Monthly Archives: January 2012

The Ideal Nose – achieving a good Rhinoplasty Result

‘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 individualized
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

Surgical Rhinoplasty: Correcting Nose Features

The goal of aesthetic nose surgery is to create a nose that is proportional to other parts of the face, has a good inhaling and exhaling function and is not recognized by others as a nose that has gone aesthetic surgery.

The most popular aesthetic surgery in our country is definitely rhinoplasty.

Patients, who are not happy with the shape of their nose because it attracts attention at first glance, refer to plastic surgeons.The goal of aesthetic nose surgery is to create a nose that is proportional to other parts of the face, has a good inhaling and exhaling function and is not recognized by others as a nose that has gone aesthetic surgery.

The most popular aesthetic surgery in our country is definitely rhinoplasty. Patients, who are not happy with the shape of their nose because it attracts attention at first glance, refer to plastic surgeons.

Taking into account, your facial structure and the physical properties of your nose, your doctor can provide you with an idea as to how your nose would look after the surgery by making changes on a digital image of your face. Prior to this operation the patient should be examined and the doctor should understand the expectations of the patient thoroughly and the doctor should provide the patient with feedback explaining to what extent these expectations can be met.Because every patient has a different skin, cartilage and bone structure, results of the operation would vary from patient to patient. Thus, your doctor will inform you as to the expected results based on your anatomic features.

Aesthetic nose surgery can be applied to any person aged 18 and above with no serious health conditions. These operations are done to correct not only the physical features but also airflow problems that prevent inhaling in patients.

These operations are usually carried out under general anesthesia. Depending on the nose structure and properties of the patient, the operation can be carried out with the closed or the open technique. With the open technique, an incision is made right under the nose but this heals quickly most of the time and only a barely noticeable scar remains. With the closed technique, on the other hand, all incisions required for the operation are made through the nose holes and no scars form.

After the surgery, the nose is covered with plaster cast and remains so for 7-10 days. And a stype is placed inside this cast. Because we mostly use silicone stypes at our clinic, the patients don’t experience the same pain as they do with cloth stypes during stype removal.

Following the surgery, there might be bruises and swellings around the nose and the eyes and these would usually heal within 3-4 weeks. However, it takes around 3-6 months for the swellings and hardness inside the nose that are invisible from outside to heal and for the nose to have a gentler look.

What are some undesirable conditions that might occur after the surgery?

Some of the unwanted conditions are bleeding, infection and anesthetic complications and sometimes a second retouching might be necessary in 5-10% of the patients.

Medical Rhinoplasty: Botox and Dermal Fillers

More and more Surgeons are moving away from traditional Rhinoplasty (Corrective Nose Surgery) in favour of less invasive options with Botox and Dermal Fillers.

Surgical Rhinoplasty is an extremely popular plastic surgery procedure worldwide. The surgery itself unfortunately is extremely complicated and the risks are significant. Popularity versus time in theatre and risk has propelled the surgical world into finding faster, safer and more efficient ways to cosmetically alter a person’s nose.

Most Cosmetic Nose Surgery involves alteration to the bridge of the nose or the tip of the nose, or both. The dissection is complicated in the nose as the nasal scaffold of bone, muscle and cartilage all need to be manipulated, leading to increased risk and long recovery times. This same scaffold however is the perfect base to stabilise Botox and Dermal Fillers and more and more Doctors are turning to these non-surgical options to get their patients their desired cosmetic nose results.

Nose tip correction using Restylane

The Medical Rhinoplasty

The non-surgical treatment of the nose or Medical Rhinoplasty has become of prime importance. During the procedure there is no change to the nasal scaffold and no risk of deformity. Also the products used in the Medical Rhinoplasty have significant clinical data detailing their safety.

There is of course sill some risk involved with the Medical Rhinoplasty and as a patient you need to seek out an experienced injector with an in depth knowledge of nasal anatomy. Knowledge of Nasal anatomy will allow your Aesthetic Physician to obtain a good aesthetic result by combining the mobile elements in the nose with the static bone structure and surrounding facial features.

A good aesthetic result by combining the mobile elements in the nose with the static bone structure and surrounding facial features.

Medical Rhinoplasty can be used as a precursor to invasive surgery but it is becoming more and more popular as a regular treatment option. In combination Botox and Dermal Fillers can be used as a non-permanent correction for:
Nose asymmetry
Deformity correction
Nose tip repositioning
Nostril repositioning
Nose Bridge straightening

Your nose after all takes up one third of the face and forms an integral part of facial aesthetics. It great to know that clinical papers are currently being presented promoting the Medical Rhinoplasty in favour of surgical intervention.

Deviated Nasal Septum (DNS)

This is a 25 year-old pharmacist who has always been bothered by the appearance of her nose. She described her nose initially as one that is slightly crooked. It was large when viewed on the side. She also had problems with noticeable asymmetry when viewing her base view. She had a deviated nasal septum causing her nasal obstruction and difficulty breathing out of the left side of her nose. She underwent nasal reconstruction and Rhinoplasty and as you can see on base view, the septum of the nose has been straightened making the aperture of the nostril larger on her left side (this is the patient’s left side, however when viewing the photograph it is actually on the right.) As you can see from the post-operative photographs on the right side the patient’s nose is straighter on frontal view where her nose fits her face more. We have decreased the projection slightly (the distance that the nose protrudes from the face) and also addressed the area above the lip that was more obvious and gave the illusion of having a large nostril. The profile was brought in alignment and the patient was very pleased with this outcome as well as the ability to now breathe through her nose.
Photo RKN1-3a

crooked nose - patient 3 - before 1

Photo RKN1-3b

crooked nose - patient 3 - after 1

Photo RKN1-3c

crooked nose - patient 3 - before 2

Photo RKN1-3d

crooked nose - patient 3 - after 2

Nose Aesthetics: Facts about Rhinoplasty

The Keystone of the Face

The nose is located in the center of the ‘communication band’, that is, the area of the face where people first look at you, which also encompasses the eyes. For this reason, there is often some anxiety about its appearance.

Rhinoplasty – And The Nose You Want

A rhinoplasty will alter the shape and appearance of your nose. Rhinoplasty creates the new look by changing the underlying cartilage and bone. Nose surgery can make:
A large nose smaller
A wide nose thinner
A long nose shorter
Refine a big or drooping tip
Straighten a crooked alignment

In most rhinoplasty procedures, surgery removes a hump or re-builds a flat nose. The possibilities are endless and after a detailed consultation we tailor the operation that addresses your concerns. Importantly surgery to the nose

should enhance your airway.

Your first step!

The key to a successful rhinoplasty is accurate information and good communication, and it’s the reason I have compiled the “Making The Right Choices” report.

The “Rhinoplasty Report” explains:
Understanding nasal structure and its importance in rhinoplasty
The importance of nasal assessment
Why computer imaging by YOUR surgeon is important
Defines unusual variations and their correction
What are the your options
The inter-relationship between body image self esteem and nasal surgery.

How to stop sneezing & runny nose

Excessive sneezing and a runny nose can be symptoms of both a cold and an allergy. These symptoms by themselves are pretty harmless and will not stop you from going about your day. They are more of an annoyance and can be embarrassing if you have a job that requires you to interact with others. There are some things you can do to stop a runny nose and sneezing.


Things You’ll Need

· Netty pot
· 1/2 tsp. table salt
· 1 cup water
· Antihistamine
· Nasal spray

1. Determine whether you are suffering from an allergy or a cold. If it is an allergy, your eyes often feel itchy. Colds can come with coughs and periods of nasal congestion. If it is allergy season and you are fairly sure this is the cause, avoid the outdoors as much as possible. Keeping your windows closed and staying indoors can help get rid of your sneezing and runny nose.

2. Clean out your nasal passages with a netty pot. Fill the netty pot with warm salt water. Place the tip of the pot in your left nostril, and lean your head to the side. Tip the pot so that the water runs through your left nasal passage and out your right nasal passage. Repeat this with the right nostril. This will temporarily eliminate your symptoms.

3. Purchase an over-the-counter antihistamine. Antihistamines will stop the triggers causing you to sneeze and have a runny nose. The antihistamine will work for up to four hours each time you take it.

4. Spray your nostrils with a nasal spray. This will reduce inflammation inside your nasal passages. Nasal sprays are not designed for long term use, but they are effective at getting rid of sneezing and runny noses.