When you’re thinking about rhinoplasty, one of the big questions you are obviously asking is, how will the surgery change my nose? While everyone’s nose is somewhat different, taking a look at the experiences other patients have had can give you an idea of what changes can be made to your nose and how it will look when it heals.
Dr. Jeffrey Epstein, a facial plastic surgeon who specializes in rhinoplasty, recently sat down with an African-American patient who was seven weeks post surgery to discuss the changes made to her nose and her results.
Before the Surgery
In Dr. Epstein’s words, the patient started with what "wasn’t a bad nose." The main concerns with the shape of her nose before surgery were similar to the concerns of many other patients seeking ethnic rhinoplasty. She had an undefined tip, which tended to droop a bit when she smiled. The tip was flat and looked slightly rounded when viewed from the side.
Additionally, the patient had somewhat flared nostrils, which is also common among African American patients considering rhinoplasty.
The patient is seen in the video about seven weeks after her surgery. Although the changes made to her nose are somewhat subtle, the result is a very nice general improvement, not only in the shape and size of her nose, but in her overall facial harmony.
One of the major changes made to the patient’s nose was an increase in definition of her nasal tip. The tip is usually the area of focus when performing rhinoplasty on an African American patient. Once the surgeon has shaped and defined the nasal tip, he or she will shape the rest of the nose to match it.
It’s not just about shaping the tip or adjusting its size, though. Often, the tip needs to be strengthened to reduce drooping, which is also part of the steps needed to achieve better tip definition. When the patient in the video smiles seven weeks after her surgery, the tip stays upright and doesn’t droop downwards. Along with strengthening and defining the tip, the surgery also reduced the width of the nose and improved its slope, so that it dips just above the tip (called a supratip break), further defining it.
The patient also had nostrils which flared slightly and were slightly wide. To make her nostrils narrower and to reduce how much they flared, Dr. Epstein made Weir excisions both on the inside and outside of the nostrils. Also known as wedge excisions, the process involves cutting away skin from the nose to make the nostrils smaller in size. Excising skin from the outside of the nose changes the shape of the nostril somewhat (this is called an alar flare reduction), while excising skin from the internal and external areas can make the nostril even smaller (this is called an alar base reduction).
Incisions and Scars
The location of the incisions is something that commonly concerns patients considering rhinoplasty. But, usually, the incisions made during the surgery are not only quite small, but they are typically positioned so that they are easily concealed and thus not noticeable.
If the surgeon performs an open rhinoplasty, an excision is usually made across the columella, or the part of the bottom of the nose that divides the two nostrils. With the patient seen on the video, the incision made in the columella is healing well, leaving barely a trace behind.
Cartilage and Grafts
Dr. Epstein used the patient’s own cartilage when defining the tip and increasing the bridge of the nose. Some of her cartilage was used in creating a caudal septal extension graft, which is used to secure the tip and improve its projection. In cases where the profile is being built up, sometimes the patient’s own cartilage and other tissue can be removed, but occasionally the surgeon will use Goretex. As the video makes clear, the patient’s new nose is subtly yet noticeably different from before surgery and enhance her facial features.
If you are considering rhinoplasty, taking a look at the results enjoyed by other patients is just the beginning. The next step is to talk to a facial plastic surgeon, such as Dr. Jeffrey Epstein, about the surgery. During a consultation, Dr. Epstein will evaluate your nose and make recommendations based on what you hope to get from the surgery.
Dr. Epstein sees patients at practices in Miami and in New York City. For an appointment in Miami, call (305) 666-5884. Call (212) 759-3484 for an appointment at his Manhattan practice.