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    Cosmetic Rhinoplasty Procedures: Projection Adjustment

    Cosmetic Rhinoplasty Procedures: Projection Adjustment

    Cosmetic Rhinoplasty Procedures: Projection Adjustment | Beverly HillsNose projection is the distance that it protrudes outward from the juncture where it connects the upper lip to its tip. If the tip protrudes excessively, it can have a significant impact on the overall appearance of the nose.

    Conversely, an under-projected nose appears too shallow and makes the nose appear too small in comparison to the other features of the face. A surgeon can trim away a portion of the cartilage at the nasal tip to reduce the projection of the nose.

     

    Key Points

    To increase the nose projection, the surgeon may separate and realign the cartilage. They will move it forward and suture into a desirable position. If there is insufficient cartilage in the nasal tip, the surgeon may use a cartilage graft to build it up.

    Board certified plastic surgeon Dr. Gary Motykie provides rhinoplasty to patients in Beverly Hills, West Hollywood, Los Angeles, and surrounding locations.

     

    Correcting an Over Projected Nose

    People who have over projected noses that are too protuberant from their face can consider corrective cosmetic surgery involving trimming away the nasal cartilage at the tip. In this procedure, the surgeon moves the nasal tip back to create a more desirable appearance. This is called nasal de-projection or retro-displacement.

     

    Treating an Under Projected Nose

    Re-projection of a nose which is under-projected involves lengthening the nose cartilage. There are two surgical approaches to achieve this depending on the nasal structure. One technique involves shaving the nose cartilage and suturing it up again to achieve a better nasal projection.

    The second technique involves the surgeon sourcing a cartilage graft from another part of the body where there is adequate cartilage availability to use it to enhance the nose projection. The cartilage graft is usually taken from the nasal septum in primary rhinoplasty. The cartilage can also be taken from the ears or the ribs as well, if necessary.

     

    Types of Cartilage Grafts

    The location and method of cartilage graft use determine whether columellar struts are used to provide support to the columella which divides the nostrils. There may be an inadequate availability of septum cartilage if the patient is undergoing revision rhinoplasty. The surgeon will typically take the bone from the rib cage for the cartilage graft in such cases.  

    The ear cartilage is believed to be advantageous in providing support to the nasal tip due to its elasticity. A common cartilage transplant from the ear will be denser compared to septum cartilage. But the results could be a nasal tip that feels more natural rather than one that is solid and rigid due to the elasticity.

    If the patient needs cartilage for the primary rhinoplasty plastic surgery, the surgeon may also consider costal or rib cartilage as a feasible option. Septal or ear cartilage is generally used for nasal tip refinement. But at times, rib cartilage may also be used.

     

    Considerations for Male Patients

    Men considering nose tip refinement surgery may have concerns about the nose looking too feminine after the procedure. However, a skilled and experienced plastic surgeon can preserve the masculinity of the nose while simultaneously enhancing the nose projection.

    A nose projection surgery can effectively enhance the nose shape while preserving its masculine attributes for men who not want to consider a full traditional rhinoplasty. Cosmetic surgeon Dr. Gary Motykie receives patients from Beverly Hills, West Hollywood, Los Angeles, and nearby areas for rhinoplasty.


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    Cosmetic Rhinoplasty Procedures: Tip Rotation and Reduction

    Cosmetic Rhinoplasty: Tip Rotation and Reduction | Beverly HillsThe lack of proper rotation in the nasal tip means that the tip either lacks definition or is overly defined. Rotation is the upward or downward turn of the tip of the nose.

    The surgeon will correct the nasal tip by cartilage reshaping. They will pay close attention to the nose base during this cosmetic surgery as it affects the tension and rotation.

    Board certified plastic surgeon Dr. Gary Motykie provides rhinoplasty to patients in Beverly Hills, West Hollywood, Los Angeles, and surrounding locations.

     

    What is Nose Tip Rhinoplasty?

    Any surgery performed on the lower third portion of the nose is known as nasal tip rhinoplasty. This is an intricate plastic surgery procedure. The nose surgeon should be highly-skilled and experienced and have an in-depth understanding of the nose structure and how the cartilage and other tissue impact the process of nose refinement.

    Nasal tip refinement is not necessarily a cosmetic surgery. In some cases, it may be a medical requirement. For example, sometimes the patient may have breathing problems because of an abnormally-shaped nasal tip either in their daily life or while sleeping (leading to breathing obstructions, and snoring among other issues).

    An abnormal nasal tip can also cause a sinus infection. At times, patients may experience speech impediments due to the abnormal shape of their nose tip.

     

    Need for Tip Refinement

    Patients seek tip refinement for multiple reasons. But it is typically undertaken to correct a fuller or “bulbous” nasal tip.

    Certain patients may be unhappy about their natural nose structure, especially patients with noses that droop at the tip, “hooked” noses, or upturned noses.

    A tip refinement surgery can impact the overall nasal and facial appearance. These procedures typically help develop a slimming look.

     

    Wide Tip Correction

    A wide or bulbous nose usually occurs due to a combination of large nasal domes that are spaced widely apart and thick nose skin. The nasal domes refer to the tip defining points of the tip cartilage. A thick ligament or fat separates the nasal domes in many cases.

    The nose surgeon will work on the soft tissue and shift the domes closer to address this condition. For patients with thick skin, the surgeon may place the graft on the nasal tip itself. This technique offers a better definition to the nasal tip.

    The nasal tip can be made narrow by shaving off or tweaking the cartilage structure underneath the skin as well.

     

    Less Invasive Procedure

    The nasal tip refinement surgery is much less invasive than a full nose reshaping procedure. A typical nose surgery involves significant modification of the inner nose structure. This may involve fracturing the bones of the nose which will increase the recovery period.

    However, tip refinement typically involves two to three incisions to allow the surgeon to access the underlying cartilage in that site. The surgeon will close the incisions after reshaping the nose. The recovery duration following tip refinement surgery is comparatively short.

    A tip refinement surgery can be a suitable alternative to a “complete” rhinoplasty surgery if it is appropriate for the patient’s unique anatomical requirements. Cosmetic surgeon Dr. Gary Motykie receives patients from Beverly Hills, West Hollywood, Los Angeles, and nearby areas for rhinoplasty.


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    Cosmetic Rhinoplasty Procedures: Straightening a Crooked Nose

    Cosmetic Rhinoplasty: Straightening a Crooked Nose | Beverly HillsIf the patient’s nose has moved to one side or is slightly crooked, they may consider a surgical procedure to straighten it.

    In this cosmetic surgery, the surgeon may reduce some cartilage or bone or physically move the tissue. In addition, they may also place a splint to hold the nose in position as it heals, similar to a fractured nose after functional rhinoplasty.

    The level of the crookedness of the nose depends on the underlying cause. Crooked noses are usually only an aesthetic concern. But, at times, it can cause breathing challenges. Board certified plastic surgeon Dr. Gary Motykie provides rhinoplasty to patients in Beverly Hills, West Hollywood, Los Angeles, and surrounding communities.

     

    Causes of a Crooked Nose

    There are two main types of crooked noses. The first type occurs because of an issue within the intricate cartilage, bone, and tissue system of the nose. This can happen due to the following reasons:

    • Birth defects
    • Severe infections
    • Injuries, such as a fractured nose
    • Tumors
    • Nose surgery

    The reason will determine if the crooked nose will be I, C, or S-shaped.

    The other type of nose crookedness occurs due to a deviated septum. The septum is the internal wall that divides the left and right nasal passageways. If the patient has a deviated septum, this wall leans to one side which partially blocks the nose. Certain people have a deviated septum since birth while others develop if following an injury.

    A deviated septum can cause the nose to look crooked. It can also lead to the following conditions:

    • Loud breathing
    • Issues sleeping on one side
    • Nosebleeds

    The patient should consult a qualified surgeon to determine the reason for their crooked nose. This can help identify the most suitable treatment option for them.

     

    Surgical Treatment

    While dermal fillers may help straighten a slightly crooked nose, more severe cases will usually require plastic surgery. Rhinoplasty plastic surgery aims to treat the cosmetic issues of the nose. On the other hand, septoplasty straightens the wall the divides the inside of the nose into two parts.

    Rhinoplasty

    The two types of rhinoplasty are cosmetic rhinoplasty and functional rhinoplasty. The only focus of cosmetic rhinoplasty is correcting the appearance of the nose. In comparison, functional rhinoplasty helps address breathing problems.

    According to a 2015 study, rhinoplasty can successfully straighten crooked noses in patients with or without facial symmetry regardless of the technique used. Facial symmetry is the similar appearance of both halves of the face.

    Septoplasty

    Septoplasty reshapes the wall between the nasal passages, effectively straightening the nose. If the patient has a crooked nose due to a deviated septum, the surgeon will likely recommend them to undergo septoplasty. This surgery can straighten the nose while relieving nasal passageway obstructions because of a deviated septum.

     

    The Bottom Line

    A crooked nose commonly occurs due to a past injury or a deviated septum. Around 80 percent of people have some form of a deviated septum. The patient should choose an appropriate treatment if their crooked nose is leading to breathing issues or significant cosmetic problems.

    Cosmetic surgeon Dr. Gary Motykie receives patients from Beverly Hills, West Hollywood, Los Angeles, and nearby areas for rhinoplasty.


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    Cosmetic Rhinoplasty Procedures: Correcting The Radix

    Cosmetic Rhinoplasty Procedures: Correcting The Radix | Beverly HillsSome patients may undergo dorsal hump or bump reduction as part of rhinoplasty cosmetic surgery. This condition also has a variation which causes the illusion of a significant bump, known as the pseudo-hump or low radix.

    The radix is the upper bony part of the nose. Both the radix and underlying cartilage may be substantial creating the appearance of a bump. If the radix is shallow, it can cause a depression and a bump. The cosmetic surgeon can reduce the size of the radix by carefully trimming away small portions.

     

    Seeking that Natural Look

    The surgeon may add volume to a depressed area of the nose by sourcing the patient’s cartilage from another nasal site. Augmenting the space right above the radix allows the surgeon to create a straighter slope. Proper radix management is vital to give the nose a natural appearance.

    Board certified plastic surgeon Dr. Gary Motykie provides rhinoplasty to patients in Beverly Hills, West Hollywood, Los Angeles, and surrounding locations.

     

    Pseudo-Hump

    In case the patient has a pseudo-hump, it means that the radix is not adequately developed and is under-projecting. This leads to a facial profile where the tissue beneath the radix (towards the tip of the nose) seems even more bulbous and fuller than it really is. If the radix bone does not project the overlying soft tissue properly, it causes the appearance of a pseudo-hump.

     

    Correcting an Underdeveloped and Low Radix

    The most appropriate treatment for an under-projecting radix is nose plastic surgery with radix tissue grafting. A radix graft can consist of cartilage, fascia, or other soft tissue. It is typically a sculpted cartilage piece, usually taken from the septum. The surgeon places this graft beneath the skin and muscle of the radix where it stays hidden.

    The placement of the cartilage graft over the bone where it raises the depressed soft tissue addresses the deficit in the bony structure. This procedure creates a much straighter profile without the requirement to remove any bone or cartilage beneath the radix.

     

    Can you have Weak Radix and a True Hump?

    A patient can have both an under-developed radix and a true hump. The benefit of treating these issues together is that the surgeon can undertake a more conservative hump removal.

    They will bring the ideal profile line closer to the hump through raising the position of the radix. As a result, the surgeon will have to eliminate a lesser portion of the hump to develop a straighter profile.

    The result of this procedure also looks less “surgical” and more natural because of a stronger nasal starting point.

     

    Correcting Radix as Part of Revision Rhinoplasty

    The height of the radix is the angle between the frontal and nasal bones of the nose. For balanced and harmonious outcomes, this height should be proportionate to the dorsal height, length, and tip proportionate.

    If the radix remains too high, or the graft used during the procedure is too substantial, the nose will have a Romanesque appearance after the surgery. In revision rhinoplasty, the surgeon reduces the radix to its correct and most harmonious proportions in comparison to other nasal aspects and facial features.

    Cosmetic surgeon Dr. Gary Motykie receives patients from Beverly Hills, West Hollywood, Los Angeles, and nearby areas for rhinoplasty.

     

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