Primary rhinoplasty refers to a first time rhinoplasty. What this means is that there is typically (but not always) less scar tissue and less distortion of the nasal anatomy. An exception to this can be noses that have sustained significant trauma in the past. In these cases, even though no surgery was performed, there may be significant distortion of the anatomy.
There can be a very wide range of anatomical differences among patients undergoing primary rhinoplasty, and the surgical challenge may be significant even though there is no pre-existing trauma.
Common Aesthetic Issues Addressed by Primary Rhinoplasty
Some of the most common aesthetic issues addressed by primary rhinoplasty include:
- Bump on the nose - This is one of the most common concerns of patients seeking rhinoplasty surgery. The bump a patient is referring to is a prominence of both bone and cartilage located on the bridge of the nose. It may be a mild deformity or a striking deformity in some individuals. It is treated by reducing the prominence with specialized nasal instruments until a pleasing contour is obtained. Because reduction of the bridge of the nose creates a wider appearance of the nose from the front view, narrowing of the nasal bones is typically performed at the same time to create a more refined look.
- Wide or bulky tip – Many patients are bothered by a wide or thickened nasal tip. The nasal tip is composed of the external skin, some subcutaneous fat, the ‘tip cartilages’ (lower lateral cartilages), and the internal lining skin of the nose. Depending on the patient’s unique anatomy, the correction of this problem might involve trimming of the cartilages, thinning of the fatty layer beneath the skin, or the use of specially placed sutures to reshape or reposition the cartilage.
- Wide nose – Another common concern is a nose that appears wide from the frontal view. Usually the tip is wide as well. Several different places in the bone may be weakened to allow repositioning of the bones to a narrower, more pleasing location.
- Excessively long nose – This is a common concern, particularly for those who have a prominent nasal bridge. Care must be taken to avoid over-shortening the nose, but a careful trim of the end of the septal cartilage will usually correct this problem. Occasionally, the internal lining of the nose or the tip cartilages may be modified to improve this situation.
- Wide or excessively large nostrils – In patients with this concern, an inconspicuous incision is placed at the junction of the nostril and lip where it is concealed within a naturally occurring fold in the skin. Depending on the design of the skin excision, the nostrils may either be narrowed, made smaller, or both.
- Snubbed or blunted tip – Patients may not always be as aware of this problem as they are of other aesthetic concerns. Rhinoplasty surgeons refer to this deformity as a tip with inadequate projection or definition. Adjustments of the tip as noted above may suffice to improve the appearance of the tip. However, frequently tip grafts of cartilage, harvested from the nasal septum, the ears, or even the rib in more difficult situations may be used to create a better defined nasal tip – one that also projects more away from the plane of the face.
Most patients benefit from the correction of one or more of the problems noted above. Again, each patient is unique, with a different anatomy, differing concerns, and differing ratios of skin, cartilage, and bone. Nonetheless, most can expect a distinct improvement in appearance following a primary rhinoplasty.
Fort Lauderdale plastic surgeon Dr. Jon Harrell also performs secondary rhinoplasty procedures, also called revision rhinoplasty, on patients who are not satisfied with the results they achieved in a prior rhinoplasty.
Please contact the Weston Center for Aesthetic Medicine and Surgery today to schedule your initial consultation. Dr. Jon Harrell serves patients in Weston, Fort Lauderdale, Miami, Plantation, and Davie, Florida.