Rhinoplasty / Nose

“Rhinoplasty – How it should be done “

rhinoplasty

Rhinoplasty – How I like to do it!

I like to keep in mind the overall balance of your face. If your a female, I will soften those features of your nose to make your nose more feminine.

Factors Which Influence Your Result:

  • Age – the younger person will have better skin texture with very little sun damage, which results in better shaping.
  • Thickness of the Skin – female noses are easier to shape because the skin is less thick and oily.
  • Largeness of the Nose – if your nose is very large it is impossible to make it small.

Desirable Feminine Features

  • Straight bridge of the nose or a very slight curve
  • Slight upward tilt to the tip of the nose
  • A nose which is not overly long or too pointed
  • Narrow tip, that does not have a round ball appearance
  • Nostrils that aren’t too wide

Undesirable Feminine Features

  • Short stubby nose called the “piggy nose”
  • Too much upward tilt of your tip, which lets others see up inside your nose
  • Overly wide or flaring nostrils
  • Collapsed bridge of the nose, giving a pug nose or boxer look
  • Large hump which gives a masculine appearance to the nose
  • Droopy tip, that looks like it is falling off the end of your nose
  • A wide, round or boxy tip

Things I Can Do to Give You a Better Looking Nose

Reducing the hump on your nose: The hump is more acceptable on a male nose and isn’t a desirable feature if you are a female. The hump of the nose is made up of cartilage and bone. If your hump is large, then removing it will flatten and widen the top of your nose. This will require that I fracture your nasal bones to narrow the bridge.

Narrowing the width of your nose: If your nose is wide in the middle it may be necessary to fracture your nasal bones. This will bring into balance the long part of your nose with your tip.

Shaping the tip of your nose: If you have a boxy, round or wide tip, I usually remove some of the cartilage in the tip of nose and use internal sutures to hold the shape during healing. If your tip needs lifting or reducing the height , I may need to use supportive or filler grafts made from your own cartilage.

Grafts sources: Sources for a supportive graft are:

  • Septal cartilage – I will use this to help lift and hold your tip upward.
  • Ear cartilage – A great source for me to use for filler grafts. These grafts are used to fill in collapsed areas and to help reshape and support the tip of your nose.
  • Rib cartilage – This would be rare for me to use, but is a good source to rebuild the bridge of nose after trauma or cancer removal.
  • Bone graft – Also, rarely used, but a good source to rebuild the bridge of nose after trauma or cancer removal. I have used bone from the skull (calvarium) for this purpose.

Overview of What You Need to Know – FAQ

Types of incisions

External or Rethe Incision is a small incision placed on the middle column of the nose. The advantage is so great with this incision that I use it in almost all my Rhinoplasties. This incision allows me direct access to the cartilage and bone structure of your nose for better shaping.

Internal Incision placed inside the nose is rarely used because all shaping is done blindly with no ability for me to visualize your cartilage and bone structures. I will only use this incision if you do not require shaping of the tip of your nose.

Can I pick the nose I want?

Because the nose has structures that cannot be completely changed, you will be unable to select a nose. For example, picking a photo from a magazine. Skin, cartilage and bone structures will determine how much shaping can be done to change the shape of your nose. Let’s say you have a large nose and want a petite nose. It will be impossible to achieve this, because of the extra skin left after reducing the underlying structures during the Rhinoplasty. Thick, oily skin, for example on an older man will not result in great changes in the shape of the nose after Rhinoplasty.

Age is a factor in Rhinoplasty

If you are a young person, you have a better chance of getting the results you want from a Rhinoplasty, than a middle-aged or older individual.

Can you show me what my new nose looks like on a computer?

I don’t like to use Imaging, because you cannot truly duplicate the changes that take place during healing that ultimately affects the final shape of your nose. Your shape will not be the same that you viewed on a computer rendition.

I want to fix my previous nose job, can you help?

Generally, there are many things I can do to correct a shape you don’t like from a previous Rhinoplasty. This may involve grafting with cartilage, reshaping the tip, defining the bridge of your nose and correcting asymmetries. However, once you have had a Rhinoplasty the internal scar tissue will limit the amount of correction possible. Sometimes, instead of 100% improvement, you may only get 80% or less.

Can I correct my breathing (Septoplasty) at the same time?

Yes, in fact if you have a deviated septum or enlarged turbinate glands that are obstructing your airway, this would be an ideal time for you to think about combining a Septoplasty with your Rhinoplasty. Generally, healthcare insurance will cover correcting your breathing problems.

My Rhinoplasty Procedure

  • Surgical time is approximately 2-3 hours
  • General anesthesia
  • This can be performed as an same day surgery (out-patient) procedure
  • You will wear a splint for 1 week
  • I rarely use internal nasal packing
  • Your pain will be easily controlled by analgesics
  • Possible bruising for 2 weeks
  • You can return to unrestricted activities after 4 weeks
  • Rapid reduction in tip swelling in a few weeks followed by a slow resolution of the residual swelling over a few months

For More Information & a Free Consultation for a Rhinoplasty/Nose Job with Dr. Costanzo, Call (805) 373-9919

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