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Rhinoplasty – Nose Reshaping

by ttplastadmin on 03/24/2010

Reshaping the nose by a procedure called rhinoplasty is another great example of underlying anatomic structure creating shape and beauty. In this case the structures under consideration are the cartilages and bones of the nose. Deviations from the “ideal, beautiful, normal” in these cartilages and bones cause various nasal deformities a client may find objectionable. Correction by logic inference is most successful if the underlying structural problem is identified and an alternate, more satisfactory structure can be created. The skin then again just drapes over the new structure. Due to the delicacy of some of the underlying cartilages in the nasal tip the best results in this area can usually be obtained in clients with equally thin and delicate skin. Thick, oily skin tends to blunt the underlying anatomy.

In an oversimplification the structures under consideration are the two U-shaped lower lateral, the paired quadrangular upper lateral and the unpaired  midline quadrangular septal cartilages together with the two nasal bones. The lower lateral cartilages determine shape and projection of the nasal tip, while the two upper lateral cartilages and the nasal bones make up the shape of the dorsum of the nose. The relationship of the parts to each other and to the underlying facial skeleton imparts balance and harmony, but also deviation, straightness and ease of breathing.

A well done rhinoplasty creates a nose that fits the face with parts being in harmony and structural anomalies corrected while respecting the ethnicity of the client. A nose shaped after a caucasian ideal may be far from ideal for an Indian client for instance.

At Trinidad Institute of Plastic Surgery  we follow a balanced approach to rhinoplasty. It is not a procedure merely to “reduce” those parts of the nose which appear prominent but to bring all parts of the nose into harmony. This may entail augmenting certain areas of the nose with grafts taken mostly from the midline septum as certain prominences may actually be evidence of deficiency in other areas and are reduced by strategic augmentation, all aiming to achieve balance amongst the individual parts. Determining where how much reduction and augmentation restore harmony is an artistic and rarely a scientific undertaking, or – as one of my teachers put it – this is where the magic comes in.

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