Rhinoplasty, or a "nose job" is performed to improve the shape. It's one of the most difficult and sensitive operations in cosmetic surgery. If this procedure is done poorly, touch-ups are problematic and many times produce an even worse result. You don't want a nose that is too small, too pointy, or shaped wrong. You don't want your friends to be able to look directly down into your nostrils. Don't laugh, it happens. Your nose is in the middle of your face and is the first thing people see. Preserving something of your natural look is important, and this takes great experience. If you have a very good nose and want a small change, think twice about it: you may be asking for trouble.
We do use fillers, however, for small improvements in nose shape. In 2006, Radiesse® is used to fill in small defects, and this works well for the proper candidate. Durability is from 1 to 3 years.
All that aside, nose surgery can be very, very gratifying. The small bones and structures in the nose can be skillfully trimmed to make a better shape that complements the rest of your facial features. And incisions can usually be concealed inside the nostrils.
Medical nose surgery: Turbinectomy and Septoplasty
The medical reason for a nose job is simple — to breathe better. This can be done in several different ways. Sometimes nose repair is done to improve a crooked septum (the interior "wall" between the two nostrils). Everybody has some irregularity in the septum because nothing in the body is perfectly straight or perfectly symmetrical. But if this deflection is extreme, it can obstruct airflow. The corrective procedure, called septoplasty, is done with the same incision and the same instruments as rhinoplasty.
Another medical reason for nose reconstruction is to help counter the long-term effects of certain allergies. Inside the nose there are small round balls of bone and soft tissue called "turbinates." People who are allergic to dust, pollen or other irritants may find that over the years, the turbinates have swollen and grown larger in response to the allergens. If the allergies are diagnosed and managed properly, the turbinates will shrink. But in cases where the allergies are persistent, these structures may be reduced surgically to increase the air passage size. This is a purely medical procedure, but often the surgeon can do a little redesigning of the nose while doing the turbinectomy.
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