Cosmetic Surgery and Beauty Magazine #68

nose
Anatomy & Function
There’s a good reason rhinoplasty is often referred to as
the most intricate of facial surgeries. An intricate network
of bones, cartilage, cells, blood vessels, nerves and skin,
rhinoplasty needs to not only improve the appearance of
the nose, but also maintain or improve upon its function.
Different parts work together to filter the air that then enters
the lungs, and to send messages to the brain to enable the
sense of smell.
The nose can be divided into two main parts – the
external and the cavity. A ‘wall’ called the nasal septum
divides these sections vertically.
‘External’ refers to the actual structure of the nose,
comprising bone, cartilage and tissue. At the very top
of the nose, two nasal bones link the nose to the frontal
bone of the forehead. These bones form the ‘bridge’ of the
nose, or dorsum. The lower part of the external structure is
made up of cartilage and tissue, which give shape to the
nose. The nasal bones give way to septal cartilage, which
forms the dividing wall of the nose. Further down, major alar
cartilage runs from the tip to either side of the nose, forming
the nostrils.
The internal structure of the nose centres around the
nasal cavity, which can be thought of as a tunnel with an
opening on the face and an opening at the top of the throat.
The nasal septum divides the cavity vertically. The upper
part of the nasal cavity is lined by the olfactory epithelium,
which contains receptor cells that detect odours and enable
the sense of smell.
Three small bones called turbinates protrude into the
nasal cavity on either side, which help to maintain the
temperature, humidification and filtration of the air as it
passes through the nostrils. The lungs need to be supplied
with air that is around 35 degrees centigrade and 95 percent
humidity, and therefore the nose is structured to not only
receive the air but also to warm and filter it prior to entering
the lungs.
Often, the type of surgery selected will come down to
the preference of the surgeon. Where some prefer open
surgery because it unveils the underlying structure of the
nose, others prefer the closed approach because it offers
better ability to judge the final shape and contour of the
nose. This is because there are no external incisions
compromising the appearance of the nose.
The closed technique offers surgeons considerable
freedom to reshape the nose. Bone and cartilage can both
be removed using this technique or in some cases taken
from other parts of the body and used to better shape and
support the nose.
However, despite offering plenty of scope to address
minor modifications, the main disadvantage of the closed
technique is its limited use. Although suitable for reshaping
the contours of the nose, complex cases cannot be tackled
as effectively with closed rhinoplasty.
Relatively recently, non-surgical techniques have also
been adopted in order to correct minor irregularities in the
nose, allowing suitable candidates to alter their appearance
without having to undergo surgery.
Already known for their ability to ease the appearance
of wrinkles, fillers are increasingly being used to refine facial
contours. Indeed, nasal irregularities can be corrected
using either temporary or long-lasting dermal fillers, allowing
suitable patients to alter their appearance without the need
for surgery.
Non-surgical rhinoplasty can correct minor external
nasal deformities, depressions, asymmetries, collapsed
nasal bridges and saddle noses. It can also be an effective
technique for making corrections post-surgery where the
results of earlier rhinoplasty have been unsatisfactory.
A relatively quick procedure, non-surgical rhinoplasty
requires no anaesthesia and involves minimal downtime.
Most fillers will leave residual redness and slight tenderness
for up to a few days and patients can expect slight swelling
and bruising.he results are immediately evident and can last
up to a year in some patients.
Recently, non-surgical
techniques have been adopted
in order to help correct minor
irregularities in the nose
Sometimes, surgeons are called on to address
complications from earlier rhinoplasty procedures.
Considered one of the most difficult forms of cosmetic
surgery to perform, revision rhinoplasty, or ‘secondary’
rhinoplasty, involves the correction of previous cosmetic
procedures.
Despite the best efforts of any skilled surgeon, revision
rhinoplasty is necessary in five to 12 per cent of rhinoplasty
cases. Whilst some may require only minor adjustments,
others may need major modification, and may be a result of
too much or too little bone, cartilage or tissue having been
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