Rhinoplasty, commonly known as a nose job, is a type of cosmetic surgery for correcting and reconstructing the nose. It can correct a nose that is too large/wide or small, a nose that appears crooked, or a nose that has a distinct bump on top. It can also improve the proportions and balance of the nose, making your nose more aesthetic looking. However, rhinoplasty does not have to be just for aesthetic purposes. Some people may suffer from medical conditions, such as a deviated septum, which causes breathing impairment. In this case, rhinoplasty can help to adjust the nasal structure to improve the patient’s breathing and quality of life.
Rhinoplasty is perhaps the most coveted surgery in South Korea, next to eyelid surgery. The procedure is mostly developed for increasing the height of the nose bridge and lifting the tip because of the flat nose structure that Koreans tend to inherit. If you are an Asian with similar nose structures like the Koreans, there is no better place in the world than South Korea that can perform your rhinoplasty. That being said, it does not mean that having a high nose is always attractive. Everyone has different facial features and what may look good on you may not necessarily be the same for other.
Types of rhinoplasty
There are several different types of nose correction that people may choose to go for, depending on each individual’s needs and preferences. Common ones include Nose Bridge and Tip Enhancement, Deviated Nose Correction, Short Nose Correction, Alar Reduction, Hooked Nose Correction, and Wide Nose Reduction.
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1. Nose Bridge and Tip Enhancement
The nasal tip & bridge enhancement procedure is highly requested and popular among those who have a flat nasal bridge with a short nasal tip. The nasal tip procedure helps to raise and narrow the tip of the nose while the bridge enhancement surgery helps to elevate the bridge of the nose. These two cosmetic procedures usually go hand in hand to bring about a more natural-looking and well-balanced change to the nose. For the nasal tip procedure, incisions are made inside the nose or at the columella. In most cases, your surgeon will extract cartilage from the back of your ear, also known as auricular cartilage, to add to the tip of your nose. This allows for the sculpting of the nose tip to your desired shape.
Similarly, the bridge enhancement procedure begins with an incision inside the nose or at the columella. Instead of using cartilage, surgeons will use silicone for an implant because of its proven safety and customizability in most cases.
Photo Credit: Ruby Plastic Surgery
2. Deviated Nose Correction
For some people, a deviated septum is present at birth - occurring during fetal development or due to injury during childbirth. After birth, a deviated septum is most commonly caused by an injury that moved your nasal septum out of place (i.e. playing contact sports). A deviated septum can make it harder to breathe through your nose and can increase the risk of sinus infections due to poor drainage. Septoplasty is usually being done to repair a deviated septum. Septoplasty is a surgical procedure that helps to straighten the bone and cartilage dividing the space between your two nostrils (septum). During septoplasty, your nasal septum is repositioned to the middle of your nose. This may require your surgeon to cut and remove parts of your nasal septum before reinserting them in the proper position. Once a septoplasty is healed, you'll likely find it's easier to breathe. Most people find that recovery from surgery to correct a deviated septum is relatively painless and that nasal breathing is permanently restored.
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3. Short Nose Correction
The short nose problem mainly results from congenital or hereditary nasal tip cartilage hypoplasia or upward retraction of the exceedingly tense nasal tip skin and subcutaneous ligament. Severe patients may even have aplasia or defects of the nasal septal cartilage. Correction of the short nose is one of the most challenging parts of Rhinoplasty. It is even more difficult in Asians compared with Caucasians due to the thicker skin soft tissue envelope and weaker cartilaginous frameworks. Additionally, most Asian patients will also require augmentation of the nasal dorsum, and projection of the nasal tip together with the short nose surgery, which makes the procedure even more complex. To correct a short nose, septal extension grafts can be performed. Surgeons may employ both the nasal septum and auricular cartilage to perform this surgery. The nasal cartilage is often used to elongate the nasal columella while the auricular cartilage is used to augment and extend the nasal tip. This combination elongates the nasal supratip and nasal columella and extends bilateral alar margins downward to conceal the nostrils.
4. Alar Reduction
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The alar is the area of the nose that extends from the tip of the nose and rounds outwardly towards the cheek. The alar width is associated with the frontal visual area of the nasal tip, while its shape determines the nostril contour, so it plays a vital role in the overall evaluation of rhinoplasty. Alar Reduction is a specific technique that primarily addresses the width of the nostrils. It is a procedure that helps to improve the shape and size of the nostrils by changing the nostril from an original circular shape to an oval shape, and the alar feet direction from the preoperative toe-out to the postoperative toe-in shape, which prevents the widening of the ala nasi while speaking or laughing. To reduce the size of the alar, an incision is usually made on either the exterior or interior of the alar region to remove excess tissue. Exterior incisions may leave scars and attention should be paid to scar care. Clinically, alar reduction is frequently integrated with open rhinoplasty or open tiplasty to reinforce the overall look of the nose.
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5. Hooked Nose Correction and Wide Nose Correction
Hooked Nose Correction
A hooked nose, also called an Aquiline nose or a Grecian nose, is characterised by an excessively long nasal tip in the frontal view, where the nasal tip completely covers the nasal columella or even conceals part of the philtrum. From the lateral view, the nasal tip is pointed and hook shaped like an aquiline beak. A hooked nose primarily results from the congenitally overt development of the nasal tip. In cases of a minor hump, it can be easily removed. However, in more severe cases, osteotomy can be performed to reduce the wide nasal bridge bone by removing the bone and cartilage in phases, and to fix your nasal tip with a support made of autologous ears-cartilage.
Wide Nose Correction
A nose can appear wide for a number of reasons. For many people, a nose may look wide due to the lack of nasal bridge height which is often genetic. In other cases, a prior nose job could have caused the nose to take on a wider appearance. The nasal bone forms a pyramid structure at the top of the nose and is reconstructable. This pyramid structure determines the overall shape of the nose. In order to change the shape of the nose and give it a thinner appearance, the pyramid structure must be broken into smaller, movable pieces. A nose job for wide noses is most commonly conducted using also an osteotomy. There are two common types of nasal osteotomies: medial and lateral. Many wide nose rhinoplasties use both types to create an overall thinner appearance in the nose bridge. Medial osteotomies focus on small breaks in the middle portion of the top of the nose, while lateral osteotomies deal with the longer, outer sections of the nasal bone. Once the breaks are made, the surgeon is able to reshape the nose by moving the pieces closer together to create a narrower nasal structure.
Photo Credit: Wannabe Plastic Surgery
Photo Credit: Ruby Plastic Surgery
Common questions on rhinoplasty
Q. What materials are commonly used?
A. There are mainly two kinds of materials that are commonly used in rhinoplasty. Firstly, artificial materials include silicon, gore-tax, and siligore. There is also a relatively new experimentation on 3D printing materials. By combining two different types of silicone, a team of Penn State researchers was able to produce silicone parts with complex geometries by 3D printing. These printed parts also have better mechanical characteristics and biological adhesion than parts produced by conventional silicone production processes. That being said, such a procedure would take considerable time to percolate through to humans in a clinical setting. However, it is a promising path to patient-specific 3D printed nose augmentations using biological materials. Secondly, autologous materials include cartilage, dermis and fat tissue.
Materials used will depend on the type of correction a patient is going for. Like earlier mentioned, the most common material for nose bridge enhancement is silicon while the most common material for nose tip enhancement is ear cartilage. Some people may prefer to use only autologous materials for both nose bridge and tip enhancement, but it is not always the best option due to the high costs and complexity of the surgery involved. We recommend you consult with your surgeon for the most suitable option.
Q. How long is the procedure and what is the downtime?
A. Rhinoplasty generally takes 1.5 to 3 hours and is usually an outpatient procedure. Following surgery, most patients experience mild to moderate discomfort that can be controlled with medication. Patients should expect to wear splints on the nose for about a week after surgery to protect the nasal bones and cartilage, and stitches will generally be removed after a week. Strenuous activities should be avoided for three to six weeks after surgery and depending on an individual’s preference, patients may return to social activities within two to three weeks when there are no longer any obvious signs that a procedure was done.
As such, we recommend that patients stay in Korea for at least a minimum of seven days. In terms of full recovery, it takes approximately three to six months for the nose to completely heal and look more natural.
Q. What are the possible risks?
A. All surgeries have risks. Fortunately, rhinoplasty risks are small and complications are rare given that you chose certified, experienced plastic surgeons. Possible risks include difficulty breathing through your nose, permanent numbness in and around your nose, and the outcome of an uneven-looking nose. Your doctor will talk to you about the surgery's risks and benefits in detail before the operation.
The nose is a complex structure made of delicate cartilage and bone. A small change to one part of the structure will affect the rest of the nose, so Rhinoplasty requires expertise to achieve a natural, functional outcome. You should make sure that you do proper research to find a reputable clinic that best suits your needs. Nose jobs are also not meant to completely change your face and any reputable surgeon will tell you that you cannot just ask for someone else's nose as it may not be suitable for your face. Be realistic and ask yourself why you want to do the procedure - do not rush into an important decision like this.