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A dorsal hump is one of the most common physical indications for rhinoplasty. It is a convexity along the bridge of the nose, composed of both bone (upper third) and cartilage (middle third). This feature often creates a perceived hook shape in profile and can make the nose appear larger than it is.
The hump disrupts the straight aesthetic line from the brow to the tip. Patients often feel their nose dominates their face, particularly in photos taken from the side. Reducing the hump requires precise removal of the excess bone and cartilage to create a straight or slightly concave profile.
A bulbous tip is characterized by a rounded, broad, or amorphous appearance at the end of the nose. This is often caused by hypertrophic (large) lower lateral cartilages that are convex, or by thick skin that masks the underlying definition.
Patients with a bulbous tip often feel their nose lacks refinement or looks “fleshy.” Correction involves trimming and reshaping the cartilages, frequently using sutures to bind them together and create a more triangular, defined point.
A ptotic tip points downward, creating an acute angle between the nose and the lip. Long caudal septal cartilage, weak tip support mechanisms, or the effects of gravity and aging can cause this. It often becomes more pronounced when the patient smiles.
This indication can make the nose appear longer, and the face appear older. Surgical correction involves rotating the tip upward to open the nasolabial angle (typically 90-95 degrees for men, 95-105 degrees for women). Structural grafting is used to support this new rotation.
Alar flaring refers to nostrils that extend horizontally beyond the ideal vertical lines drawn down from the inner corners of the eyes. This can make the nose appear wide at the base, particularly during facial expression. Wide nostrils can also contribute to this appearance.
Alar base reduction (alarplasty) is the procedure used to correct this. It involves removing a wedge of tissue from the nostril base to narrow the width and reduce flare. This is common in ethnic rhinoplasty and provides a balanced triangular base view.
A crooked nose is a complex deformity where the nasal pyramid deviates from the central vertical axis of the face. This usually involves deviation of both the nasal bones and the septal cartilage. It creates marked asymmetry in the frontal view.
Correcting a crooked nose is one of the most challenging aspects of rhinoplasty. It requires osteotomies (controlled bone fractures) to reset the bones and aggressive septal reconstruction to straighten the central pillar. Spreader grafts are often used to splint the nose in the midline.
Many nasal characteristics are hereditary or congenital. The shape of the cartilage, the thickness of the skin, and the strength of the nasal bones are genetically determined. Congenital deformities can range from minor aesthetic variances to significant cleft lip and nasal deformities.
Genetics dictates the starting point of the anatomy. For example, thick skin is a biological trait that limits the amount of definition that can be achieved. Understanding these biological constraints is crucial for surgical planning and managing expectations.
Trauma is a leading cause of acquired nasal deformity. Sports injuries, car accidents, or falls can fracture the nasal bones and dislocate the septum. If not treated immediately, the bones heal in a displaced position, leading to a permanent callus or deviation.
Post-traumatic noses often have significant scarring and fibrosis. The septum may be fractured in multiple places (crumpled). Surgery involves re-breaking the bones to reset them and reconstructing the septum to restore the airway.
Aging affects the nose just as it does the rest of the face. The ligaments that hold the tip cartilages to the septum weaken over time. Simultaneously, the cartilage itself may weaken, and the skin loses elasticity.
This biological process leads to drooping of the tip (ptosis) and a perceived lengthening of the nose. The skin may also thin, revealing previously hidden bony irregularities. Rhinoplasty for aging noses focuses on re-supporting the tip and restoring a youthful rotation.
The nasal valves are the narrowest parts of the airway. The internal valve is located in the middle third of the nose, and the external valve is at the nostril rim. Weak cartilage or a narrow angle can cause these valves to collapse inward during inhalation, blocking airflow.
This functional issue causes significant breathing obstruction, especially during exercise or sleep. Spreader grafts are used to widen the internal valve, and alar batten grafts are used to strengthen the external valve to prevent collapse.
A septal perforation is a hole in the nasal septum. It can be caused by trauma, previous surgery, or chronic intranasal drug use. Small perforations may cause whistling; large ones can cause crusting, bleeding, and a feeling of obstruction due to turbulent airflow.
Repairing a perforation is complex and often requires the use of tissue flaps from the nasal interior. While rhinoplasty usually focuses on the outside, restoring the integrity of the septum is vital for the health of the nasal lining and proper humidification of air.
The turbinates are structures on the side walls of the nasal cavity that warm and humidify air. Chronic allergies or septal deviation can cause them to become permanently enlarged (hypertrophy), blocking the airway.
Turbinate reduction is frequently performed alongside rhinoplasty. The surgeon shrinks the tissue or removes a small portion of the bone to open the breathing passages. This addresses the lateral component of airway obstruction, while the septoplasty addresses the central element.
A saddle nose deformity is characterized by a collapse of the nasal bridge, creating a scooped-out appearance. This is caused by the loss of septal support, often due to trauma, autoimmune disease, or over-resection in a previous surgery.
This is both an aesthetic and functional disaster. The collapse disrupts the airway’s structural integrity. Reconstruction requires major structural grafting, often using rib cartilage, to rebuild the dorsal height and support the tip.
Send us all your questions or requests, and our expert team will assist you.
The shape of the lower lateral cartilages often results in a bulbous tip. If these cartilages are wide, convex, or spaced far apart, they create a rounded appearance. Thick skin can also mask the definition of the underlying cartilage.
Yes, a broken nose can be fixed years after the injury. The bones will have healed in their crooked position, so the surgeon will need to perform osteotomies (controlled fractures) to straighten them and correct any internal breathing issues.
Turbinates are structures inside your nose that humidify air. If they become permanently swollen due to allergies or a deviated septum, they block breathing. Reducing their size opens up the airway without changing the external appearance of the nose.
This is caused by the depressor septi nasi muscle pulling the tip down, or by a lack of structural support in the tip itself. During rhinoplasty, the surgeon can release this muscle and strengthen the tip support to prevent it from plunging during animation.
It is permanent unless surgically corrected. The collapse of the nasal support structures causes it. To fix it, the surgeon must rebuild the bridge and tip using strong cartilage grafts, often taken from the rib or ear.
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