Rhinoplasty is one of the most intricate plastic surgery procedures, requiring great skill and precision. Various techniques can be employed to correct a wide range of issues, from a rounded, bumpy tip to flared nostrils or a crooked nose bridge.

In this article New Jersey rhinoplasty surgeons Gary D. Breslow, MD and Jordan P. Farkas MD discuss some of the most common aesthetic concerns that can be addressed through this transformative procedure.

Tip Plasty: Fixing a Bulbous Nose Tip

A bulbous nose tip can appear bulging, rounded, and misshapen. This is caused by excess tissue in the lower lateral cartilage of the nose. Plastic surgery can easily correct this, bringing the tip back into proportion and giving it a more triangular shape that gently blends into the bridge.

There are several techniques that can be used to improve the appearance of a bulbous nose. In some cases the reshaping can be performed through surgical stitching: permanent sutures are inserted throughout the area to narrow and bring together the lower lateral cartilages, thus shaping the tip of the nose.

Another common technique is known as the cephalic trim maneuver: the protruding cartilage on the part of the nose facing the head is trimmed or removed to refine the nasal tip.

Cartilage grafts have also been known to produce outstanding results in some patients. Cartilage taken from the septum, rib, or elsewhere is placed under the bottom of the nose in order to reshape the tip, making the rounded contour straighter on each side.

Crooked Nose Surgery

A crooked nose can be caused by your genetic background or an injury, including facial trauma during birth. At times the distortion appears during the teenage years as the result of a growth imbalance, causing the cartilage and bones to pull the nose towards one side.

Rhinoplasty can correct aspects of the nose that are misshapen or out of proportion, producing a more pleasant, symmetrical look.

Straightening a crooked nose is one of the most difficult procedures, and usually involves resetting the nasal bones through osteotomies. An osteotomy is a surgical procedure in which a bone is cut or otherwise altered and reshaped — this is what many people refer to as “breaking the nose” during an operation. Septoplasty, a corrective surgical procedure to straighten the nasal septum (the part between the nasal cavities) may also be required.

In some cases, spreader grafts are placed in the middle third of the nose to even out the inward-sinking side or provide support on either side of the septum.

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Nose Bump Removal

A bump on the nose, or “dorsal hump”, can result from either your family history or an injury.

Patients with a pronounced bump on the nose typically want to improve their profile. Some may want to level out the nose completely to make the nose completely straight, while others may leave some fullness to the bridge to reflect ethnic or family traits. Straightening the bump can remove a distraction from the face, and draw more attention to your eyes or other features.

Depending on the size of the hump, it may be treatable without an osteotomy, or surgery to cut bones. If the hump is less than 1-2 millimeters, treatments may only require local anaesthesia, and focus on filling the bone and shaving or rasping cartilage.

If the bump is due to a depression in the profile between the eyes, called the radix of the nose, a small graft of cartilage can be used to elevate the depression and eliminate it. If the bump was caused by an injury to the bottom third of the nose, the septum can be raised and/or a cartilage graft put in place to improve the profile.

Osteotomy is generally necessary when the hump is over 1-2 millimeters. This involves general anesthesia and traditional rhinoplasty surgery.

Fixing Large, Flared Nostrils

While some find their nostrils to be too narrrow, others judge their own to be too wide; plastic surgery provides solutions for all to achieve a more harmonious, attractive look.

Large nostrils may come about from having a wide nasal base, or due to a bulbous nose tip. There are several other factors that can come into play, such as the patient’s ethnic background. These should be taken into consideration, as some may want to preserve certain aspects to celebrate and reflect their unique heritage.

In some cases several techniques are employed, especially if adjustments must be made to the shape of other areas of the nose. Other times, simply removing tissue from the area between the nostril and the column of the nose will be enough. This technique is valuable because there is next to no visible scarring.

If the nostrils are not only wide but pointed outward, incisions on the base of the nostrils can bring them closer to the nose and reduce their width. Additional incisions can also be used in cases of excessive width to close the gap and bring the nostrils closer to the face.

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Reshaping a Wide Nose

This type of nose which is flat or broad — especially across the bridge — is more common in certain ethnic groups, especially among those of Hispanic, African, or Asian descent.

Nose reshaping surgery for a flat or wide bridge usually involves elevating the soft tissues of the nose to access the tip cartilages, which are then shaped and sutured into the desired form. If the wideness is located closer to the midline, an osteotomy, or surgery to alter the bone structure, will probably be necessary. This is typically a more demanding procedure.

These rhinoplasty techniques are highly specialized — a personalized approach that combines several approaches often produces the best results.

Our board-certified plastic surgeons are recognized throughout New Jersey for their years of experience and outstanding results. Contact them for a private nose job consultation today!