Rhinoplasty

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There is a famous quote by Gertrude Stein that “a rose is a rose is a rose” which however does not hold true for the nose! A nose that may seem beautiful on the face of a Caucasian lady would look equally bad on the face of an African! The “perfect” nose is therefore an individualized one depending on the size and shape of the face as well as the ethnic background of the individual.

There has been an ongoing debate about what an “ideal” nose should look like. In ancient times, large noses (Greek noses) were regarded as beautiful because smaller noses were typically associated with congenital syphilis. A nose with up-tilted nostrils was searched for by women in the 1930s corresponding to Myrna Loy which was the style prevalent during that time. Gradually, as the concept of facial proportions came into place, ideal proportions of the nose were worked out as well as the specific angles. However, it must be noted that all of these calculations are made by humans and “imperfect” noses which do not cater to these ideal proportions might look great on the faces of people as in the case of Meryl Streep.

Rhinoplasty is a surgical procedure in which imperfections in the nose are attended to. While the trend in the West is to go in for a “reduction rhinoplasty” in which a dorsal hump and a large nose are catered to, in the Indian subcontinent people mostly desire an “augmentation rhinoplasty” to cater to their flat noses which are considered unattractive.

Rhinoplasty is a very sophisticated form of cosmetic surgery and requires careful preoperative analysis. It is extremely important that the surgeon tends to discuss the requirements of the patients in details and also provide suggestions regarding the suitability of a particular thing. For example, a patient may desire something that may not look good in his/her face. It is this careful analysis and discussions that underlie the success of any rhinoplasty surgery.

When doing augmentation rhinoplasty to prop up flat noses, one tends to use autogenous materials from the patient’s own body like rib cartilage, bone or artificial materials like silicone implants. Silicone implants are easy to insert but there is always a potential of the body rejecting the implant with resultant extrusion. On the other hand, implanted cartilage tends to be stiff but chances of infection and extrusion are much less.

On the other hand, in reduction rhinoplasty, the surgery is more straightforward and involves the reduction of a dorsal hump which makes the nose look extremely unattractive. Along with this, the tip of the nose may be addressed to giving a very beautiful transition from a smooth dorsum.

One must read carefully into the possible side effects of rhinoplasty surgery because there is always a chance of complications emanating from the surgery. Extremely finicky patients should think a thousand times before getting a nose job because the result of a nose job is usually measured in millimeters! What you expect might not be what you finally get, so, have a detailed knowledge about this surgery before delving into it.

dscn0980The article has been written by Souvik Adhikari, MBBS who works as an Assistant Professor in the Dept of Plastic Surgery at Institute of Post Graduate Medical Education & Research in Kolkata (IPGME&R and SSKM Hospital). He can be reached at souvikadhikari@gmail.com.