Nose surgery, perform or not perform

Besides the eyes, the nose is one of the most distinctive features of the human face and in addition to its obvious physiologic function, noses are used also to recognize people and even more interesting, associate a persona to a ethnic group or even a country.

It’s not unusual to hear phrases like “my boyfriend’s Greek nose” or “the distinctive nose of Italian people” and considering how important the nose is not only for our own identity but also because of its ethnic, cultural and symbolic significance, deciding between performing a surgery or not sometimes is not an easy task since it can be difficult to meet patient’s expectations and furthermore, avoid complications.

There are also several clinical conditions requiring special attention including patients with nasal obstruction, septum deviation or improper nose shape (deformities) who should receive nose surgery, technically called rhinoplasty, regardless of (low to moderate) risk and cosmetic implications.

In such cases, it’s usual to perform such procedures with a combined specialist surgical team including not only a plastic surgeon but an otorhinolaryngologist too. Combined efforts will take care of aesthetic concerns including bone and cartilage reshaping while also making sure the nose functions properly.

But when there’s no medical condition to justify a rhinoplasty, things may be a little more complicated because the real reason to operate on a patient becomes less evident.

Well … the first reason could be how happy the patient feels with her/his nose! Yes, it may be a little subjective but despite proportions, measurements and many other features that may be perfect, if a patient does not feel happy with the shape or the size of his/her nose, that’s enough to perform a rhinoplasty, however as Dr. Jan Garcia says “it’s mandatory to set realistic expectations”.

On this regard it’s frequent to hear requirements such as “I’d love to have the nose of (celeb name)” or “I’d be so happy with my mother’s nose shape!”

The first thing to do in such situations is to clearly explain why such a nose shape or size fits patient’s face and in addition, it’s also necessary to talk about how such a nose would look like on the patient’s face. For this purpose, simulation software using 3D reconstructions can be a valuable tool.

Such software may be used on those cases were the nose seems to be too small or too big for the patient’s face bone structure or when there are alignment issues. Using simulations, both patient and surgeon may anticipate to the result and decide what is the best approach.

If the process is completed properly, patients’ expectations are met and the surgery performed according to a depurate technique can achieve final results that tend to be highly satisfactory, hence it’s mandatory to dedicate as much time as required to the preoperative preparation. This way there will not be any surprises after the surgery and all results are desirable.