In This Page : Rhinoplasty Nose job description & Before After Pictures of Augmentation rhinoplasty, Dorsal Hump removal rhinoplasty,
Broad (Big) & Long nose rhinoplasty, Rhinoplasty for deviated or crooked & Saddle Noses, Cleft Rhinoplasty, Rhinophyma (Acne Rosacea or Potato Nose)
Rhinoplasty (Syn: Nose Job or Cosmetic Nose Reshaping Surgery
or Plastic Surgery of Nose)
is one of the most common cosmetic plastic surgery done
world wide. Central part of face including forehead ,
nose and peri oral area ( lips and adjacent area) gives our face a unique
feature. Nose, Being the most projected part of face is noticed first when one
sees our face. Various Rhinoplasty criteria have been defined for aesthetically
pleasing nose but all these cant be used on every case. Each and every race
(Indian, Caucasian, Negroes, Asians Orientals) have different characteristic and
any Rhinoplasty Nose job surgery should be planned considering the
characteristic of that race. We have multiple races with minor to major
variation in facial features in our country , means we have almost every type of
face and so every type of nose here. Your Rhinoplasty surgeon should be able to
design and tailor surgery individually for your best.
Breathing problems / Septoplasty :-
Nose is an organ of breathing first, cosmetic next. Correction is done to
improve both look and function. Any cosmetic correction is never done at the
cost of function anywhere in body. Nose
works as humidifier and warmer for the air we breath.
Septum, the middle wall of nose which divides it in two passages, is partly bony and partly cartilaginous.
Deviated nasal septum or DNS is a very common occurrence in general population and often considered
reason of obstruction in breathing, which is not always true.
Nose is having two valve areas, external and internal, breathing difficulty occurs usually due to narrow valve
area rather than deviation of septum, unless the later is very severe. Of course deviated nasal septum gives nose a
deviated look from outside and correction restores its look and when associated with procedures to open the
collapsed valves, improves both look as well as breathing.
Most of our male population face breathing problem which
is not due to deviated septum but external valve
collapse, very common in India.
Rhinoplasty Surgery (Nose job) Before After
- 60 years old male with severe drooping of tip with
external valve collapse leading to obstruction in
breathing - first treated with Septoplasty , turbinate
reduction and tip correction outside India without improvement - Simple nose lift
with external valve correction provides best correction
of breathing as well as look.
Deviated Nasal Septum (DNS) (Septoplasty) :- Correction of DNS with or
without other rhinoplasty procedures or nose job
procedures.
Before after picture of severe S shaped curvature of septum,
this septum was curved not only in upside down plane but
also in antero posterior plane, straight septum after
correction. (Note: - Please Dont see this picture if sight of blood hurts you,
we have tried to blur the blood soaked areas. Complete Septoplasty involves
correction of cartilaginous septum as well as bony part & realignment of all
structures to provide a straight nose with patent nasal
passages.
Common complaints by patient & Concerned Rhinoplasty or
Nose Job / Nose Reshaping Surgery Procedures :- Broad Nose:- Osteotomy & Narrowing of Nose with Tipplasty. Hump Nose or Bumpy Nose :- ( Hump) Reduction Rhinoplasty or Nose Job Long Nose with Drooping tip :- Tip-plasty with or without Augmentation
Rhinoplasty (Nose Job) or Reduction Rhinoplasty (Nose Job) Lateral Deviation of Nose or Crooked nose :- Straightening of Nose or
Corrective Rhinoplasty (Nose Job) Low Dorsum or Bridge of Nose :- Augmentation Rhinoplasty
or Nose Job with or without tip plasty Big or Bulky Nose:- Reduction rhinoplasty with tip plasty. ( for examples of all - see pictures below) Commonly, combination of various Rhinoplasty or nose job procedures is needed to provide a cosmetically or
beautiful nose in every Rhinoplasty or nose job.
In general, a narrow nose with optimal projection beyond
face, straight dorsum (with slightly elevated tip in females), nose lip angle 105
degrees with tear drop shaped nostril is considered good.
Overall , changes done during surgery are demand based, means what patient feels abnormal. Congenital and post traumatic deformities :-
Rhinoplasty or nose job in such situations are designed
according to the deformities or nose and other associated
deformities. Rhinoplasty Video demonstration :-
Individual Rhinoplasty procedures and before after pictures
(Case Examples) - Scroll down to see individual nose types. i) Augmentation Rhinoplasty :-
Some amount of augmentation you will find in almost every nose job
except hump reduction, even in nasal hump reduction,
cartilage graft in dorsum is needed to close open roof.
Augmentation rhinoplasty or nose job done to elevate the depressed dorsum or tip or both.
In augmentation rhinoplasty autogenous and artificial material can be
used. We usually use autogenous material unless there is no natural source for it.
Here in this page augmentation has been associated with other nose job procedures in almost all cases
except hump reduction and in every case
only nose framework has been modified for natural & best rhinoplasty results.
Silicone nose implant or any other implant has not been used in any rhinoplasty.
Augmentation rhinoplasty before &
after picture of dorsum or bridge of nose augmentation
to match with tip along with tip plasty : Augmentation
with septal cartilage graft : For Surgery see rhinoplasty video.
ii) Alar Nostril Reduction & Nose Tip Rhinoplasty : (A) Droopy projecting tip)
Tip plasty usually involves correction of nearby framework also to create a harmony with rest of nose.
Tip of nose gives us a distinct appearance and nose tip
deformity is always obvious as its the most projected part of our nose.
Before after picture Tip plasty
- Such deformity is usually found in occult type 0 facial cleft.
This tip plasty has been done by remodeling of nose framework (Alar & upper lateral
cartilage under local anesthesia , no artificial material used. (B) Low (Bridge) Dorsum & Bulky Tip (Big Bulky
or Bulbous Tip of Nose) :- Augmentation Rhinoplasty or Nose Job with Tip
Plasty. Tip plasty to reduce bulkiness , in such noses
alar cartilages are usually hyperplastic and fat accumulation is found between cartilage framework and
skin. Ear (Conchal) cartilage has been used for nose dorsal elevation. Done under local anesthesia.
Before After Rhinoplasty for Bulky or Bulbous Nose tip and depressed
dorsum - Dorsum augmentation with conchal (ear) cartilage graft with tip plasty.
(C) Flat Broad Tip : Tip-plasty
for falt broad tip (these cases usually have hypertrophied alar cartilages)
Rhinoplasty Nose job before after -
Hyperplastic alar cartilages- hyperplastic variant of type 0-type 14 facial cranial cleft- a cleft nose
variant without a visible cleft - feature of cleft on surface is
increased distance between eyes.
(D) Low / Depressed Tip : Nose tip Augmentation for depressed tip
Nose tip plasty before after
picture : This depressed tip is an example of binders Syndrome (Central face hypoplasia-
Nose, maxilla ( upper jaw) and chin (Mandible) Hypoplasia ( Underdevelopment ). Tip and dorsal nose
augmentation with coastal cartilage (rib cartilage).
E) Ala & nostril reduction :
some people have wide and big ala & nostrils. side wall of nose surrounding
nostril is called ala. a wide nostril is usually associated with a low tip and
low dorsum. correction of involves reduction of ala & narrowing of nostril with
or without tip plasty and augmentation of dorsal bridge of nose ( see picture
iii below)
(Dorsal hump reduction, cartilage graft to smoothen
dorsum, tip-plasty, narrowing of nose with Internal Osteotomy) Rhinoplasty with
alar base nostril reduction before after picture (Photo).
iii) Septo-Rhinoplasty with Nostril Adjustment & Tip Plasty : Rhinoplasty or Nose Job with tip plasty.
septal cartilage for elevation of bridge of nose, tip plasty and osteotomy - under general anaesthesia.
Septo-rhinoplasty before after picture: Wide or broad depressed nose with depressed tip
- Septoplasty to harvest septal cartilage graft (best graft material for nose augmentation), osteotomy to make
nose narrow tip plasty and nostril reduction.
iv) Deviated Nose / Crooked Nose :-
deviated nose ( Abnormally healed nasal bone fracture or Congenital Deviation ) Rhinoplasty or Nose Job
for correction of nose deviation.
Post Traumatic Deviation of Nose - Before After Rhinoplasty, Patient wanted to retain other
racial Characteristics like tip and Nose length which has been respected.
More Deviated Nose examples : See Revision rhinoplasty below and Photo Gallery
v) Long & Broad Noses A) Broad nose or Wide Nose :- Broad or Wide Nose with lack of tip
definition Before after rhinoplasty picture :
Rhinoplasty Before After for Broad Nose with wide nose tip- This
nose was one of extreme broad nose treated with Nose reduction, osteotomy and tip plasty.
B) Extreme Broad Nose
One of extreme broad nose with dorsum irregularity (history of dorsal hump reduction
and rhinoplasty somewhere else) , deformed flat tip, supra-tip depression , huge ala and wide nostril -
before after rhinoplasty picture or photo
C ) Long Nose Rhinoplasty : Long Nose with deviated &
drooping tip - Before after rhinoplasty picture.
Rhinoplasty for long nose correction, long nose with drooping tip before after
Picture
D) Low & wide dorsum with broad & low tip :- Rhinoplasty or Nose Job with tip-plasty.
An Example of Asian Rhinoplasty.
Low Broad dorsum Broad tip -
Before after rhinoplasty tip-pasty picture.
Low broad dorsum with wide
drooping tip - Rhinoplasty before after picture- Dorsum
and tip augmentation with correction of drooping tip and
creation of a sleek nose.
E) Short Nose : Short Broad Nose with visible
upturned Nostril Before After
picture. Narrowing of nose with tip & septum lengthening done
vi ) Dorsum hump or Bumpy (nose) with or without drooping tip :-
Hump Reduction Rhinoplasty or Nose Job with tip plasty & Narrowing of nose in male.
Before After Picture Rhinoplasty or Nose Job with Hump Reduction,
Correction of supra-tip depression, Tip plasty for
elevation of tip of nose as well as narrowing and Correction of wide nasal base.
Before After Pictures Reduction Rhinoplasty Hump Reduction, Tipplasty
Broad Nose Correction in Female
VIII ) Post traumatic nose deformity :- (Broken Saddle Nose with nostril and airway stenosis or blockade) :
Augmentation Rhinoplasty or Nose Job with tip plasty and reestablishment of nasal passages. Case Example-
X )Cleft Rhinoplasty : Nasal deformity associated with cleft lip and palate :-
Cleft Rhinoplasty or Nose Job with tip plasty & correction of
Cleft lip nose deformity along with base of nose ( Maxilla)
Cleft Lip Palate & Cleft Nose Deformity Correction -
Cleft Nose Correction involves correction of base of nose i.e. adjacent maxilla (jaw bone) which is less developed in
cleft lip cases along with nose correction. Almost every structure of nose id deviated deflected and deformed
including bony and cartilaginous septum, alar cartilage , upper lateral cartilage , nostrils and ala with alar
base- so correction involves every aspect of nose along with bone grafting or implant augmentation of jaw bone or maxilla.
Details you may see in our research paper on cleft lip nose deformity - link is there in publication page.
for Details of Cleft lip and palate - Visit Cleft Lip and Palate Page.
For details on open rhinoplasty & cleft nose correction
you go through our research paper on cleft nose & open rhinoplasty - please
visit Research & Publications page.
X ) Revision Rhinoplasty for Crooked Deformed Nose :-
Revision Rhinoplasty or Nose job Revision is for those who are not satisfied with their
result of primary surgery. as such best opportunity to provide the best result is in first surgery,
but sometimes patient wants some more change, or some
changes are deliberately left for second stage ( rare). In such Cases Revision Rhinoplasty
Can be done after 3 to 6 months after first surgery, depending upon
magnitude of dissection in first surgery and resolution of swelling. In our
Cases, We do all possible changes in one go only but we are getting cases for revision
rhinoplasty first operated elsewhere, this is one example.
Revision Rhinoplasty Before After :
(History of hump reduction and rhinoplasty somewhere
else 3 years back ) presented at our clinic for revision rhinoplasty
with Long Deviated Nose with Severe DNS (Septum totally out of midline) Bony Hump, Supra-tip
Depression Deviated & Drooping tip - Natural Septo-Rhinoplasty (No artificial material used).
xi ) Rhinophyma :- Cosmetic rhinoplasty or nose job .
Before after picture Rhinophyma or potato
nose correction : Rhinophyma is exaggerated activity and growth of sebaceous
glands of tip of nose which discharges creamy white oily substance. Discharge
instead of coming out becomes collected in glands.
1) What are open and closed approaches for Rhinoplasty?
Ans:- in closed approach, incision for modifying
nasal framework, are entirely inside the nose, no visible
mark outside. In open rhinoplasty , the same inner
incisions are connected externally either in mid columella
(middle pillar of nose between nostrils when seen from
basal view) or at lip columella Junction. Over the time they
heal well and practically there is no visible scar in long
term.
2) which rhinoplasty or nose job approach is preferable, open or close?
Ans:- preferred approach depends upon amount of
work needed in any particular nose. Both can be done in
any nose, close is preferred for minor modifications. Open
approach provides clear view of entire nasal framework so
fine manipulations are always better with this. All the
incisions are kept inside nose in both approaches and
not visible outside except that a mid collumellar
incision or lip columella junction incision joins
incisions of both sides in open approach. No noticeable
scar in both cases.
3) How long the rhinoplasty or nose job surgery takes?
Ans :- may take one and half to two and half hours , depending upon amount
of work needed.
4) General or local anesthesia for rhinoplasty or nose job ?
Ans:- local and nerve block anesthesia is
sufficient for most of cases. Short term general
anesthesia is used for osteotomy (cutting and inward
mobilization) of nasal bones.
For a complete Septo-rhinoplasty general anesthesia is
preferable to local as its safer, more controlled and
more comfortable for patient, also it allows surgeon to
work in a comfortable environment which is most
important for fine cosmetic and functional
manipulations.
5) What manipulations usually done in rhinoplasty / Septoplasty / Septorhinoplasty or nose job.
Ans:- A complete rhinoplasty usually involves
correction of bony and cartilaginous dorsum ( the part of
base of nose visible in front view), tip correction (
narrowing or elevation) , correction of nostrils and lip
nose relationship.
Overall all work needed in a nose are done simultaneously,
depending upon individual requirement.
In , septorhinoplasty, septum is dealt along with rest of
nose, straightening, debulking etc are done , again
decided by need of individual nose. Besides this septum
provides the best possible source of cartilage for dorsum
augmentation or tip work. so septoplasty is often added to
rhinoplasty as it corrects septum as well as provides
autogenous material for use in rest of procedure.
6) What about breathing difficulty in Rhinoplasty or nose job ?
Ans:- Nose has two valve areas , internal and external. In an
otherwise normal looking nose , it’s the internal valve
collapse which causes breathing difficulty and needs to
be widen with spreader graft. In a nose with drooping
tip, external as well as internal valves are affected
and need correction.
7) Rhinoplasty Recovery After Surgery : How much is recovery time after Rhinoplasty or
nose job surgery?
Ans:- surgery takes around two and half hours . recovery from general anaesthesia is almost instant after
Rhinoplasty surgery. You may feel little tiredness for a few hours
(2-3).
Mobile and may take normal diet after 5-6 hours.
Nose will be packed for 48 Hours. Discharge from
hospital after 6-8 hours or next morning. Dressing on nose 7
days.
Your nose will look normal to others but you will
feel swelling at 2 weeks.
After three weeks , nose looks almost normal , in newer
shape, but mild ( undetectable) swelling is still there. It takes around three months before nose looks almost
normal with all evidences of surgery resolved except very
little amount of edema ( Swelling ) which is unnoticeable.
8 ) Any difference in Female & Male Rhinoplasty.
Ans : Male Rhinoplasty is always believed
to be a separate entity , as male noses are usually more
deformed also expectations in male is always more than
females, their thick skin makes result late to appear.
In our practice we see every nose as a different and
individual entity be it male or female Rhinoplasty and
contrary to the common belief in plastic surgery society
our male patients are equally happy. In females skin is usually thin and shape
of nose appears well after rhinoplasty.
9) what are materials used for nose augmentation?
Ans:- materials used for augmentation can be autogenous (
from patients own body) or artificial materials. Autogenous :- 1. Cartilage:
from nasal septum—most commonly used.
conchal cartilage ( from ear) or rib cartilage. 2. Bone:- pelvic bone ( iliac creast)
Calvarial ( outer table of skull ) Artificial materials:-
Medpore
Silicone
Goretex .
10) Which material is better autogenous or artificial ?
Ans: use of
autogenous material is always better whenever available
and applicable. use of artificial material is second choice. in most of noses
remodeling of nose bony and cartilaginous framework
itself is sufficient to give desired result, if not
cartilage harvested from septum , or ear cartilage or
any other option is chosen for. Among Implants silicone is more acceptable for dorsum and Medpore for paranasal augmentation.
We usually dont use implants, if needed we use it in a different way so that
Implant becomes incorporated part of nose rather than separate
many people think cosmetic surgery always needs use of
artificial material, its a big confusion, cosmetic
surgery is surgery which is intended to improve your
look when function problem is not there, in fact almost
every cosmetic surgery involves improvement of both look
and function.
11 ) Any rest required ?
Ans: yes, Rest for six hours after
surgery, its better to take leave from work for 2-3
days, avoid exertion and heavy work for a week at
least. There will be dressing on your nose for Seven (7)
days if osteotomy has been done , for 5 days if not.