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A prominent nose, non symmetrical nose makes people start defining you by that single feature on your face. It becomes your identity overshadowing the ‘real’ you, making you the ‘odd nosed teen’ because, that is exactly when your true features take shape, adding to the growing-up blues. A perfectly normal, tiny nose can grow into a bulbous mass sitting on a lovely face, becoming the cause of drained self confidence.
Some noses, thanks to hereditary become hooked, or develop humps, grow off center among other things. Obviously this is not a happy place to be. Nose problems can, however, be corrected through rhinoplasty, the most challenging of all cosmetic surgery procedures.
An interesting fact: recorded rhinoplasty originated here 500 BC. The performing surgeon was Sushruta and his procedure is recorded in the Sushruta Samhita. Modern facial surgery travelled to the west and was pioneered by Dr. Jaques Joseph, an orthopaedic surgeon who became interested in facial plastic surgery. This happened in 1898. During those days, it was far more painful than it is today.
Getting into the act:
Remember, you’ve got to be completely sure that you want to go through this surgery, and the nose you end up with may not be ‘like’ anybody else’s. It has to suit your other features. Your surgeon will explain this to you in detail. If he doesn’t don’t be afraid to ask for one. The nose needs to be photographed from all angles for recording purposes and to assess the kind of work essential.
Blame it on race or on genetics, the most common problems in the nose area include:
- Broad nose with rather wide nasal bones
- Depressed nose, where the bridge is nonexistent
- Hump over the nose
- Bulbous tip of the nose
What is closed Rhinoplasty?
Closed Rhinoplasty involves hidden incisions, made on the inside of the nose.
What is open rhinoplasty?
An open Rhinoplasty employs internal incisions as with the closed technique, however, it requires another short incision on the underside of the nose between the nostrils.
Depressed noses, where the bridge is almost or completely non-existent, need height. For such noses, it is best to use specially made implants. The Indian skin accepts implants quite well, making the necessity for harvesting cartilage from other parts of the body, like the rib or sputum unnecessary.
There is no need to damage another part of the body for this purpose. Nose surgery is very fine surgery. It is important that the surgeon takes great care in concealing his work, making it invisible. Like a work of art, the surgeon will do his best to give you a nose to be proud of. However, if you want a nose like your favorite celebrity, you may not get it, because that nose belongs on their face, not yours.
Obviously, like any other surgery, this one too takes time to heal. You need patience to see the end results, which will appear after four to six months. You cannot expect to be operated on and get into a modelling assignment the very next week, or even month. Before you leap into a rhinoplasty, you need to plan yourself and work on your schedules in such a way that you have time to recover nicely and go back to your life with a brand new nose. And freshly fabulous self confidence.
How is Rhinoplasty performed?
A proper surgery, Rhinoplasty involves a multitude of surgical techniques to reshape the nose. A thorough nasal analysis, including assessment of the external and internal nose, determines the exact technique the surgeon will employ. If the surgeon decides to go in for Closed Rhinoplasty, incisions are hidden as they are made on the inside of the nose. The skin (overlying soft tissue) is lifted off of the underlying framework of the nose, namely, cartilage and bone. All these are then carefully altered to achieve the desired new shape. The upper two-thirds of the nose, mainly the bony vault and cartilaginous middle vault, is often reshaped in its original position.
Altering the tip of the nose using the closed technique requires the cartilage to be taken out of the nose before it is reshaped. Precise changes are made to the cartilage while it is outside of the nose, then it is replaced back into the nose.
Using the Open Rhinoplasty technique involves similar internal incisions as with the Closed Rhinoplasty technique, but it also includes a short incision made across the Columella, or the skin between the nostrils, allowing the surgeon to lift the skin off of the underlying cartilage and bone, for complete and direct exposure of the entire framework. In comparison to the closed technique, Open Rhinoplasty allows a much wider view of the underlying nasal structures, especially the nasal tip, making the operation more predictable and accurate.
A number of alterations can be made to the nose. They include changes in the bridge height and bridge width, straightening of a crooked or poorly aligned nose, and alterations to the tip of the nose. Once the desired changes are achieved, incisions are meticulously closed. The nasal skin is then taped to minimize soft tissue swelling. In the event of bones being reshaped, an external nasal cast will be placed to stabilize the nasal structure.
If the nose skin is thin, the surgeon would recommend the use of a fascia graft to help thicken the overlying nose skin from the inside. He would prefer to use temporal (temple) fascia as opposed to Alloderm (acellular dermis), because the fascia is your own tissue, therefore it provides more reliable, durable results. When harvesting temporal fascia the surgeon makes a hidden incision within the hair-bearing scalp, without shaving the hair. This incision heals relatively quickly. After the nose has been reshaped, the harvested fascia is placed just below the skin, over the bone and cartilage. Because the original skin was thin, the grafted fascia provides an additional ‘cushion’ layer, making the nose look more natural and even as it heals.
What sort of nose needs correction?
You could consider Rhinoplasty if:
- Your nose looks too large in proportion to the rest of your face
- The nasal bridge has a bump
- Your nostrils are flared and too wide
- The nasal tip plunges downwards, droops or is thickened and enlarged
- Your nose doesn’t seem to belong to your face as it is off center or crooked
- A previous surgery has distorted your nose and it is asymmetrical
In some cases, there could be a combination of more than one of the above factors and could need either open or closed Rhinoplasty.
Thicker skinned patients take longer than the thin skinned ones to heal. This is because thick skin does not ‘shrink wrap’ around the new nose as quickly as the thin skin.
Your surgeon will need to see you more often if he has realigned the bridge or narrowed the bones in your nose. You may be asked to do ‘digital exercises’ so as to maintain the proper alignment and position of the bones.