The Simple Reduction Rhinoplasty
As a primary and revision rhinoplasty specialist, Dr. Randal Haworth of Beverly Hills excels with all types of complicated nose jobs, but sometimes it is a simple pleasure to be confronted with a classic reduction rhinoplasty. Though these are relatively simple in concept, all nosejobs (or rhinoplasties) must be handled with utmost care and dedication to excellence.
Why does a prospective patient consult with me requesting a nosejob?
Well, most come to me with the latter concerns such as: “Doc, my nose is just too big for my face”, “I always hated my hump”, “My tip is falling like a bird’s beak”, etc., etc.
Upon examination, the nose will usually manifest the aforementioned undesirable characteristics to varying degrees:
If this common checklist is mainly affirmative, then the patient will need a classic reduction rhinoplasty. In this surgery, the tip is made narrow with either tip grafts (composed of cartilage usually invisibly harvested from the patient’s own septum), strategic suturing or both. The nasal hump is either chiseled or filed down and finally the nasal bones are narrowed by delicately in-fracturing them (“breaking the bones”). If this latter maneuver is bypassed, then an”open roof” deformity may likely arise in which the nasal bridge will look artificially flat and wide itself. Therefore the nasal bones (which comprise the sidewalls of the nose) are carefully angled inwards towards the midline in order to close the open roof which resulted from the hump removal in the first place.
Check out this patient, who underwent a classic reduction rhinoplasty on the Swan.
Here is a typical example of a classic reduction rhinoplasty,even though only subtle changes were performed. Note that a radix graft (to raise the nasal frontal angle) was placed to add height and therefore elegance to her nose.
For a more general overview of rhinoplasty, go to: http://www.drhaworth.com/rhinoplasty/
Archive for January, 2012
The Radix Graft
This lesser known anatomic point of the nose is often purposely overlooked by rhinoplasty specialist surgeons because of the challenges it poses to those attempting to alter it. It is represented by the angle formed by the uppermost portion of the nose as it blends into the forehead proper. Yes, altering this area does have a subtle, yet profound influence upon the final appearance of a nose job- it can differentiate an excellent result from a “so-so” one. The surgeon can raise the radix so that the nose blends into the forehead at a higher latitude as well as softly elevate the natural valley that can exist at this are if it is too deep. Furthermore, one can deepen the radix if too much bone is present between the eyeball and the bridge on profile view.
The ideal position of the radix lies approximately at the latitude of the upper eyelash/upper eyelid crease. Beverly Hills plastic surgeon, Dr Randal Haworth can raise it by placing a precisely shaped softened cartilage graft (usually harvested from the nasal septum or ear) with beveled edges onto the bone of the radix area. Alternatively the radix or nasion can be rasped or chiseled with specialized delicate instruments to a lower, deeper position.
Why does raising a radix from a low position improve the final appearance of a nose? Well, imagine two noses which are identical in shape and forward projection except that one has a low radix while the other has a high one. The one with the low radix is shorter compared to the one with the high. Now imagine two men, both with the same 34 inch waist, but one is short while the other tall. Who appears fatter? The short person does, of course. This same optical illusion applies to the nose with a low radix-it appears as it projects further out from the face as compared with the one with the higher radix and not necessarily in an attractive way.
The following photos represent a beautiful result of a corner lip lift and concomitant rhinoplasty in which the radix was raised.
|Work here results in some extra swelling localized to the space between the eyebrows in the sense that it lasts a few days longer. Dr Haworth at the Haworth Institute has a few tricks up his sleeve to accelerate the resolution of the nasal swelling by injecting a dilute mix of Kenalog under the skin (and it is relatively painless) two weeks out. This “turbocharges” the swelling to go away!
Of course, the radix can also be augmented with a filler of some sort, such as fat, Radiesse, Juvederm, Aquamid and Artefill.
Tags: aquamid, artefill, beverly hills plastic surgeon, beverly hills revision rhinoplasty, beverly hills revision rhinoplasty specialist, beverly hills rhinoplasty, Beverly hills rhinoplasty specialist, corner lip lift, fat transfer, los angeles revision rhinoplasty, los angeles revision rhinoplasty specialist, Radiesse, radix graft
Posted in Artefil, plastic surgeon, Radiesse, Restylane/ Juvederm, silicone leakage, Uncategorized | January 17th, 2012 | No Comments »