle nose. This can be improved by building up the dorsum with your own cartilage from the nasal septum, ear, or rib, or by using an artificial material. If you are unhappy with the width of your nose, your surgeon will take into account several factors that may be contribut- ing to the width, such as the distance between the nasal bones, the width of the cartilage in the tip of the nose, and the thickness of the nasal skin. The width of the nasal tip can often be made more harmonious with the face, but the width of the middle third and nasal base are not usually as changeable.