dr al aly - plastic surgeon
rhinoplasty, or nasal reshaping surgery
rhinoplasty, or nasal reshaping surgery, is one of the most complex surgeries in all of plastic surgery. for patients who have it done it is so central to their appearance and for doctors who perform it, it is one of the most difficult to learn and master. altering the shape of a person’s nose has to be taken in context of their culture, personal desires, and what their presenting anatomy is. some people think that plastic surgeons can take any nose and make it look like any other nose that they desire. this is simply not true.
one can think of a nose like a tent, with the underlying metal and wood covered by the cover of the tent. in the nose the equivalent of the metal and wood are the underlying cartilages and bones, which give the overlying skin, the cover, its shape. if the cover or skin of the nose is normal in thickness then altering the shape of the underlying cartilages and bones will be easily seen on the surface. if the skin is thick the nose will appears bulky, which is often the case in a gcc nose, then the alterations will not be easily visible on the surface.
many gcc patients come in complaining of a large nose that has a bulbous or bulky appearance. unfortunately if the surgeon falls in the trap of reducing the nose aggressively because the patient complains of excessive size, the nose will look even more bulky, which would be similar to reduc-ing the size of the metal and wood of a tent. in those patients the surgeon can only reduce the thickness of skin minimally because aggressive thinning will kill the skin.
so to attain less bulkiness, or more definition, the surgeon usually has to project the nose further out than its original size, which in a sense is making it bigger. this is done in conjunction with coordinating the different parts of the nose to each other.
this coordination is actually more important to the appearance of the nose than its actual size and the patient has to be educated about that prior to surgery.