Nose jobs, also known as Rhinoplasties, are typically highly successful surgeries, in which the appearance and/or functionality of the nose is improved. Common changes include removal of a bump on the bridge, also known as a dorsal hump, narrowing and modification of the position of the nasal tip (usually lifting for a droopy tip), and straightening of a crooked or deviated nose.
Profile changes are most accurately portrayed with preoperative imaging, while narrowing and straightening are harder to predict. While improvement in all areas is typical, there may be limitations to the surgery that can prevent complete correction in specific areas.
What nose jobs often cannot fix completely:
- Deviations cannot always be completely corrected, due to underlying asymmetry of the face and supportive structures to the nose itself. Scar formation after surgery can also influence the result, as they tend to pull the nose towards its preoperative form. The nose can only be as straight as the face it sits on.
- Narrowing is sometimes more or less than desired. This is due to settling of the cartilage, which is stronger in some patients than others, as well as differences in skin thickness and degree of skin shrinkage plus scar formation after surgery. Grafts are often used in Rhinoplasty to control the cartilage position and increase the predictability of the frontal contour changes.
- Tip position can also be variable, as a result of the same issues that influence narrowing. In a well performed Rhinoplasty, it is more typical to be slightly LESS lifted than desired, if tip position differs from the goal.
- Thickness of nostrils can only be partially corrected. The majority of the nostrils are skin and fibrofatty tissue which cannot be removed without causing significant scarring. Changes can only be made to the attachment areas to the face, which results in smaller nostrils, but not thinner ones. Botox and Fractora can be used to thin ‘chunky’ nostrils later on if necessary.
In general, a Rhinoplasty can correct central structures better than ones off towards the side of the nose. As you travel away from the midline, you begin to encounter support structures and the influence of the surrounding facial anatomy. You cannot remove these tissues, as they are supportive in nature, and there is a limit to what you do before support begins to be compromised.
The take aways are simple: Bridge height, narrowing, and changes to tip position are all typically corrected very well in Rhinoplasty. Complete correction of deviation, nostril thickness, and specific degrees of narrowing are not always able to be fully corrected even with a well performed nose job.
If you're considering rhinoplasty, we invite you to take the next step with Dr. Richard Westreich in NYC. With a focus on natural-looking results and personalized care, Dr. Westreich offers the expertise and artistry to help you achieve balanced, refined facial harmony. Contact us today to start your journey toward a more confident and refreshed appearance.
