Nose Surgery (Rhinoplasty) Bay Area & San Francisco
Overview of Rhinoplasty
Rhinoplasty is any surgery done to reshape the nose. Commonly rhinoplasty is preformed to reduce or increase the bridge of the nose, change the shape, size, and angle of the tip; change the shape of the nostrils, straighten a crooked nose and improve breathing, shorten or lengthen the nose, and alter the projection of the nose. Also the nose is commonly involved in trauma, thus rhinoplasty is often necessary to correct post-traumatic deformities. More so than any other procedure, rhinoplasty must be tailored to the individual because each person has unique features to their nose and commonly their own concept of nasal aesthetics. It is also important to evaluate the rest of the face when planning rhinoplasty in order to create a balanced look. The chin especially has a major impact on facial aesthetics and the appearance of one’s nose.
Rhinoplasty techniques can be divided into two major categories, “open” and “closed”, based on the incisions used. The goal of both techniques is to separate the skin of the nose from the underlying bone and cartilage framework. This is then sculpted to create the desired shape. In open rhinoplasty, the incisions are made inside the nostrils and connected with an incision at the bottom of the nose across the tissue that separates the nostrils (columella). This allows the skin envelope to be lifted completely off the framework which offers the best visibility. The disadvantage is a small potentially visible scar across the columella. In closed rhinoplasty the incision across the columella is not made; incisions are only made inside the nostrils. This produces invisible scars but visibility for the surgeon during the operation can be limited and some techniques are not possible. Often the decision depends on your surgeon’s preferred technique and the nature of the changes that need to be made. Often surgeons can perform either technique and will choose the best one for you. If you have flaring of the nostrils, this may require additional incisions on the outside at the base of the nostrils. If you have breathing problems, your nose is crooked, or cartilage is needed to build up your nose, the surgeon may also perform a septoplasty. The septum is the vertical cartilage that separates the two nasal cavities inside your nose. Any incision for a septoplasty is made inside the nose. In some circumstances like revision procedures, this cartilage from the septum is not enough to build up the nose and cartilage may also be needed from other locations like the ear or ribs which requires additional scars.