Published: Oct. 30, 2008
Updated: Apr. 26, 2012
In this DukeHealth.org podcast, Dr. Jeffrey Marcus tells us all about rhinoplasty, also known as nose surgery.
Listen to this podcast (requires iTunes)
This is Dr. Jeff Marcus for Duke University. We’re talking today about rhinoplasty.
What is rhinoplasty? Rhinoplasty is surgery of the nose. Plastic surgeons see patients seeking changes in the nose for both aesthetic reasons as well as functional reasons. Many patients have both.
Rhinoplasty is a marriage of both form and function, as are other things that we deal with in medicine and in dentistry.
For example, the teeth serve an important function. A beautiful smile is an important aesthetic trait, but the teeth also allow you to chew.
The nose has important functional attributes as well. The nose allows you to breathe.
From an aesthetic standpoint, it’s an important part of your anatomy. It stands at the forefront of your face. It’s something that people see immediately when they see you. It’s very prominent.
The importance of nasal breathing cannot be overemphasized either, though. Ease in breathing allows you comfort while you are sleeping and allows you comfort while you exercise.
Aesthetics play a role in rhinoplasty. Many patients come to visit seeking a change in their nose to enhance their beauty. Some patients see plastic surgeons to address functional problems, breathing problems. And many patients have both functional and aesthetic problems that they wish to have treated.
From a functional standpoint, there are a number of parts of the anatomy that are important for the nose. One that you hear quite often is the septum.
What is the septum? The septum is a sheet of cartilage that separates the right and left sides of the nose. There are two sides to the nasal airway, both right and left. If the septum leans one way, or bends one way or the other, that’s called septal deviation. Septal deviation can cause problems breathing on either side.
Septoplasty is a common procedure that is done to straighten the septum so that it is easier to breathe through the nose.
Another part of the anatomy that is important are the turbinates. The turbinates are outpouches of mucosa that are found on both sides of the nose. They periodically increase in size, first on one side and then the other. You may notice that when you turn to one side or lay on one side versus the other, the obstruction that you feel on one side goes away. That’s the turbinates at work. Its periodic swelling and that’s normal. Sometimes patients have enlarged turbinates, which is a chronic condition that doesn’t get better with position.
Finally, the nasal airway is affected simply by its size on either side. Some patients have a narrow space on one or both sides. That space can be increased on either side. You may be familiar with athletes who wear adhesive strips on the nose. This dilates the middle of the nose so that it’s easier to breathe.
There are procedures that can be done to improve your breathing depending on what the cause is.
From an aesthetic standpoint there are many concerns a patient might have with the appearance of their nose. The key for a plastic surgeon is to figure out what patients want, what is it that they are looking for, what might be right for them.
A factor that plays in here is a patient’s ethnicity. Different patients with different ethnic backgrounds can have different attributes. Some patients would like to have some of those attributes enhanced or changed. Nowadays it’s less frequent that patients would like to absolutely change their nose and change their ethnicity. They like the way they look – they just want to look a little better: To decrease certain features, or to enhance certain features. There’s a lot of difference between rhinoplasty now and what people may have heard or been familiar with back in the 1970s and 1980s. Today people are seeking natural changes, more people want to retain their look, their ethnicity.
This doesn’t remove the surgeon entirely from the process. It’s not only about what the patient wants, but also about what’s realistic, what can be done for them. A surgeon can help guide a patient to know what would fit for them, what would work for them. Are the changes that they want realistic? Or are they unrealistic?
What kinds of concerns do patients often have from a cosmetic standpoint?
There are a number, and it does depend on the individual. Some common things that people ask about are problems with their nasal tip – either they have a bulbous tip that looks too large or too round, or it looks somewhat boxy. Some patients feel that their nose just generally looks too big.
When patients have a general concern, we try to help them pinpoint which areas they specifically like or don’t like.
A bump on the nose is sometimes referred to as a dorsal hump. This is one of the most common things plastic surgeons continue to see and its one of the most straightforward things to correct.
Sometimes patients have asymmetry. Asymmetry can affect the tip, asymmetry can affect the dorsal line – the line running down the nose – making it look like the nose twists. Sometimes patients can have asymmetry as the result of trauma, but often it’s simply the way someone is. Everyone has a certain degree of asymmetry.
For patients seeking aesthetic corrections, or who have problems with nasal function or both, they can visit with us at Duke Plastic Surgery. Procedures that are performed to correct these problems are done at the Duke Aesthetics Center. The Duke Aesthetics Center is a private facility located nearby Duke University. Privacy is paramount to us, particularly in cosmetic surgery. Our faculty at Duke are all present within the Aesthetic Center, including, and most importantly, board-certified anesthesiologists.
Nowadays, concerns regarding safety are most important. Patients should consider not only the surgeon, but also the facilities in which they work and the staff with which they work.
For more information about rhinoplasty, to correct aesthetic or functional problems, you may contact my office at 919-668-3110, or visit www.dukehealth.org.
This is Dr. Jeffrey Marcus for Duke Plastic Surgery.