‘The art and science of nasal surgery’

‘The art and science of nasal surgery’

Proportion and balance determine symmetry and beauty

Rhinoplasty – cosmetic or plastic surgery of the nose – is not simply about medical science and technical expertise.
It is also about aesthetic appreciation and visual-spatial skills. Knowledge of
the correct proportions makes all the difference to nasal surgery results.
The ideal nose conforms to smooth triangular shapes, which is why the Nose
Clinic applies a system of triangles to achieve the optimum individualised
results for every patient.

The Nose Clinic uses triangular overlays and digital previews to plan the aesthetic proportions of the nose.
Cosmetic surgery requires many skills, one of the most important being aesthetic appreciation – a finely judged awareness of beauty and an intuitive grasp of balanced proportions. Nasal surgery is particularly demanding in this regard. Inaccurate or less than optimum results can affect the entire face, with devastating effects on a patient’s appearance and self-esteem — just ask any of the Nose Clinic’s ‘redo’ patients (46% of the total number) who come to us for revision surgery to correct disappointing results produced elsewhere.
While most noses correspond to basic geometric shapes, every individual nose exhibits subtle variants. It requires talent and skill to assess the underlying anatomical structure of a face. If you deconstruct your own face, for example, you’ll see that your features correspond to triangles, with your eyes forming an inverted pyramid in relation to your mouth and chin. Underlying these triangles, your nose has 240 anatomical variations, each of which will affect the functional and aesthetic outcome of your nasal surgery.
The beauty of nasal surgery is that it brings about local change – but has a global effect. Simply put, rhinoplasty can vastly improve not only the appearance of your nose, but that of your entire face. While we encourage our patients to choose nasal surgery for their own satisfaction – not to please partners or friends – they often find that, after surgery, they don’t only enjoy new-found self-confidence, but that family, friends and colleagues react more positively towards them. We all strive, consciously or unconsciously, for beautifully balanced proportions!
The anatomy of the nose can easily be understood in terms of triangular shapes. The external anatomy or shape of the nose is divided into triangles and thirds. Whether you view your nose from the front, side or bottom, the shape remains a triangle.
Rhinoplasty - External Triangles

Rhinoplasty – External Triangles
This focal point can therefore be described as a three-sided triangle set in the middle third of your face. The nose itself can be divided into three distinct parts. The upper third has a bone structure. The two lower thirds are made of flexible upper and lower lateral cartilages.
  1. The lateral triangle or side view represents the outline of the ideal profile. The shape of the nose should not overlap the sides of the triangle.
  2. When viewed from the front, the triangle defines the outline of the ideal nose. Again, the nose should not overlap the outline of the triangle.
  3. Even when viewed from below, the nose should retain the triangular shape. The nostrils should not overlap the triangular outline.

Rhinoplasty - Functional Anatomy

Rhinoplasty – Functional Anatomy
The septum is made of cartilage and bone and divides the interior of the nose into two triangular spaces. These spaces are usually about the same size. On the lateral sides of the nasal cavity you will find the three turbinates — consisting of fixed bone and soft tissues — that swell or shrink in response to different stimulants or conditions.

1. Your nose should comfortably conform to the ideal triangle. We reshape it by trimming or repositioning the nasal bones and the upper and lower lateral cartilages. Incisions are made inside the nose.

2. We trim the nasal bones to reduce the height of the upper third of the nose.
3. The middle third of the nose is reduced by trimming the upper lateral cartilage and the septum.
4. Shortening the septum and the upper lateral cartilages can raise the tip of your nose.

5. We shape the tip of your nose by trimming the lower lateral cartilages.

6. This is the result. Your nose corresponds to the model triangle, enhancing the overall appearance of your face.
( John B. Tebbits. 1989. Primary Rhinoplasty: a new approach to the logic and techniques. Mosby )

Nose tip projection in relationship to the chin.

Ideal Nose

This is a sub-optimal (poor) result. Notice how the tip of the nose droops.
Ideal Nose

Here is a good result. Notice how a ‘tip rotation’ sharpens the profile

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