5 steps of nose-sculpturing surgery
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5 steps of nose-sculpturing surgery

 

In general, the entire nose can be divided into the glabella, radix, nasal dorsum, nose tip, nose wing and nasal column. The size, height, and proportion of each part are all important to nose-sculpturing surgery. Simply put, the purpose of nose-sculpturing surgery is to make the nose achieve the perfect ratio on the face.


The nose-sculpturing surgery of Director Dr. Yi-Sheng Kao – the perfect five steps:






STEP1 Pad the radix

The brow ridges of oriental people are not as prominent as those of the Westerners, and their radix areas are also relatively depressed. In the past, rhinoplasty surgery was carried out using I-shape and L-shape artificial silica gel for padding, which could not solve the problem of depressed eyebrows. It was ended up with a very unnatural tall nose, and there were pit marks at the junction. Of course, it is also feasible to use hyaluronic acid to strengthen the depression and deficiencies between radix and the two eyebrows, and the best solution is of course having the surgeon to tailor-made a Y-shape silica gel or Gortex at the glabella during the surgery so that the glabella becomes full and the problem can be solved.



STEP2 Pad the nasal dorsum

The traditional "L-shape" artificial nasal nose can pad the nasal dorsum and the nose tip at the same time, but because the artificial nasal bone is integrally formed, others can sense that the area between the radix and the nose tip looks very straight and fake after the rhinoplasty surgery. Therefore, we advocate the use of "I-shape" artificial nasal bone made of silica gel or Gortex to increase the height of the nasal dorsum.


STEP3 Sculpturing the nose tip



In general, consumers think that if autologous aural cartilages are used in the nose tip, it is considered the "Korean-style rhinoplasty." It is actually incorrect. The characteristics of the nose of oriental people are different from those of the Westerners, mainly due to the thicker skin soft tissue, weaker nasal bones and nasal cartilages, the insufficient length of the entire nose, and the larger nose tip (such as upturned nose and bulbous nose) of oriental people. Such differences resulted in the fact that the Westerners' approaches cannot be used in the nasal shape of oriental people. In the past, the open incision had to be used for the nose tip correction, but now it is completely possible to use closed incisions. During the operation, the surgeon separates the nasal septal cartilage and nose wing cartilage, correct them, suture the nasal cartilage and remove the excess cartilages and tissues, and, if necessary, perform cartilage transplantation. At the same time, use the autologous aural cartilage or hetero-rib cartilage as the materials for septal extension surgery so as to adjust the angle of the nose tip, increase the length of the nose, and even reduce the nose tip.


STEP4 Nasal bone osteotomy

The purpose of Nasal bone osteotomy is to reduce the width of the nasal bones and remove the nasal knots. The practice is to knock out the raised nose hump, and then knocks on both sides of the nasal bone to separate it from the maxilla bone before compressing it to reduce the width of the nasal bone.

The  nasal bone osteotomy technique has long been ignored in rhinoplasty surgeries  among oriental people. We used to think that the two small pieces of nasal  bones had no effect on the whole nose-sculpturing surgery. However, in terms of  nasal aesthetics, whether the nose is “3-dimensional” in the face or not  determines whether it looks good. For most oriental people the nose should be  long, the nose wing should not be too wide, the nose should look tall from the  side, and the one thing often overlooked is that the nasal bones also should  not be too wide, so that the nose will look “3-dimensional.” In terms of surveying,  the width of the nasal bones should not exceed the distance between the inner  edges of nasal angle of two eyes, otherwise, as with the nose wing being too  wide, the nose does not look delicate and smart enough. In the past, the idea  was that the oriental people had flat nasal bones, so simply padding up the  nasal dorsum will do. However, the fact is  that it will cause the nose being large and inappropriate, especially for  girls. In many cases, it is necessary to perform the nasal bone osteotomy to  narrow the width of the nasal bone to make the nose look “delicate”.
  
  

STEP5 Reduce the nose wing

A good-looking nostril looks like a dropping waterdrop shape from below. The approach of surgery also is to work toward this direction. In short, a bad-looking nostril most likely has some of the below problems:
        
  1. The nose wing is too wide: The width of the nose wing at front is greater than the distance between the nasal angle of the eyes. The solution is to remove the skin and tissues at the bottom of nose wing and reposition the muscle.
        
        
        
        

    Retracted nose wing

        
        
        

    Retracted nose wing that turns outwards

        
        
        

    Retracted nose wing that turns outwards and upwards

        
        
        
        
            
        
  2.     
  3. The nose is too rounded: It refers to the nose wing from underneath to form an ideal curvature. The solution is to remove the skin and tissues outside the nasal wing.
        
        
        

        

    Nose wing turning outwards

        
        
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  5. Sagging nose wing: It refers to not being able to see the nostrils from the side. If the nasal column cannot be seen, it is not necessarily due to sagging nose wing. It might be due to retracted nasal column which needs to be considered separately.
        
        
      
        

        

    Retracted nose wing

        
        

        

    Retracted nose wing that turns outwards

        
        

        

    Retracted nose wing that turns outwards and upwards

        
        
            
  6.     
  7. Retracted nostril: It refers to exposing too much nostril from the front side. However, exposing too much nostrils can also be due to the retracted nose tip, which is also called upturned nose. For upturned nose, as long as the nose is extended, the nose wing will follow. However, a simple retracted nose wing must be corrected with skin grafting surgery. The ultimate goal of nose wing surgery is to reduce the exposure of the nostrils, reduce the width of the nose wing and control the relative positions of the nose wing, nose tip and the nasal column, so as to create the perfect proportion for the nose-sculpturing surgery.

Dr. Yi-Sheng Kao Director | Plastic Surgery Aesthetic Clinic

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