Procedure chair and equipment at NEU Advanced Aesthetics Center

Face

Rhinoplasty

Nose enhancement, nose lifting, nose re-shaping

Rhinoplasty is a cosmetic surgery procedure to change the shape of the nose, usually performed for enhancement. Rhinoplasty can make profound differences to the symmetry, size, and shape of the facial features, not to mention the effect on the person’s esteem.

During rhinoplasty, the nose cartilages (tip), bones (bridge), and ala (sides) are modified to make the nose narrower, lower, or higher.

Nose lifting enhances the nose by increasing the height of the nose bridge including projection of the nasal tip. It involves insertion of either a Silicone implant, Goretex (ePTFE) or Osteopore (poly-Caprolactone PCL). The patient’s own cartilage, usually from the ears, can also be harvested and used as a natural graft.

For structural support of the nose, a more firm cartilage is taken from the midline and inner part of the nose called septum. This can provide stronger support to correct septal or nose deviation (Septo-Rhinoplasty). Typically this procedure needs sleep anesthesia.

Closed rhinoplasty places incisions along the inner border of the upper and medial nostrils, making the scars less visible when recovered. Open rhinoplasty connects those incisions over the columella, allowing the surgeon to lift the front flap of the nose for better exposure of the cartilages of the lower nose.

Techniques and options

Silicone implant

The gold standard, used for the past several decades. Can be carved or shaped to fit the patient’s features. Minimal incisions, fast recovery, lower in price. Rejection rate of 2-3%, higher than Goretex or cartilage. The body forms a capsule around the implant, making it easier to remove or replace later.

Goretex (ePTFE) implant

Newer than silicone in implant technology. Natural looking but more expensive, with an almost nil rejection rate. Softer in consistency, so there is less pressure over surrounding skin, and tissue integrates into the implant over time. Requires open rhinoplasty and may be hard to remove or replace.

Cartilage rhinoplasty

Guaranteed all natural, with lifting material taken from the cartilage at the back of the ear. 100% no rejection. May require an open-type rhinoplasty plus an ear incision. Lifting is not as high as silicone or Goretex for the bridge. Longer surgery and recovery, and pricier.

Osteopore (PCL) tip plasty

Poly-Caprolactone used for tip projection, frequently combined with a silicone or Goretex bridge for the best overall outcome.

Dorsal hump reduction

Addresses nose bridges that are a bit too high or have humps. Involves breaking or shaving the nasal bone. Recovery may take longer than other rhinoplasties.

Alarplasty (nose trimming)

For patients with wide noses, large nostrils, or overhanging or thick ala. Performed concomitant with other nose procedures. Requires the patient to avoid opening the mouth widely - yawning, eating large food, frequent smiling - for 3-4 weeks.

Tip plasty

Modifies the nose tip to reduce, make more pointed, lift, or de-rotate it. Depending on the aim the surgeon may perform de-fatting, approximation of the nose cartilages, or place grafts.

Recovery

Day 7 Stitches out.
Weeks 3-4 After alarplasty, continue avoiding wide mouth opening.

Aftercare

Follow the surgeon’s instructions on avoiding wide mouth opening after alarplasty for 3-4 weeks.

Questions

Is rhinoplasty done under general anesthesia?

Rhinoplasty is an office procedure usually done painless under local anesthesia. Sedation or general (sleep) anesthesia may be requested by the patient. Septo-rhinoplasty typically needs sleep anesthesia.

Which implant material is best?

There is no single best material. Silicone is tried, tested and lower in price. Goretex has an almost nil rejection rate but is more expensive. Cartilage has no rejection at all but lifts less and costs more. Dr. Jaafar recommends the material based on your anatomy and goals.