The Different Types of Rhinoplasty: Which One Is Right for You?

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Are you curious about the secrets behind the modern-day nose job? Rhinoplasty, the surgical procedure to reshape the nose, has evolved over the years to combine both art and science. With a range of approaches and techniques available, it’s now possible to get the nose of your dreams while fixing form and function concerns. Here, top facial plastic surgeons share the important factors that go into the most successful nose transformations.

Various Approaches

Palo Alto, CA facial plastic surgeon David Lieberman, MD explains that rhinoplasty involves restructuring the nasal cartilages, bones, and soft tissue. “Rhinoplasty is basically a restructuring or re-contouring of the nasal cartilages, nasal bones and sometimes the nasal soft tissue. While this is frequently done to address aesthetic concerns, the function of the nose must be accounted for in any nasal surgery,” he says. “Often patients want to achieve an improvement in their nasal airway and take that surgery as an opportunity to improve the external shape or contour of the nose.” 

Two main approaches are widely used: the open (or external) approach, involving a well-hidden incision between the nostrils, and the closed (or endonasal) approach, with incisions made within the nose. Both techniques can yield excellent outcomes, so it’s crucial to choose a surgeon based on their experience, track record, and level of care. “Over the last several years, the popularity of preservation rhinoplasty has risen,” he adds. 

This patient underwent a rhinoplasty with Dr. Most to improve breathing issues and meet aesthetic goals. Dr. Most made her nose more symmetric, refined her nasal tip and reduced the hump. @smostmd

Preservation Rhinoplasty

“In recent rhinoplasty, the only tool the surgeon uses is to remove structure from the nose to make it smaller. We know this can cause collapse over time,” explains Stanford, CA facial plastic surgeon Sam P. Most, MD. ”Structure and preservation rhinoplasty seek to strengthen or preserve the nose while reshaping it. In fact, I perform a hybrid of these, which I call ‘structural preservation rhinoplasty.’”

Beverly Hills, CA facial plastic surgeon Kimberly J. Lee, MD further explains that the various techniques used are suited to different modifications. “The open rhinoplasty technique involves external and internal incisions, allowing for complex reshaping. In contrast, the closed technique involves internal incisions only and is suitable for less extensive modifications.” Tip rhinoplasty, or a “tip lift” focuses on refining the nasal tip, while septoplasty corrects a deviated septum for improved breathing. “A revision rhinoplasty addresses complications from previous surgeries,” she says.

Understanding these techniques can help you discuss the best approach with your surgeon. When deciding to undergo rhinoplasty, our experts say several factors should be considered. “Patients should have a clear understanding of their motivations for seeking rhinoplasty and realistic expectations about the outcome,” notes Dr. Lee. “It’s important to communicate openly with the surgeon about desired changes and understand what can realistically be achieved.  I like to use 3D computer imaging to ensure that the patient and I are on the same page.” Dr. Lee also stresses the importance of selecting a qualified and experienced board-certified facial plastic or plastic surgeon who specializes in rhinoplasty.

This patient’s nose drew attention away from her beautiful eyes, skin, and smile. Her other features were quite delicate, relative to her nose. Dr. Lieberman and Dr. Sachin Parikh performed a rhinoplasty to straighten her nose to let her other features shine. @forthefacebayarea

Creating Facial Harmony

Determining the most aesthetically pleasing size and shape of the nose requires a balanced approach. “Reshaping a nose involves a delicate balance of skills,” says Dr. Lieberman. “It requires structural engineering to ensure harmony with existing features like the chin, cheeks, and eyes. There’s also an artistic aspect, making micro adjustments to enhance the overall facial features. Additionally, understanding the patient’s desires and achieving realistic expectations is essential.”

Like any surgical procedure, rhinoplasty carries potential risks and complications, as outlined by our experts. These may include pain, infection, bleeding, reoperation, scarring, nasal obstruction, and poor aesthetic outcomes. Minimizing these risks is achieved through careful surgeon selection, open communication, and realistic expectations. Dr. Most highlights the importance of selecting an experienced surgeon. “The biggest risk is dissatisfaction cosmetically with the final result,” he adds. ”The most important things to prevent this are selecting an experienced surgeon, spending time with them to understand what they can do for you and having realistic expectations. Remember, even in the greatest hands, sometimes things don’t heal properly.”

Managing patients’ expectations is a crucial aspect of the rhinoplasty journey. Dr. Lee emphasizes the importance of clear communication between the patient and surgeon. It’s essential for patients to convey their desires and expectations for their nose while also being open to the surgeon’s professional opinion and expertise. Understanding the limitations and possibilities of rhinoplasty is vital to achieving a satisfying outcome.

Whether it’s addressing aesthetic concerns, improving breathing function, or correcting previous complications, rhinoplasty can be a life-changing procedure. By choosing a qualified surgeon, setting realistic expectations, and actively participating in the process, patients can embark on their rhinoplasty journey in capable hands.

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