What is rhinoplasty?
Rhinoplasty is a very common procedure that aims to change the appearance of the nose to make it more harmonious on the face. The operation can be thin, increase, increase, contract or lengthen, and significantly change the shape of the nose. Rhinoplasty is commonly called nasal work. This can lead to coarseness of the nasal bones, to remove the relief, to tie the cartel to change its projection, to cut the basket to make it smaller and more defined, and a whole variety of procedures.
Most rhinoplasty procedures are performed after the patient ceases to mature on the face. This usually occurs between 16 and 17 years of age in girls and a little later in boys. Rhinoplasty can be combined with an enlarged chin, which can help balance the appearance of both the nose and the chin. Sometimes a problem in one area creates a perceived problem in another.
Common reasons for choosing rhinoplasty
Perhaps everyone has a reason to dislike something in their nose. Regardless of whether this disappointment is enough for you to strive to change it, depends on the person. People who want to get rhinoplasty, should remember that this is a cosmetic change, it is important to understand the limitations of the procedure - something that may or may not be changed. There are realistic and irrational reasons for finding a nose.
General complaints of people looking for rhinoplasty: too large, too flat, large bulges or convex profile, too wide or thick, too thin, too long, too short, too clamped, blackened or concave profiles (ski slope), hanging columella, functionality - difficulty breathing, curve, asymmetry (nostrils or general structure), bumps, bivalve tip - indentation down the center of the tip, scar tissue, injury from accidents, hooked nose, upturned nose, pointed, bow ovic, lack of definition
General complaints or conditions of people who do not have to strive for rhinoplasty: become increasingly popular, improve life, become more desirable, defeat someone, dysmorphogenic body disorder (BDD) or any other self-assessment disorder, low self-esteem due to the absence of a visible cause , weak chin, weak jaw, weak or well-known upper jaw, pressure from third parties, promotion
What does your nose look like on the inside?
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The bone structure of the nose makes up the upper part of the nasal area. It consists of perfectly symmetrical bones that form the shape of a pyramid. This is commonly called the bridge. The back is a flat surface in the front of the nose, caused by the meeting of the nasal structures. Glabella is the place where the bridge connects to the forehead.
The lower two-thirds of the nose consists of skeletal structures. They consist of five large pieces, a partition, two side nasal sticks and two large cartels. There are also a few small pieces of cartilage, known as less alar cartilage.
The septum is a part of the cartilage that flows down the center of your nose, and it divides the nasal cavity in half. The front part of the septum (farthest from the face) is the thickest, it is the thickest, where it joins the nasal bones.
The lateral cartilage is located about halfway down the nose. It is wide and flat, has a triangular shape. The front of the lateral cartilage is thicker, and its upper side is connected to the nasal bones, the lower part of which is connected to the higher alal cartilages.
Large alar cartilages are small, thin and flexible. They are located in the lower part of the nose and lean back on themselves, forming the tip and forming the lower walls of the nose. They are connected in the center, and as they spread from the center, they become flatter, narrower, and more oval.
The nostrils can be changed in rhinoplasty by cutting sections from the floor of the nose or at the crossroads where the nose meets the cheek.
Perfect nose
There is no perfect nose, the perfect nose is based on the features of this person and what works on their face. A nose that may be attractive to one person may look out of place and actually detract from their appearance on the other. Given that, over and over again, people were looking for a formula for determining the ideal face.
Leonardo da Vinci
The width of the nose in the widest part of the base should be approximately the same distance as the distance between the eyes.
The length of the upper lip should be twice the distance between the lower lip and the chin.
A slight upward rotation in the tip is better and more attractive.
Yale Medical University
(a) The distance from the infraorbital rim to the base of the nose should be equal to the width of the nasal base (outside each nostril to the nostril) and the distance from the middle third of the face (forehead to the nose base.
(b) The length of the nose (radius to the apex or RT) should be equal to the distance from the concessions to the menton, equal to 1.6 x TS (tip for stomatology).
(c) The ideal projection of the tip (folds of the alar on the tip) is 0.66 x ideal nose length (RT).
(d) The line from the middle of the glabellar region to the menthons should halve the nasal bridge, the nasal tip, and Cupid's bow.
(e) The nasal dorsum should be delineated by two slowly curving diverging lines extending from the medial over-eyed crests to the clearance points of the tip.
(f) The width of the bone base is approximately 80% of the base of the alar.
(g) The width of the base of the alar is equal to the intercanal distance or width of one eye.
(h) Single discs should have a small external flash in the lower direction.
(i) The lines connecting the points of clearance of the tip, the region of rupture of the supratep and the collineular lobular angle form two equilateral triangles.
(j) The line denoting alar discs and columella resembles seagulls in gentle flight.
(k) When viewed from the front of the eyes, the nasofrontal angle lies on the level between the upper eyelashes and the supramental fold.
(l) The female nasal dorsum lies approximately 2 mm posteriorly and parallel to the line from just above the nasofrontal angle to the tip cleaning points. In men, the back is slightly higher.
(m) 50-60% of the tip lies in front of a vertical line, extended near the most protruding part of the normally located upper lip.
(n) Projection tip is equal to the width of the base of the alar.
(o) The rotation of the tip is determined by the degree of the nasolabial angle, measured as the angle between the vertical and the straight, passing through the front and rear edges of the nostrils (normal 95-100 degrees in women and 90-95 degrees in men) (nasolabial angle does not match the lateral angle colomellar).
(p) The columbular lobed angle is approximately 45 degrees.
(q) In the basal image, the outline of the nose base forms an equivalent triangle; share to nostril - 1: 2.
(r) The upper lip protrudes 2 mm more than the lower lip, and for women, the chin lies slightly behind the lower lip; slightly stronger in men.
The distance from the angle of the mandible to the menthons is the distance from the menthons to the natural hair (or trichon).
Procedure
- open or close
Surgeons performing rhinoplasty have a choice between two types of incision methods. Open or closed technical differences in the incision method, open method, the surgeon cuts the nose, exposing the inner dwarfs. The closed procedure is performed using incisions, usually inside the nose. This operation is performed without visual. More importantly, this is the skill level of the surgeon. Some surgeons prefer one method over another.
In open rhinoplasty, an incision is made through the base of the columella, a small wedge of flesh that creates and separates your nostrils. The incision is usually done either with a “Z” or with an inverted “V” cut, which helps minimize the appearance of a scar. The scar that he leaves when healing is complete is usually very guilty and will disappear in most people, sometimes there can be a thin pink line where the incision is made. In more rare cases, a keloid scar may form, but it may be preceded or treated by postoperative care (for example, dermabrasion or kenalog injection).
- Enlarged nose
Various forms of the implant can be added to the structure of the nose, increasing its projection or width. There is a wide choice of materials to choose from, most doctors will use one particular material because they think that it is better. There are implants that can be assembled from your own body and artificial implants to choose from.
Bone grafts are usually taken from the ribs of patients. During implantation, a small percentage of absorption is observed, as well as a longer recovery period. An additional operation is performed to extract the graft. There are opportunities for bone infection, as well as excessive calcification. It has been reported that rib grafts are deformed and deformed, like any graft.
Cartilage grafts can be taken from patients, either from their ribs or from their ears. When the ear is removed from the back of the ear, a tiny ribbon is removed, usually used in patients who have too much cartilage removed. Ribbed cartilage is usually taken from false floating ribs.
Silicone implants have been used for face implantation since 1956. They are complex, but flexible depending on how they are produced.
Alloderm is a donor tissue, by treating the donor tissue is separated until it is only a protein frame. It does not contain human cells. This can last up to two years, and in some cases indefinitely. Product is expensive. It will not mimic the appearance of the bone, but can be used for the implantation and structural work of cartilage.
Polyethylene is a plastic that is porous, resembles coral. Scar tissue can heal in these pores by protecting the implant.
Gore-Tex is a biocompatible microporous material that allows tissue to grow into it. It is soft, flexible and durable. Gore-Tex is easily cut for further personalization for both patients and needs.
Medor / Porex is a lightweight high density polyethylene. The implant material has a long history of medical use without any harmful effects. Due to porosity it has one fall. If at a later stage the implant needs to be removed, the operation will become more complicated as it fuses.
- Ethnic Rhinoplasty
As with any rhinoplasty, the goal is to create something that will work harmoniously with the patient. In ethnic rhinoplasty, it is important to preserve and include this ethnicity in the final nose. A good rhinoplasty will create a nose that does not stand out and does not attract attention. In most cases, the patient wants more projection and definition in the nasal bridge, as well as narrowing of the nostrils.
Ethnic skin has a higher likelihood of keloid scar, which is the formation of excess scar tissue. In pigmented skin, there is also the possibility of hypo-or hyperpigmentation.
