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In our last blog post, Dr. Lawrence Tong discussed some common goals and concerns of his rhinoplasty patients. This second installment of our three-part blog series will outline the technical aspects rhinoplasty surgeons need to consider to achieve exceptional results.

Because the nose is such a surgically dynamic anatomical area, there are some principles of rhinoplasty a surgeon (and their patients) must always keep in mind:

  1. Planning is key. As outlined in my prior post, the consultation process allows the surgeon and patient to agree on an intended objective. The method to arrive at that goal involves using a careful step-by-step surgical plan. Prior to the surgery, I create this plan by referring to a patient’s photographs, their detailed consultation notes, and the VECTRA® rhinoplasty simulations.
  2. Perfect results are impossible. There are limits to what can reasonably be accomplished with rhinoplasty. For example, it is unreasonable for a patient to expect that their nose will look like some chosen celebrity’s nose following rhinoplasty. An individual’s basic nasal architecture, tissue characteristics, and the effects of post-operative swelling and internal scar formation set limits that no amount of surgical skill can overcome. Patients should be educated on realistic expectations, or else even the best possible surgical outcome may still lead to patient disappointment.
  3. An individual’s tissue characteristics have a significant effect on the surgical outcome. A patient with firm cartilages and forgiving skin generally has the best tissue characteristics for rhinoplasty. Thick, oily skin tends not to redrape easily, and conveys changes made to the underlying structure to much lesser degree. Very thin skin, although able to show these changes, is much less forgiving, and can highlight even small contour irregularities. The quality of the cartilage also dictates the need for adding structural support for preventing unwanted distortion in the long term. Recognizing a patient’s tissue characteristics and managing it appropriately is a key to successful rhinoplasty results.
  4. If you operate on one area of the nose, another area is affected. These relationships have to be carefully considered during surgery. It is rare that a surgeon can perform a limited amount of nasal surgery without affected the surrounding areas, due to the ripple effects caused by the original maneuver. Learning how to account for these shifting dynamics requires a skilled, experienced hand.
  5. Post-operative changes can alter the appearance of the nose following surgery. Rhinoplasty surgeons must have an understanding of these changes, such as edema (swelling), the emergence of scar tissue, and deviation of the cartilage. Some changes resolve on their own, some require minor intervention, and some may need revision surgery. Reassuring the patient is critically important while temporary changes resolve, but the ability to differentiate and decisively treat more persistent concerns is the mark of an accomplished surgeon. Keeping these factors in mind and managing them appropriately is essential in achieving optimal rhinoplasty results.

Check back soon for the last installment of our series, which will explore the unique surgical approach required for successful ethnic rhinoplasty.

To speak with Dr. Lawrence Tong about how rhinoplasty can help you achieve your aesthetic desires, or to learn more about the Yorkville Institute of Plastic Surgery, contact our office today.