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Reasons Patients Seek Rhinoplasty Fayetteville

There are a multitude of specific reasons patients seek a rhinoplasty. Unusual or disproportionate nasal anatomy can cause loss of self-confidence and self-assurance. Lack of self-confidence for any reason can be self-defeating, and affect every aspect of a person’s life. Rhinoplasty can and has improved self-confidence and self-assurance levels in many patients. The most common reason patients seek rhinoplasty is a prominent nasal dorsum, which some patients refer to as a nasal “hump”. This can occur as result of trauma, which is quite common, or can result from a familial (genetic) trait. This anatomic trait (dorsal “hump”) is generally, but not always, considered more masculine. Patients, especially women, will frequently state at the consulataion, “I hate the way I look from the side”. They will also convey that they are very self-conscious about this trait, especially when observed in a profile view photograph. Patients will also frequently state, “I have always hated my nose and I finally decided to do something about it”.

In general, the aesthetically preferred nasal dorsum for men is straight or slightly over contoured. In general, the aesthetically preferred nasal dorsum for women is straight or slightly under contoured. Of course, there are always some exceptions to these general considerations. Bob Hope, the famous comedian, often self deprecating, joked about his “ski slope nose”, which was very feminine. As a result, his nose became a significant part of his public image to the degree that it was frequently a focus of his caricature. This emphasizes the enormous impact nasal aesthetics have on a person’s overall image. While his nose was feminine, he also had many feminine facial features so his nose “fit” his general appearance. This emphasizes the importance of proportion and congruence in relation to the concept of beauty. While many patients have never thought about the objective criteria of beauty and proportion, they all understand the general concept.

Bob Hope

Bob Hope profile

Bob Hope caricature

Another common concern patients voice and another reason for seeking rhinoplasty is related to the nasal tip. Nasal tip problems are widely varied. The wide variation in nasal tip anatomy combined with the wide variation in facial structures means there are many different solutions (surgical maneuvers) to correct these problems. A frequent concern voiced by patients is the broad nasal tip. Patients might state “my nose is too big” and they mean that the nasal tip is too broad. This nasal tip problem is also referred to as a “boxy nasal tip”. Patients with a “boxy tip” have a squared off appearance to the nasal tip rather than a more pointed tip. This group of patients may also have an “over projecting tip” which means the nasal tip is too long. Another common complaint patients seeking rhinoplasty voice is the drooping nasal tip. This is typically a familial trait that is expressed to varying degrees, and is usually a result of overgrowth of the nasal septum and alar (lower lateral cartilages). The “drooping tip” can also be a result of an undergrowth of the structures (nasal septum and anterior maxillary spine) at the junction of the upper tip and nose. In this circumstance, the nasal tip is really not drooping, it just appears to be drooping because of the under contouring of the aforementioned area. Asymmetry of the nasal tip is another concern patients voice when seeking rhinoplasty. Asymmetry can occur in the tip of the nose, and also in the dorsum of the nose (see section below), or both. Many patients with nasal asymmetry will report a history of trauma, and this is especially true for the nasal dorsum. Nasal trauma can also result in airway obstruction, which can also be addressed at the same time as the aesthetic rhinoplasty.

Patients often seek rhinoplasty for asymmetry (deviation) of the nasal dorsum, simply stating “my nose is crooked”. This problem may be developmental, but patients frequently report that nasal trauma was the cause of the dorsum asymmetry. A commonly observed clinical situation is the patient that suffers nasal trauma and does not seek immediate care. The nasal trauma results in a shifting of the nasal dorsum (asymmetry), but the acute swelling masks the deviation. Later, when the swelling subsides, the deviation (asymmetry) of the nasal tip becomes very obvious, and by this time, the nasal structures have healed in this abnormal position. The dorsum asymmetry can be severe or slight, and the severity of the deviation in part determines the technique(s) that are chosen to correct the problem. In some circumstances the dorsal nasal structures are simply shifted to the midline, and in other circumstances, a graft is used to correct the problem. The primary structures that are involved in the correction of the asymmetrical (deviated) septum are the cartilaginous septum and the nasal bones, which, in addition to undesirable aesthetics, can cause obstruction of breathing.

A less common concern patients voice is the width of the nose (base of nose too wide). In this group of patients, the alar cartilages flare too widely changing the shape of the nostrils and the appearance from a front view. When planning to address this concern, many factors including facial shape, gender, habitus, ethnicity, and most importantly, the patients’ goals, should be considered. In some circumstances and depending upon the specific technique that is chosen, this concern is addressed at later time (staged surgery) due to the potential problems with blood supply.

In summary, there are many reasons patient seek the rhinoplasty procedure. The majority of patients have more than one anatomical trait that can be corrected. It is important for patients seeking rhinoplasty to understand that a new nose is not created (except in the circumstance of reconstruction), but rather their own nose is changed to a more ideal shape. It is also important to realize that the ideal nasal shape for one person may not be the ideal shape for another person, including family members. Most every Plastic surgery procedure has limitations. It is important for the patient seeking rhinoplasty to understand those limitations before making the decision to have surgery.