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Nose Surgery (Rhinoplasty)

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Rhinoplasty (nose surgery) is one of the most common plastic surgery performed today. Through rhinoplasty, one can reshape, reduce or augment a person’s nose to achieve facial harmony and boost self-confidence. Rhinoplasty can also be performed to reconstruct a birth defect or an injury such as a broken nose. La Foret Nose Clinic has a variety of surgical procedures to harmonize your nose to your face according to individual’s needs.

Ideal Nose

What is an ideal nose that harmonizes with other facial features? A nose is considered “ideal” when it is in harmony with other facial features. The “ideal” face can be divided into equal facial thirds and horizontal fifths.
La Foret Nose Clinic Facial Thirds Facial thirds:
Upper third: trichion to glabella
Middle third:
glabella to subnasale
Lower third:
subnasale to menton

It is ideal for the width of the nose to fit in between the eyes. The length of the nose should be 1/3 of the face’s overall length. The tip of the nose should be the center of the entire facial features and the cartilage that holds up the nose should be about 30~45° from the philtrum, while the dorsum should be 90~100° from the philtrum. Recent trend prefers for the tip of the nose to be a little higher than the dorsum. Koreans tend to have smaller cartilages as well as a smaller dorsum creating a flatter nose. Since the nose is located at the center of the face, the nose plays an important role in creating the general look of a person. La Foret Nose Clinic Ideal Nose

The Anatomy of the Nose

La Foret Nose Clinic Nose Anatomy
The nose looks rather simple when viewed from the exterior. However, the nose is actually a lot more complicated than one thinks. The most important part of the nose is the dorsum and the cartilages that make up the length, width and the shape of the nose. The dorsum, just like any other bone, is very solid and firm. Therefore, when performing rhinoplasty to raise the nose, hard and solid materials, such as silicone or Gore-Tex, are used to mimic the hardness of the bone. The cartilages that make up the width of the nose are one of the softest cartilages in our body. Cartilages from other body parts or fat are used to mimic this softness. To make the most natural looking nose as possible, it is important to understand the anatomy of the nose and take those factors into consideration.

Rhinoplasty is an excellent procedure to:
-Balance the size of the nose with the other facial features.
-Modify the width of the nose at the bridge.
-Improve the nasal profile, including hump and depression removals.
-Change the angle between the nose and the mouth.
-Narrow and reshape the nostrils.
-Correct asymmetry.

Types of Nose Surgery (Rhinoplasty)

Flat Dorsum Nose Surgery

Cause and Necessity

The most common and popular area for rhinoplasty is the dorsum. The dorsum is often raised to create a sharper nose. To make sure a person obtains a pretty and ideal nose, it is important to decide how high to raise the dorsum to leave the nose looking natural yet sharp. The incline of a naturally looking and ideal dorsum starts at the eye line of a person’s face. The dorsum should be about 2mm lower than the tip of the nose. The most important factor is to create a nose that fits a person’s face naturally. In addition, it is important to examine and discuss the material that will be used to raise the dorsum.

Rhinoplasty Implants

Silicone Implants

One of the most traditional implant materials used for rhinoplasty is silicone. They are still the most popular and most common material used today. The best results are seen when the skin surrounding the dorsum is thick. Silicone implants are most suited for those who wish to obtain a high dorsum. The silicone used for rhinoplasty is safe and approved by the FDA. Silicone is easy to handle and can be easily shaped into a natural looking dorsum and lasts for a long time. Silicone can also be removed at any time for those who wish for them to be removed. La Foret Nose Clinic Silicone Implant

La Foret Nose Clinic Gore-Tex Implant

Gore-Tex

Gore-Tex is a porous material that naturally adapts with the body when implanted into the body. By adapting to the body, Gore-Tex provides a soft and gentle feel. This material is recommended for those who wish to obtain a gentle and natural looking nose. Contrary to the recent myth that the height of the dorsum decreases as time goes by, Gore-Tex lasts a long time and with recent advancement made in the material, patients can feel more at ease with the Gore-Tex implants.

Dermis, Fascia, and Costal Cartilage Implants La Foret Nose Clinic Body Extract Implant
Though not the most commonly used materials, these materials are used for those who have had rhinoplasty more than once which resulted in the outer skin of the nose becoming thinner than normal. Dermis, which are extracted from the hips or thighs, or fascia, which are extracted from the scalp, can be used alone or wrapped around another supporting material. Because the implant materials are extracted from the patient’s body, there are no side effects and produces the most natural look. For those who have a short nose and have a need to create a sturdier nose, costal cartilage is extracted and inserted from the breast to the nose.

Flat Dorsum Nose Surgery Procedure

Unlike the tip of the nose, which consists of subcutaneous tissue and soft cartilages, the dorsum consists of hard, solid bones and cartilages. Therefore, it is important to select the correct implants to shape the nose with during the rhinoplasty procedure. Generally, the rhinoplasty procedure starts with anesthetics being applied to create a painless surgical process for the patient. When the flat dorsum rhinoplasty procedure only consists of raising the dorsum, the supporting implants are inserted through the nostrils. It is important for the implant to be inserted through the periosteum rather than underneath the skin to secure the implant in place. This process also prevents the implants from being seen from the exterior and causing the skin to turn red. The time to complete the rhinoplasty procedure is around 30min and around an hour and a half for any kind of cartilage transplants. 4~5 days are required for the swelling to settle down and patients may participate in everyday activities. However, the patient should take care to not apply any pressure to the nose for about 2~3weeks after the rhinoplasty surgery. La Foret Nose Clinic Flat Dorsum Nose Rhinoplasty

Nose Tip Rhinoplasty

Cause and Necessity

The tip of the nose has the most effect when determining whether the nose is “sassy” or “trendy”. No matter how high the dorsum may be raise, beauty can’t be portrayed when the tip of the nose is flat and round. However, if the tip of the nose is raised to the proper height, the general image and the shape of the nose can portray a different image, even with a flat dorsum. Therefore, when raising the nose to a higher height, it is recommended for patients to consider raising the nose tip along with the dorsum for best results.

Nose Tip Implant

The nose tip rhinoplasty implant material is alar cartilage and the skin surrounding it. The nose tip rhinoplasty success largely depends on the alar cartilage because it determines the shape of the tip of the nose.

Nose Tip Rhinoplasty Procedure

There are 2 main methods of performing nose tip rhinoplasty. The first method involves reshaping the base of the nose tip, the alar cartilage. The alar cartilage is shaped like a pair of wings and gives shape to the nostril. When the wing-shaped cartilages are tied together with a thread, the tip of the nose will automatically rise and give a slimmer and higher nose tip. There are numerous ways to adjust the alar cartilage and give it a new shape. A part of the alar cartilage can be cut out and tied together with the unbalanced portion to raise the nose tip.
La Foret Nose Clinic Nose Tip Reshape Rhinoplasty
If the tip of the nose is flat to a certain degree, or if the dorsum has been raised to a certain point and the nose tip must be raised higher than normal, tying the alar cartilage may not be enough. Cartilages from other body parts, such as the ears, fascia, dermofat and other areas, can be used as transplants to the nose tips. Generally, cartilages from the ears are used. When raising the columella, the surrounding cartilages of the septum or artificial cartilages are used.
La Foret Nose Clinic Nose Tip Implant Rhinoplasty

Crooked Nose Rhinoplasty

Cause and Necessity

La Foret Nose Clinic Crooked Nose Rhinoplasty
A crooked nose is generally caused by a physical impact to the nose. Genetics can also be a cause, such as the “hooked nose”. A crooked nose can cause symptoms for rhinitis and nose congestion. To correct a crooked nose, it is important to reshape the inner structure of the nose.

Crooked Nose Rhinoplasty Procedure

The rhinoplasty procedure begins with the correction of the inner and basic structures of the nose. From there, the position of the bone and cartilages are corrected. In most cases, the nose bone being crooked is the cause of the crooked nose and osteotomy is used to correct, re-position and/or relocate the bone. In rare cases, the nose bone may be fine and the cartilage may be the cause of the crooked nose and a procedure to correct the cartilage’s location and position is performed. The cartilage in the nose is located right below the nose tip, making up 1/2 of the upper nose cartilage. This cartilage is separated from the septal cartilage to correctly re-position and re-shape the nose.

Long Nose Tip (Arrow Shaped) Nose Rhinoplasty

Cause and Necessity

An arrow shaped nose (long nose) is often caused by the tip of the nose being loose due to structural problems with the cartilages in the nose. The cartilage that makes up the nose tip may not be perpendicular where it meets the mouth and may cause the nose to seem longer. In these cases, the muscles on the sides of the nose are developed more than usual, causing the sides of the nose to become wider and making the arrow-like shape. When the nose tip is loose, the nose looks longer, causing the face to look longer than it actually is. The long nose breaks the general feel of the face and cause people to look older than they actually are. An arrow shaped nose is often seen with an aquiline nose. In the case of an aquiline nose along with the long nose tip, the bump on the middle of the nose must be correct first by leveling the bump to the level of the dorsum and raising the nose tip.

Long Nose Tip (Arrow Shaped) Rhinoplasty Surgery Procedure

There are 3 methods in rhinoplasty to correct a long nose tip (arrow shaped nose). The first method consists of raising the cartilage on the nose tip to shorten the length of the nose.

The second method is to raise the tip of the nose by adding additional cartilages extracted from a different area of the body.

The last method is to correct the level of the dorsum by adjusting the dorsum according to the height of the nose tip. If there is a bump on the nose, the bump is removed and if the dorsum is too low, it is raised with implant materials.
La Foret Nose Clinic Long Nose Tip Rhinoplasty

Wide-Bridged Nose Rhinoplasty

Cause and Necessity

A wide-bridged nose portrays a round and all around flat feel in a face due to the flatness of the nose. In order to correct this feature, it is important to reshape the dorsum and create a narrower nose rather than focusing on raising the tip of the nose.

Wide-Bridged Nose Rhinoplasty Procedure

The shape of the nose bone determines the width of the dorsum. The wide-bridged nose surgery procedure consists of reshaping the dorsum so that the nose bone is brought towards the center. To bring the bone towards the center, a method called lateral osteotomy is used. A tool called osteotome is used to crack the bone and fold them towards the center. The lateral sides of the nose bone have no problem healing. After the osteotomy, the level of the nose is adjusted by bringing the bones towards the center, allowing the nose to be narrower.

Pug Nose Rhinoplasty

Cause and Necessity

A pug nose is formed when the angle of the mouth and the tip of the nose are more than 110°. A pug nose causes the nose to look shorter than it is and the nostrils are more visible. The length of the nose gives shape to the balance of face. Normally, people who are short and have a round face have a pug nose. There isn’t a problem if the nose is short on a person who is small in size, however, it could pose a problem for those who have a longer face with a short nose. It is possible to reshape the entire image of a person just by elongating the nose.
There are 3 main ways to perform the rhinoplasy surgery. The first method is to elongate the cartilage on the tip of the nose by stretching the nose tip downwards and securing it in place.

The second method is to extract more cartilage from a different part of the body and transplant the cartilage to the nose tip and reshape the nose.

The last method consists of raising the dorsum of the nose with silicone to level out the tip of the nose with the dorsum.

Cartilage plays an important role in making the nose look shorter than it actually is. If the alar cartilage is pointed up, the nose tip looks as if it is pointed up as well. In those cases, the upper section of the alar cartilage is cut out and secured in a place to make the nose look longer. In the case where reshaping the cartilage is not enough, additional cartilages are implanted to ensure that the nose has enough support to be elongated. The implanted cartilages may be extracted from different areas of the body or may be artificial cartilages.
La Foret Nose Clinic Pug Nose Rhinoplasty

Aquiline Nose Rhinoplasty

Cause and Necessity

An aquiline nose is a nose with an unusual bump in the middle of the nose. The aquiline nose is not common and awkward among Asians. Especially Asians with a round face. The aquiline nose is usually found in people who have a long nose tip (arrow shaped nose) causing the nose to look longer than it normally is.

Aquiline Nose Rhinoplasty Procedure

In the case that the dorsum of the nose is very high, the main objective of the rhinoplasty is to refine the bump so as to highlight the curve of the nose. This rhinoplasty procedure is most suited for those who have a high and big nose, and it is often applied to lower the dorsum of the nose to make the curve as natural as possible. When the dorsum of the nose is normally high and wide, the width of the nose is pushed towards the center using osteotomy to make the dorsum of the nose look narrower after the bump has been refined. The doctor will then decide whether the patient needs another supporting material implanted to make the most natural looking nose. In the case of when the dorsum of the nose is very low, a supporting implant, such as silicone or Gore-Tex, will be inserted after refining the bump on the nose to raise the dorsum. Cartilages from the ears are usually used for implants to the tip of the nose to balance the shape of the nose. La Foret Nose Clinic Aquiline Nose Rhinoplasty

Bulbous Nose Rhinoplasty

Cause and Necessity

A bulbous nose has a large and round nose tip and nose wings. This is one of the most common noses found among Asians. The bulbous nose is usually found with people with a short nose and flat nose dorsum. Generally, a bulbous nose is caused by an unusually developed cartilage at the tip of the nose or thick skin surrounding the tip of the nose. A bulbous nose lacks the feel of a polished and refined nose.

Bulbous Nose Rhinoplasty Procedure

In the case of a short nose, the nose is elongated to make sure that the nostrils are not visible when viewed from the front. Then, the cartilage in the nose tip is usually separated by cutting then tying the cartilages together. Lastly, the skin at the end of the nose is removed to make the nose look thinner and narrower. Due to multiple methods involved in the bulbous nose surgery and limits in the removal of skin surrounding the nose tip, the bulbous nose surgery is one of the hardest procedures in rhinoplasty.
La Foret Nose Clinic Bulbous Nose Rhinoplasty

Wide Nostril Nose Rhinoplasty

Cause and Necessity

A nose with wide sides causes the nostrils to look bigger than normal. A wide nostril will also make the nose look flatter than it actually is and interfere with the general feel of the face. In such cases, the skin and the structure on the sides of the nose are adjusted accordingly to make the nostrils look longer in length. The sides of the nose are then pulled together to make the nose tip look narrower.

Wide Nostril Nose Rhinoplasty Procedure

Wide nostrils can be corrected through rhinoplasty that reduces the skin surrounding the sides. Nose with wide sides are normally caused by thick skin that surrounds the end area of the nose. Therefore, the skin surrounding the nose is cut diagonally and sewn back together to make the nose look narrower. Normally, people with wide nostrils also tend to have a round nose tip and a columellar strut is recommended to bring out the most natural looking nose. Another rhinoplasty procedure to correct a wide nostril involves pulling the sides of the nose together. This is a simple procedure for those whose nostrils aren’t too large but just wide in its width. Using a thread, the sides of the nose are pulled towards the center to make the nostril area look narrower and the tip of the nose look higher.
La Foret Nose Clinic Wide Nostril Nose Rhinoplasty

Petite Procedure Nose Rhinoplasty

Cause and Necessity

In the past, materials such as silicone, Gore-Tex and cartilages extracted from other body parts were used in rhinoplasty. The petite procedures, however, are available for those who feel uncomfortable with surgery or who have experienced unsatisfying results from using general supporting implants. The substance most often used for the petite procedure in rhinoplasty is restylane. Restylane is a natural substance that doesn’t cause any allergic reactions or side effects and fits naturally into the body. Restylane has been used in ophthalmology and orthopedic facilities for years and has been FDA approved and approved by the Food and Drug Administration of Korea.

Petite Procedure Nose Rhinoplasty Procedure

During the rhinoplasty for the petite nose, the filler is injected into the flat areas, such as the bridge, the nose tip, or the middle of the tip of the nose. The outcome of the injection is a nose that looks higher and narrower. In the case of an aquiline nose, or a nose with unusual bumps, the filler is injected to smoothen out the curve for a natural look. The rhinoplasty procedure lasts about 15min and a partial anesthetic is used. The procedure is usually painless and the results can be seen right away. Daily activities can be performed after the rhinoplasty.
La Foret Nose Clinic Before & After