Rhinoplasty, or a nose job, is an operation undertaken to change the shape of the nose. This can include parts like the nose bridge or nose tip (nasal tip). A rhinoplasty is performed for functional or cosmetic reasons.
When done for aesthetic or cosmetic reasons, the procedure can be done either as a closed rhinoplasty procedure or open rhinoplasty procedure. In Singapore, it is important that plastic surgeons are experienced in asian rhinoplasty to understand the intricacies and differences of the asian nose for the patient.
In this article however, we’ll be discussing more on nose surgery for functional reasons.
What is a septorhinoplasty?Functional nose surgery rhinoplasty (septorhinoplasty) is performed to improve the patient’s breathing passage. A septorhinoplasty is usually necessary when the nasal valves are narrow and need correction, or if the nose is crooked and affects breathing.
What is the difference between a rhinoplasty and septorhinoplasty?
It is important to note that the line between functional and cosmetic surgery is often blurred. A personal belief of mine is that a good nose surgery can and should always improve both the aesthetics and function for the patient. I often get requests from patients to improve their nose both functionally and cosmetically.
Undergoing rhinoplasty can be a big decision for many patients. If you are considering a nose job for cosmetic or functional purposes in Singapore, always consult your surgeon for his views and recommendations on what can be the best outcome for you.
See Book Chapter published by Dr. Dennis Chua on “Correcting the Post-traumatic Nasal Deformities Facial Plastic Surgery (Thieme)” June 2015
First off, the doctor/surgeon will examine all aspects of the patient’s nose from all angles to identify and understand any issues that require attention. The doctor will then communicate the problems identified and discuss the options available.
A rhinoplasty is usually performed under general anaesthesia. Nose Surgery (rhinoplasty) can be performed either via an open approach (which includes making a small incision on the lowest part of the nose) or via an endonasal approach (closed rhinoplasty) approach, which is scarless. Dr. Dennis Chua is proficient in both techniques and can advise you accordingly.
Refer to videos on the right.
See publication on alar batten grafts to help improve breathing in functional rhinoplasty (refer to 3rd video on the right)
Generally, the tiny scar on the nose from an open rhinoplasty approach if closed correctly should be barely visible after a few months.
Picture of a transcolumellar incision bare visible at 6 months after surgery.
This depends on the type of rhinoplasty needed. If a lot of cartilage is needed to strengthen the support structure, ear cartilage is harvested from a scar hidden at the back of the ear. This does not change the shape or appearance of the ear.
Rib cartilage is used if a larger amount is needed. Cartilage from the rib is typically harvested from the sixth or seventh rib. Occasionally, if more cartilage is needed, the eighth or ninth rib is chosen.
A concern of many female patients is that a scar will be left on the chest when harvesting cartilage from the ribs. Generally, the incision for harvesting can be made at the inframammary fold to reduce scar deformity.
From a doctor’s standpoint, there are several factors to take into consideration.This patient must be in good health and come with realistic expectations of what the outcome of the procedure will give them. I encourage patients to have a healthy understanding of themselves and the problems that they are experiencing, and often advise a balance between appearance and function.
From an aesthetic point of view, I believe in a balance and harmony of the features on the face. The purpose of the surgery can and should help improve this balance in the features while bringing an improvement to the patient’s breathing ability.
Functional septorhinoplasty is considered a medically indicated procedure and is generally covered by insurance. However, there is no insurance for rhinoplasty performed purely for cosmetic purposes.
After the procedure, there will be brown tapes placed over the nose for a week. After the tapes are removed, the nose will still be swollen though usually not very obvious. If osteotomies were done to refracture the nose for realignment, there will be a little bruising over the nose or eyes during the first 10 days.
Most patients will experience pain in the nose and face after the surgery, but it is generally well tolerated. Analgesic medication may be prescribed to manage the discomfort experienced.
Patients may also experienced puffiness in their face, most commonly on the first day after the surgery. Most of the face swelling will subside in the early weeks, while nasal swelling will take six months to fully dissipate.
Dr Dennis Chua is one of the few International Board Certified Facial Plastic Surgeon that can perform rhinoplasty with great expertise. He is also part of the International Consensus on Functional and Aesthetic Rhinoplasty that discusses the latest guidelines on rhinoplasty.
Rhinoplasty, especially in Asia, is commonly known to be one of the most difficult surgical procedures. Approaching the right surgeon or specialist with adequate training and rich experience can be the deciding factor in the final result of the surgery.
Dr Dennis Chua is invited several times a year to share his experience on rhinoplasty and has also published several book chapters and articles on rhinoplasty.
"Scarless” Endonasal Rhinoplasty
Open Approach Rhinoplasty
Alar batten grafts used to improve breathing in rhinoplasty
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