Rhinoplasty: Reshaping Perceptions One Nose at a Time

👃 Dive deep into the world of rhinoplasty with Dr. Kristy Hamilton and Dr. Roy Kim on The Beauty Scientists! From cosmetic transformations to functional enhancements, discover all you need to know about nose reshaping! 💫 Get insider tips on patient consultation, recovery timelines, and surgical techniques! 

🔍 Don't miss out on the secrets to a stunning nose! Tune in now! 🎧

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Transcript

0:10

Welcome to The Beauty Scientists I'm Doctor Kristy Hamilton board certified plastic surgeon here with my colleague and other board certified plastic surgeon Doctor Roy Kim how are you doing today Doctor Kim? I'm good how are you doing? great we're excited about our next episode so this one is Rhinoplasty reshaping perceptions one nose at a time the Rhinoplasty comes from the term rhino meaning nose and plastic meaning to shape or to mold so we're going to literally be discussing different ways to shape or mold the nose both surgically and non surgically and it's it's one of the older operations in plastic surgery and what I love about Rhinoplasty surgery is that it covers both cosmetic as well as functional a component so meaning the breathing aspect of the nose so it's not only beauty we also has to work well and so we're gonna discuss what Rhinoplasty is what it looks like in consultation and how we analyze the nose surgery itself and recovery at all the considerations you should be thinking about if you're pursuing this operation sometime in the future so Doctor Kim what does that typical Rhinoplasty look for you? what are the different techniques that you might use? and can you go over on a basic level just surgical versus non surgical what that might look like and who might benefit from one versus the other? I think the most patients really think of either size or shape or both so to be a candidate for non surgical Rhinoplasty it is difficult to make a large nose a lot smaller we can actually mask it or camouflage and make it look a little smoother and we can affect the shape non surgically but maybe not that much not as much as surgery so that's what really patients think about as well as sometimes patients have a hard time noticing their profile in other words they know that the bump of their nose or the overall profile or their chin nose and forehead profile bothers them but they can really only see that if someone takes a photo of the side of their head so it's important to educate patients on looking at the front of the face an angled view of the face but something that's sort of impossible for a human being to look at the side of their face and that's how I really approach how patients think about their nose holistically look at it in the middle of their face or not and we go from there so I I agree and and the way that I um approach the the topics of surgical versus non surgical with my patients is the non surgical you really can get a refinement on the nose that you already have um and specifically I think there's three components of it I was like if you have a little bump a little one you can camouflage that if your nose is slightly downward pointing you can camouflage that and then if you want a little bit more tip refinement you can create that um but at the end of the day you we can't transform your nose non surgically but we can make it more pleasing and maybe more harmonious with the rest of your face we truly need a transformation big big hump we really want to make it significantly smaller at the tip for example then we really ought to consider um surgical approaches and that for me is performed under general anesthesia um I mainly do open Rhinoplasty which means a little incision here um in the center of the nose this part's called the columella unless I'm doing a more subtle refinement than you can do it closed with only incisions on the inside of the nose and those are the basic components when we're doing surgical Rhinoplasty we of course wanna consider the cosmetic cosmetic elements whether the most important components um to the patient whether it's like shaving down the bridge narrowing the nose creating a smaller lifted tip maybe narrowing the nostrils um and also consider do they have a deviated septum um do they have airway issues you wanna make sure that the nose is both beautiful and also functions for the patient um so Doctor Kim when you're analyzing the nose the patient comes in during the consultation um how do you analyze it um what questions do you ask the patient there are a lot of questions because as you know it's a very holistic approach first thing is literally your medical or surgical history in other words we need to know have you had trauma you have a history of allergies you have sinus issues and more because Rhinoplasty as you mention is functional as well as cosmetic then of course just like our mentor Doctor Rohrich says they're usually three major things that I think patients want with their nose we as plastic surgeons may notice two things or 10 things or whatever but patients typically have three major things and we have to address those three major things finally um patients may not fully realize that but we know this there are issues with the bone there's issues with the cartilage there's issues with the upper middle and lower portions of the nose there are issues with what you want the tip to look like as well as multiple angles how do you want your nose to look at like from the front from an angle from the side and we have to take all of that into consideration so it's pretty complicated because there are a lot of questions and a lot of anatomic structures we need to think about to give the best results so how do you approach it I completely agree I think we want we wanna know everything about um the nose anything that might have happened trauma like you said it's really important anything that would impact breathing um so ask similar questions from that component I think the top asking the top three so there's so many elements I mean it's like a 20 step like physical exam analysis of the nose for us to look at it but you know we may see things that the patients like never noticed and doesn't really bother them so really getting in the mind of the patient and asking them what their major concerns are as important and then I also like um and I like this more for the profile than for the center but I like to do a little bit of photo editing too cause most people want you know if there's a bomb most people want that gone but then there's like degrees of rotation of the tip and I call it like some paces I want they want like a little bit more of a modern straighter nose then there's like the little bit of a ski slope and then there's full on Disney Princess getting most of my patients probably want something in the middle but it's helpful to do a little bit of um you know Photoshop um or similar software so that they can see that on their own face and that gives me a sense of um putting into you know an image these descriptions that there that they're giving us um and then we'll also talk about nostril position too especially if we're making a nose smaller or setting it back that can lead to some rounding of the nostrils we wanna make sure that we address those at the end of the operation to do you do you do any um imaging or photo editing yes I do use Photoshop as you do and also I ask patients for inspiration photos which really helps guide me in other words is a patient being realistic do they want a realistic nose they want a really really refined tip if so it just depends on the patient yes and they and they love sharing um filtered photos too and I like those as well cause I think if it's a conservative filter I think that's very realistic cause something that's achievable um and if they have a very cartoonish outlandish filter then maybe we need to sit down and talk about that a little bit more make sure that we're on the same page and everything about plastic surgery and aesthetics is ensuring that we're delivering what the patient wants and so that's why we really wanna get into their mindset so what's the best way if you're a patient having Rhinoplasty how would you prepare for surgery itself anything you would do or anything you would avoid I think the big things are sort of 90% of all surgery in other words get your room ready make sure that you're not taking anything that thins out your blood such as aspirin or other blood thinners or anti blood clot medications get clearance from your doctor if needed the other thing is to make sure that you as a patient are prepared to do anything and everything to reduce swelling because as plastic surgeons we know that the nose stays swollen for up to year sometimes longer with revision cases patients with thicker skin sometimes you can't see the tip as well until all the swelling is gone and yes as plastic surgeons we always say this and tell patients this however I think that patients don't fully realize we're literally saying this it's on the informed consent and patients still ask me like a month later hey I don't see the tip that well or I don't see a lot of difference I do see a difference but it's not as maximal as I wanted it depends on your body it depends on your ethnicity it depends on what was done and we just need to get rid of the swelling yes and we see that swelling come down top to bottom and where everyone wants to see it the most is at the tip typically and that takes the longest of all so they give you pull plastic surgeons across the board they're gonna tell you surgical healing for the nose takes a year even a year and a half you keep on seeing refinements and changes coming in so obviously there'll be a big difference a lot to see um in those early weeks and months but you're really not gonna see that the the true sculptural aspect of the nose until closer to a year and so patients patience is key and I completely agree with you it's just like with body liposuction or anything else the faster we can get that swelling down the happier the patient's gonna be um the less scar tissue that's gonna form we wanna make sure that we um mitigate that so I agree afterwards I think we're doing all the swelling management um think we both like to tape the noses but cast on and splints where appropriate I counsel speeches especially if we're gonna break the nose bones they make it those little raccoon eyes afterwards with some some bruising and some swelling and we do you give medications and surgery to help keep that bruising and swelling to a minimum head of bed elevations really important and a little bit of patience in that first week and I think patients feel like they've had a really bad sinus headache those first three or four days and then when we get the splints out of the nose take off the cast and they actually see the nose too um a week later then we're typically feeling a lot better at that point do you have any plastic surgery secrets for smooth recovery um I guess the other secret is patients need to understand that the outside of the nose is swollen so is the inside so we both know this Doctor Hamilton it's just that patients don't fully realise again the inside of the nose is swollen it may be hard to breathe you shouldn't really blow your nose really hard after surgery you wanna gently clean it and that seems to heal up a little faster the swelling goes down more quickly but for the first week or so after surgery it may be difficult to actually fully breathe through your nose because of that swelling and anything to help reduce the internal swelling the mucosal swelling is also definitely recommended one of the one of the changes I added in my practice the last few years was I continued to tape the noses afterwards I used to take everything off take the cast off the splints out and off they go now I like to tape them for a couple weeks after surgery or as long as the patient will tolerate and I think of it as like a little compression garment for the nose we can't put we can't put someone in a full full face compression soup but we can um do some taping so I think it's similar to why after body liposuction we put people in compression garments I like to do that for the nose too and I think that's that's helped I just wish I agree and I just wish I could have all of my Rhinoplasty patients wear some sort of tape or compression for a month or 2 or 3 months after their surgery is sort of impossible because the nose is in the middle of your face that's the issue yeah yeah I had a couple patients that they kind of they they they almost like viewed it as like a it was like a badge of honor like cool that they got their nose done and so they they like they wore their tape for like six or eight weeks after surgery and I really like they had so much less swelling than some other patients so I think uh I think I think it does help and then moving on to our next topic which is just like risks and consideration so um of course we know choose a board certified plastic surgeon choose someone who does rhinoplasties and then also make sure that there's someone that does your kind of Rhinoplasty one thing we haven't talked about is like there's all different kinds there's various kinds of like ethnic Rhinoplasty Asian noses African American noses Persian noses Turkish noses like Caucasian noses and there's within those categories which are very very broad so so many um unique considerations for each nose I think that's really important to make sure that your your surgeon is familiar with the type of Rhinoplasty you might need what do you think I totally agree and essentially if you have a bump on your nose that's great but what's the bump made out of how big is it how wide is it you want to refine it likewise some certain ethnicities and even in some patients your nose is little flat here at the Dorsum you wanna build it up well how much do you wanna build it up how do you wanna build it up do you have extra cartilage around so it's not just the technical and dirty details that we both like it's also something that's congruent with your overall face in your ethnicity there's also a difference between men and women obviously women typically can get away with a more narrow nose it's okay for men to have a slightly more prominent nose um maybe even a slight bump on their profile or more prominent profile and even a slightly wider nose at the base so all those things are very important considerations for your choice of plastic surgeon as well as what you want as your final result and of course it's always best you know if you can get everything done or virtually everything that you want on the first try because revision Rhinoplasty is a completely different topic and can be difficult to do yeah every time you have to go back and do revisional surgery it's harder um you're working through scar tissue everything's more difficult um and then you you never quite know what you're gonna encounter so when I'm doing revision Rhinoplasty I always have extra material available the patients consented for cartilage graft maybe off the shelf graft because you just you just don't know what you're gonna find um even if you have the operative report so you have to be prepared for that um so ideally choose your surgeon wisely um so you can get your nose right the first time absolutely um and then one of one of I actually I really like this topic too um just the psychological impact of Rhinoplasty I feel like obviously there's a big psychological impact with any plastic surgery whether it's like breast augmentation for body confidence or facelifting to feel like you know as youthful on the outside as you're on the inside what you notice about your Rhinoplasty patients in terms of like how they feel emotionally after surgery? I think we both know the most important thing is to pick patients properly as well as pick the correct treatment plan and we've already told patients hey pick your Rhinoplasty surgeon pretty carefully as well the nose is in the middle of your face our eyes as humans are drawn into the middle of the face really the triangle of your eyes your mouth and the nose which is in between so it's so important to have a nose again that's holistically in proportion to your face that is aesthetically pleasing in towards the size with profile tip rotation everything to your face so the psychological component of just having a more straight nose the ability to breathe better as well as the tip that you always wanted I mean that's very very powerful patients love it and since it's on their face they see it all the time I also think that the flip side is also true where if you have a patient who may be a little OCD if you have two as a 2 plastic surgeon or even the average person a minor discrepancy but if you're really fixating on that the problem or issue is since you're always looking at your face in the mirror once in a while you may fix on it a little fixated on on that really minor thing a little too much for your overall mental health so it's important to patients to really you know really focus on it might be a little OCD about this or can I live with like a 1 millimeter offset and as long as patients understand that hey everybody's asymmetric plastic surgeons can explain that in detail I think that's really the key to having a happy overall result I agree and I think it means your point exactly this is not even your body which is generally covered in clothing like a normal day to day going on this is your nose right in front of your face um one of the things I love is doing a Rhinoplasty reveal at the one week visit when they come back and get all the sutures out and all the the cast off and I mean patients like well they'll cry like happy tears all the time it's like it's very powerful um moment and there's all sorts of thoughts I hear like like patients would be like it's me but like it's different like I like I still look like myself but like but I also look like a different person and especially depending on how significant the transformation is sometimes even that can be a little bit drying like they may have gotten exactly the nose that they wanted but it's like can be just a lot to wrap your head around when you look in the mirror and you see someone that you know doesn't look the same anymore so I think it's I agree with you 100% on like are there emotionally prepared they're mentally prepared psychologically prepared not just um physically prepared alone um from a health perspective to undergo the operation um but I think it's it's a wonderful surgery and I love to perform it any any final thoughts Doctor Kim you'd like to add on this topic on this topic uh not really any final thoughts just to let the viewers and listeners know this is sort of a large picture introduction to Rhinoplasty we haven't even gone into the nerdy details about how to do a lot of this the procedure as well as even the general principles of okay you have a prominent profile what exactly does that mean um you have a wide tip what we call a bulbous tip exactly how do you refine it things of that nature where we can probably do another discussion about this and just to have the patients aware that hey if you as a patient sort of have a game plan of 2 3 things that you want done that's great because you can work with your plastic surgeon come up with the best treatment plan for you and definitely choose your Rhinoplasty surgeon very very carefully so let us know um subscribe to the the podcast leave comments um if you want us to talk about kind of the traditional reductive Rhinoplasty and how we do that versus more of like an augmentation Rhinoplasty for which we often do Asian African American noses all different kinds just let us know in the comments we'll be watching and as always stay beautiful great discussion is always Doctor Hamilton and definitely stay beautiful patient selection and just making sure that people