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When doing a rhinoplasty, how do you determine the correct shape of the nose?

Q:

When performing a rhinoplasty, how do you determine the correct shape of the nose?

A:

This is a great question. The decisions associated with the surgery of Rhinoplasty have been well addressed for many hundreds of years.  Some practitioners utilize the proportion of the patient's face, others use mathematical formulas and still others base their decisions upon analysis of thousands of patient groups divided up by ethnicity and culture.  Many surgeons combine parts of these decision trees in the analysis and performance of Rhinoplasty.

Perhaps a better question is how do I know that my surgeon knows what he is doing when he performs my Rhinoplasty surgery?  First, make sure your surgeon has hospital privileges to perform the surgery you desire.  This will hopefully insure he has the training, background, certification and experience to perform the procedure you desire. Second, request to see the surgeon's pre and post operative photographs of their actual patients who have had Rhinoplasty surgery.  You do not want to see patients pulled from a national databank of their surgeon's results.  Lastly, for your own safety, make sure the facility where you have your procedure done is accredited.

Members of ASAPS are the experts in Aesthetic or Cosmetic Surgery. They train for many years to perform the Art of Aesthetic Surgery and are required by strict ethical guidelines to follow the requirements of practice I have listed above.  Rhinoplasty is an integral part of their profession. Consider giving a member of ASAPS a call about your cosmetic concerns.

 

Best,

 

Gary R. Culbertson, MD, FACS

A:

The "correct shape" used to depend on aesthetic norms and Renaissance ideals of beauty.  These ideas are falling away as it becomes obvious that many patients do not have noses that will look right if those standards are followed.

It is much more important to me what the patient wants.  Are there familial, ethnic, or personal characteristics that must be preserved?  Is there symmetry?  Is the airway optimal?  Can nasal proportion be better?  Does the patient want more angularity in the nose or less?

All of these answers must be part of any preoperative discussion between patient and surgeon.

 

 

A:

Determining the Correct Shape of the Nose – Obviously the entire operative procedure is based on analyzing the nose pre-operatively to determine how one’s nose should be sculpted to match the nose to the face so that it does not look unnatural long-term. This really requires expertise in rhinoplasty.

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