During your consultation, your surgeon will ask about your general medical history and any previous surgeries or injuries to your nose. He’ll also want to know how well you are currently breathing through your nose.
He will be especially interested in why you are unhappy with the appearance of your nose and what results you are hoping your procedure will achieve. Most people would like their noses to be smaller. In some cases, though, an increase in size may be appropriate.
It is very important that you be entirely forthright with your surgeon about what kind of nose you would like to have. People sometimes fail to describe their true expectations, asking for an average nose when, in reality, they have a very specific size and shape in mind. Only by telling your surgeon exactly what you want can you and he determine whether it is possible and desirable.
At the same time, you need to be aware that everyone is different and what may work well for one person may not work well for another. For example, skin thickness varies enormously and a small, delicate nose and rarely be made from a large, thickened one.
Feel free to bring photographs of noses you admire. Your surgeon may also use computer simulations to help you see what changes are feasible and what they would look like. These simulations can often help patients describe the results they want and the changes they would like to avoid. You need to be aware, though, that a computer simulation is not a guarantee of the result, as each person’s tissues have their own healing pattern that may influence the outcome to some extent. This discussion of the kind and degree of change you want will determine which type of procedure your surgeon recommends.
Types of Rhinoplasty
Reduction Rhinoplasty, which aims to reduce the way a larger nose can dominate the profile, is the kind of Rhinoplasty most commonly requested by both men and women. A mistake people often make is assuming that simply reducing the size of the nose will produce a positive outcome.
It is important to appreciate that when the chin projection is insufficient, the profile seems to be dominated even by a small or average nose, but the solution in that case may be to augment the chin and possibly do a small reduction or no reduction to the nose.
In a significant reduction procedure, all elements of the nose are influenced, and the skin will take more time to redrape and settle down fully.
Augmentation Rhinoplasty (ethnic Rhinoplasty):
Augmentation Rhinoplasty, a group of procedures that involve increasing the projection of the bridge and the tip of the nose, is more commonly requested by patients from ethnic groups that tend to have a softer cartilage support to the nose and a less defined configuration of the bridge. It is also sometimes necessary in patients that have undergone significant injuries, or multiple procedures.
Materials used to support the tip and augment the bridge can be artificial, or taken from the patient’s own tissues (bone or cartilage). In our practice, we have found a rib cartilage to be versatile material that shows excellent tolerance and long-term benefits. Use of implants for augmentation purposes is widely popular, as it is a simpler procedure to do, but unfortunately carries also higher risks of infection and revision.
Secondary or revision Rhinoplasty:
In a number of instances, the outcome of Rhinoplasty is unsatisfactory as a result of technical errors, healing problems, or injuries after the first operation. In other instances, lack of communication in a preparation for surgery, leads to a different perception for the surgeon and for the patient regarding the desired end point of the treatment.
In all these instances, the repeat a Rhinoplasty surgery requires experience and dedication from your surgeon, as well as an understanding of the type of changes that the first operation would have created. Revision Rhinoplasty often involves use of grafts, commonly cartilage from inside the nose but also from other areas (rib, ear), and will often require a longer period of time to settle down.
All Rhinoplasty surgery demands customized solutions from you surgeon. The most important element of achieving a good result is giving patients the time to think through and articulate exactly what they want. This may sound simple and straightforward, but as the detailed planning proceeds, it becomes obvious that most of us need to give it considerable additional thought. For this reason more than one consultation is often needed prior to the operation.