What is Rhinoplasty?

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.