Rhinoplasty (nose surgery; also commonly known as 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). The nose surgery be performed for functional reasons or as a cosmetic surgery.
When done for aesthetic or cosmetic reasons, the plastic surgery 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 that focuses more on improving function of the nose instead of plastic surgery.
Functional nose surgery rhinoplasty (septorhinoplasty) is performed to improve the breathing passage of the patient. These are usually necessary when the nasal valves are narrow and need correction. If there is a crooked nose affecting the nasal passage, this can also be corrected at the same time.
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. It is also a common request from the patient to seek both functional breathing and cosmetic improvements.
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, both from the inside and outside to identify and understand any issues and problems that need to be attended to. Armed with this information, the doctor should then proceed to discuss the problems identified and discuss the options available with his patients.
This is usually performed under general anaesthesia. Nose Surgery (rhinoplasty) can be performed via an open approach (which includes a small scar on the lowest part of the nose) or via an endonasal approach (closed rhinoplasty or scarless) approach. 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 even if the surgery is performed via an open rhinoplasty approach, the scar on the nose 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.
If a larger amount is needed, sometimes rib cartilage can be used from the chest for this reason. 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.
There are several factors considered for a rhinoplasty procedure, from a doctor’s standpoint. 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.
For functional septorhinoplasty, these are medically indicated procedures and are generally covered by insurance. For purely cosmetic rhinoplasty costs in Singapore, there will be generally no coverage on the insurance costs.
There will usually be brown tapes over the nose for 1 week after the procedure. 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 after the surgery in the nose and face area, but is generally well tolerated. Analgesic medication may be prescribed to manage the discomfort experienced.
Patients may also have a puffy feeling their face, most commonly on the first day after the surgery. Most of the swelling involved subsides in the early weeks, though swelling over the nose will take months to fully dissipate. Nasal tip swelling will take 6 months to resolve, though the swelling tends to be minor and unnoticeable by others.
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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