Rhinoplasty, commonly known as a nose job or nasal surgery, is performed to correct or alter the size or shape of a person’s nose. It is one of the hardest procedures plastic surgeons perform. Due to its difficulty, many surgeons have begun to specialize in this field, with ethnic subspecialties such as African American and Asian rhinoplasty quickly advancing.

Types of noses and shapes

Attempts have been made to classify the types of noses or shapes. Unfortunately, no hard and fast rules exist due to the vast array of different shapes and sizes a nose can take. The shape of a nose depends largely on cultural background, genetics and deformity or injury.
Generally speaking, various nasal features can be identified with different ethnic groups. For example people from South, East and Southeast regions of Asia tend to have flatter and wider noses than Caucasians. The flatter appearance is usually caused by a short bridge and columellar retraction, where the cartilage between the nostrils slopes back toward the face. Augmentation rhinoplasty is often requested in order to heighten the bridge and tip. Since the problem is mostly unrelated to nostril width, merely narrowing the nostrils would not produce a natural result with such nose shapes.
The typical nose for Hispanic persons generally comprises a wide bridge with a bulbous drooping tip, frequently coupled with a dorsal hump. To alter the shape, such persons often request elevation and narrowing of the tip with removal of the dorsal hump. Contouring and elevation of the tip can be achieved with insertion of cartilage obtained from grafting extra tissue. Usually cartilage around the septum is used. The hump is evened out by removing cartilage and small amounts of bone if required. To create a flowing look, implants may be required to fill other parts of the dorsum. The surgeon may also narrow the nostrils to reduce the wide appearance.
Persons of African American descent are often endowed with platyrrhine noses, being especially broad and flat with flared nostrils. Many choose rhinoplasty merely to refine the shape to a more flattering look, seeking to retain the cultural heritage rather than aspiring to a Caucasian shape. A combination of the following surgical treatments is commonly used in order to enhance the structure: narrowing the nostrils and tip, elevating the dorsum or bridge, reducing the ala width, projecting the tip and removing cartilage to reduce pronounced curves. Cartilage or silicone implants are used to heighten and reshape the tip or dorsum, although cartilage is preferable to reduce the risk of rejection.

Surgery Possibilities

Surgery may be performed to ease breathing difficulties or to enhance cosmetic appearance. Most persons will have some idea of the changes they seek. Depending on physical characteristics such as the shape and size of nasal bones, cartilage and skin thickness, limitations may arise. Most surgeons are able to illustrate potential changes and realistic surgery outcomes with computer imaging technology. Incisions for most rhinoplasty procedures are made inside the nose, making scarring undetectable.

Risks

Risks do exist and potential complications can occur, as with any other operation. Infection, bleeding, scarring, extreme bruising or swelling, persistent pain or anaesthetic problems are possible. Revision surgery is required at times to correct a defect caused during the first procedure.
Rhinoplasty should only be performed by an experienced and reliable plastic surgeon. He or she will advise you of all aspects of the surgery including pre and post-operative care, physical limitations, anaesthetic options and risks.