hooked nose surgery
An aquiline nose (also called a Roman nose or hook nose) is a human nose with a prominent bridge, giving it the appearance of being curved or slightly bent. Removing a hump from the bridge is one of the most common things people want addressed during their rhinoplasty. Nasal humps can range widely in size. Perhaps you just have a small bump that you’d like refined? Or maybe you have more of a Roman Nose with a more dominating, distracting large hump? No matter if your nose falls on one of these extremes or somewhere in between rhinoplasty surgery can be used to reshape your nose. For anyone considering having a rhinoplasty to reduce a hump on their bridge there are several things to consider before having surgery.
doctor tarzi will give you all the information you need to decide whether cosmetic surgery is right for you. He will provide you with the knowledge you need, goals, recuperative plans, and potential complications, so you will be prepared for the surgery you choose. Your own personal desires for the extent and result of surgery will be the guide to what surgery is chosen and performed.
How much bridge reduction do you want?
At one level the decision of how much to reduce the bridge hump is one of personal aesthetics or preferences. Some people prefer a more concave, less projecting bridge whereas others prefer to maintain a more straight (or slightly full) profile line. Some patients may want to keep some bridge fullness after surgery to maintain some ethnic or family features, or just as a personal preference. Additionally, one must consider the fact that you want to maintain the masculinity of the nose with male patients. Regardless, it is important for you to communicate with your surgeon how much of a hump reduction you want. Your surgeon should be able to perform in-office digital morphing to simulate hump reduction and give you an idea how your nose would look with varying levels of hump removal. Preoperative digital morphing sets the stage for the discussion between you and your surgeon about how low you would like your bridge to be. The entire face and its proportions must be considered when deciding this as the bridge must harmonize with the overall facial framework.
The Rhinoplasty Procedure
Rhinoplasty surgeries are performed under general anaesthetic and can take up to two hours, depending on the nature of the procedure. For surgeries you will need to stay overnight in hospital for monitoring. Rhinotip correction may be carried out under local anaesthetic with sedation, under which circumstance you may be able to return home on the same day. Regardless of the type of Rhinoplasty surgery you are having, your surgeon will work hard to ensure you are left with no visible scarring. For a standard Rhinoplasty, your surgeon will make incisions inside your nose to allow for alterations to the bone structure, and for those undergoing Rhino-tip procedures, your surgeon will operate on the cartilage inside your nose, either removing or reshaping parts of it to give the desired shape. Prior to your surgery, your surgeon will cover all aspects of the procedure with you and will advise you on your individual case.
The Rhinoplasty Results
Results from Rhinoplasty procedures can be drastic, transforming not only the nose but the whole face. Whichever surgery you are having you will be left with no visible scarring, though you will need to wear a splint across your nose for 7-10 days to protect it. Your final results will normally show after a couple of months, once swelling and bruising have completely dispersed.
Rhinoplasty Recovery / Downtime
We recommend that you take 7-14 days off work. Bruising and swelling of the eyes and upper cheeks is normal, and will subside within 10-14 days. You may also experience a sore throat after the surgery. The swelling inside your nose may take a few months to disappear completely.
How well will your nasal skin redrape after bump removal?
The other limitation when it comes to hump reduction (or making the nose smaller in general) is that the overlying skin must redrape over the new, smaller nasal structure. Skin isn’t removed during surgery, but thanks to the underlying elasticity of the skin it will contract around the new, smaller nose. This concept of skin redraping relates to the issue of how much of a reduction to make during hump removal. Though some level of hump reduction should still be possible, in patients with thick skin it may not be possible to reduce the size of the nose quite as much as desired. If the skin won’t be able to adequately shrink wrap around the newly downsized nose the result may be an amorphous blob of skin that would likely make the nose look worse. Surgical judgement is needed to assess how well any given person’s skin will accommodate this Shrink Wrap Effect process. Generally, younger patients and patients with thinner skin will redrape very well. Older patients and those with thicker skin won’t be able to redrape as vigorously. The risk is that the excess skin will visually result in a bulbous, ill-defined nose.
In the before and after photos above you can see how a noticeable reduction in the patient’s hump was achieved while maintaining a masculine, natural appearing nose.
Is your hump due to excess bone, cartilage or both?
It turns out that not all nasal bridge humps are created equal. The bridge is actually composed of bone in its upper third and cartilage in the remaining lower two-thirds. The schematic drawing below shows this nasal anatomy nicely.
Some people’s humps are limited to the upper bony portion of the bridge. This can be addressed during rhinoplasty by removing the excess bone only. Other people may have a hump that is due to excess cartilage. This would be best treated by trimming the cartilage that is causing the dorsal fullness. By far, the most common scenario is a hump that is composed of both excess bone and cartilage. This is shown below in the following schematic figure.
A combined approach in which the bone is removed and the cartilage shaved needs to be used in this situation. This allows both the bone and cartilage to be brought down to the proper level to create the desired profile line
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