What Exactly is Done During a Rhinoplasty?

December 12, 2019

Rhinoplasty ProcedureDuring rhinoplasty consultations, Dr. Ahn is often asked, “exactly what are you going to do to make my nose look the way I want it to look?” He answers that most experienced rhinoplasty surgeons have a “toolbox” of maneuvers. Depending on what is needed for that particular nose, he will choose from a handful of techniques to achieve the results that the patient seeks. The key is to have a wide selection of “tools” and this comes with experience, training and continued efforts to improve. During the consultation, Dr. Ahn will review these techniques in detail with the patient so that communication is as good as possible.

What can be done to a nose?

  • Make a large tip (bulbous) more refined and smaller.

HOW TO MAKE A LARGE TIP (BULBOUS) MORE REFINED AND SMALLER

  • Patients who have noses with large, bulbous tips often want them to be smaller and more refined. This is accomplished by removing a small amount of cartilage from the tip while leaving enough to maintain structural integrity of the tip. The remainder of the tip cartilage can be shaped using suture techniques. It is very important not to remove too much cartilage and to be precise in the amount that is removed so that the tip is symmetric and strong. Cartilage grafts taken from the septum are often used to strengthen the cartilage and ensure that the tip does not shift or change position.

SKIN THICKNESS

  • The thickness of the tip skin is a large factor in determining how much a tip can be changed. In rhinoplasty, surgeons do not remove skin. When the surgeon changes the shape of the bone and cartilage, he/she then needs the skin to “shrink wrap” to see the changes. Thin and medium thickness skin shrinks well. Thick skin does not. The thickness of the skin can be determined at the consultation when Dr. Ahn feels the tip skin between his fingertips. While there are maneuvers that can be performed to make tip skin thinner (remove the layer of fat beneath the skin, apply radiofrequency tightening to the skin, for example) very thick skin severely limits the changes that can be made.

HOW TO CHANGE THE PROJECTION (MOVE THE TIP OF THE NOSE CLOSER TO OR FURTHER FROM THE FACE)

During the consultation, Dr. Ahn will measure the tip projection using computer imaging. If he determines that the tip is overprojected (too far from the face) he then may recommend deprojecting the tip, moving it closer to the face, to improve the proportions and balance. The opposite is true as well for an underprojected tip.

Moving a tip closer to the face usually involves cutting the tip cartilage and then precisely overlapping the segments so that the tip moves back the correct distance. Moving the tip away from the face, increasing projection, depends on using cartilage grafts to provide a strut of support. These grafts are often called septal extension grafts or strut grafts.

HOW TO LOWER THE BUMP ON PROFILE

The “dorsal hump” is the bump on the nose, made of bone and cartilage, that is seen on the profile view. It can be familial (your family’s nose) or the result of trauma. Bumping the nose can cause growth of bone.

To lower the bony part, a rasp (a tool that looks like a fine file) is used to gently take down the convexity. To precisely lower the cartilage, Dr. Ahn uses a micro blade to remove segments that are as thin as less than a millimeter. Dr. Ahn feels that it is critically important to lower the bump slowly, carefully and with great attention to detail, as a millimeter change can make a significant difference on the result.

HOW TO STRAIGHTEN A TWISTED NOSE

During his residency training, Dr. Ahn was fortunate to train at , where many patients had “twisted” noses as the result of trauma. Because there were so many people with crooked noses, Dr. Ahn and his fellow residents were able to study how best to treat a twisted nose with surgery. As such, Dr. Ahn has extensive experience with operating on the twisted nose.

The twisted nose is often the result of multiple episodes of trauma, or at least one significant incident that resulted in a broken nose. There are many factors that may contribute to the twisted nose including: a deviated septum, misshapen cartilage and displaced, previously broken nose bones. All of these need to be addressed during rhinoplasty to make the nose straighter. Unfortunately, it is not always possible to make the nose perfectly straight since so many forces have been holding the nose in a twisted position.

HOW TO CHANGE THE OVERALL APPEARANCE OF THE NOSE WHILE MAINTAINING ETHNIC CHARACTERISTICS

Careful and experienced rhinoplasty surgeons are sensitive to the concept of ethnicity preservation in rhinoplasty surgery. Not everyone wants a stereotypical northern European nose. In fact, most patients want to retain the characteristics of their specific ethnicities. They just want a nicer version of their current nose and a result that does not make them look like an overall different person. Dr. Ahn ensures that during the consultation there is excellent communication in terms of the patient’s goals. For example, some want to remove a familial bump and make the nose straight while others want to retain some of the bump but just want it to be smaller. Dr. Ahn takes great pride in his ethnic preservation rhinoplasties.

If you would like to learn more about rhinoplasty, please schedule a personal consultation with a double board certified facial plastic surgeon like Dr. Ahn. He can recommend an appropriate course of treatment after evaluating your aesthetic needs and goals. Contact the Aesthetic Wellness Center by calling or emailing us today.

What is Rhinoplasty?

October 11, 2019

One of the most popular cosmetic surgeries today is rhinoplasty. Rhinoplasty is a technically precise procedure that involves changing the shape of the nose in order to produce facial harmony. The goals are to improve appearance while maintaining (and even improving) functionality of the nose. Experience, talent, and artistic judgement are vital characteristics for a rhinoplasty surgeon. In addition, excellent communication between the patient and surgeon in terms of realistic expectations is critical.

There are two types of rhinoplasty: cosmetic rhinoplasty and functional/reconstructive rhinoplasty. Cosmetic rhinoplasty changes the appearance of the nose only. Reconstructive nasal surgery corrects traumatic injuries and improves breathing. While rhinoplasties can be both reconstructive and cosmetic, the best rhinoplasties improve form while maintaining or improving function.

An important structure of the nose is the nasal septum. The septum is a cartilage and bony wall that divides both sides of the nose. If the septum is deviated, the outward appearance of the nose can look crooked and breathing may be compromised. During a septoplasty, cartilage and bone that are not straight are removed. Septoplasties are often performed in the setting of a rhinoplasty if there are breathing problems. In addition, even in the absence of breathing problems, cartilage from the septum is often removed in rhinoplasty for use as grafts to support and shape the nose. Dr. Ahn strives for optimal results in rhinoplasty and will often use cartilage from the septum for aesthetic and functional needs.

Rhinoplasty is often described as either “opened” or “closed.” Both methods leave the patient with incisions that are barely visible post-operation but the open approach uses an incision within the columella (the skin between the tip and the upper lip/base of nose). A surgeon’s preference on what approach to go with depends on his or her preference and philosophy. Open rhinoplasty does allow for a clearer view of the nose structures in their native position and for precise placement of incisions, stitches and grafts. Dr. Ahn primarily uses open approaches because he believes it provides the best balance of form and function.

EXPECTATIONS AND LIMITATIONS

While Dr. Ahn will always strive for excellence, a “perfect” rhinoplasty result is not always achievable. It is extremely important that both the doctor and patient have realistic goals. Some factors that are less favorable in terms of ultimate outcome include:

  • Oily and thick skin
  • Extremely thin skin
  • A twisted or crooked nose
  • Asymmetric and abnormally positioned nasal cartilage

Understanding this, excellent communication is critical in the preoperative consultation process. Dr. Ahn uses his computer based Mirror Imaging morphing tool and the patient’s photos, not just to show the potential results of surgery, but also to “get on the same page” in terms of realistic outcomes. When that happens, ultimately the patient ends up with the most satisfying outcome.

 

 

Emotional Benefits of Rhinoplasty

July 16, 2018

Emotional benefits of RhinoplastyRecently, Dr. Min S. Ahn discussed how rhinoplasty, or nose reshaping surgery, can increase self-esteem and confidence. He explained how the benefits of a well-performed rhinoplasty have an emotional component in addition to addressing physical concerns.

In this post, Dr. Ahn would like to share additional ways rhinoplasty can improve your emotional wellbeing. From better sleep and an improved outlook on life to the positive impact it can make on your career, rhinoplasty has the potential to change your life for the better. Read on as the Westborough plastic surgeon discusses the emotional benefits of rhinoplasty. (more…)

Can Rhinoplasty Boost Your Self-Esteem?

April 24, 2018

Rhinoplasty and self-esteemRhinoplasty, also known as nose reshaping surgery, is one of the most gratifying procedures Dr. Min S. Ahn performs. The Westborough plastic surgeon understands that many individuals spend years feeling embarrassed or self-conscious because of a bump on the nose, a crooked nasal tip, an overly large nose or another cosmetic flaw. Rhinoplasty is a surgical procedure that modifies the proportions of the nose to create a more harmonious and balanced facial appearance. Because the nose is the central focal point of the face, it’s no surprise that rhinoplasty can have a dramatic effect on one’s physical appearance and self-esteem.

In this blog post, Dr. Ahn shares some of the benefits rhinoplasty offers, including a self-esteem boost. (more…)