Nose Surgery (Rhinoplasty)

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Nose Reshaping (Nose Job), or Rhinoplasty surgery, is one of the most commonly performed cosmetic plastic surgery procedures by Dr Miroshnik. When it comes to rhinoplasty surgery, keeping the nose looking un-operated on and natural looking is absolutely paramount in achieving the best result. A key point in this, is paying close attention to the shape of the nose in relation to the other facial features such as the chin, forehead and cheeks.

Often, the structure or size of the nose is not proportionate with the other features on the face. Nose reshaping procedures can help to correct the disproportionate appearance of the nose by altering the size or shape of the nose, the nasal tip, the span of the nostrils, or the angle between the nose and the upper lip.

Successful modern rhinoplasty surgery needs to be customised to the individual. It is imperative that the shape of the new nose is in balance with the other key areas of the face such as the chin, forehead and cheeks. During a consultation, Dr Miroshnik, will use computer morphing technology to show what changes in nasal structure are beneficial in bringing out the best of your facial features.

There are two basic forms of nose reshaping surgery – Open Rhinoplasty and Closed Rhinoplasty. In open rhinoplasty, the nasal skin is lifted off the nasal skeleton to allow for more exposure of the cartilages and bones of the nose. Closed rhinoplasty, on the other hand, involves internal incisions only and the skin of the nose stays in position during the entire procedure. Each of these procedures is described in more detail below.

Recovery Milestones

  • Performed as day surgery, where you can go home from the hospital the same day
  • Minimum 2 weeks off work
  • For 7-10 days you will wear a nasal splint to protect the nose


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Aesthetic Ideals by Dr M

Aesthetic Ideals by Dr M

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aesthetic-ideals

The best rhinoplasty surgery involves creating a very natural and un-operated look to not just the nose but the entire face. To this end, Dr Miroshnik works with a set of aesthetic ideals to match up your nasal profile with the rest of your facial features.

During your consultation, Dr Miroshnik will guide you with what type of results can be achieved with surgery by using a computer morphing simulation. 

Techniques for Nose Surgery (Rhinoplasty)

Open Nose Surgery

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This type of nose reshaping surgery involves small internal incisions and an additional, tiny external incision on the underside of the nose, across the columella. This allows the skin of the nose to be lifted away from the internal framework allowing for greater control over any internal modifications, especially of the nose tip. Recovery time is usually a little longer than that for a closed rhinoplasty.

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Introduction Nose reshaping, or rhinoplasty, is one of the most common plastic surgery procedures performed today. Often, the structure or size of the nose is not proportionate with the other features on the face. Nose reshaping procedures can help to correct the disproportionate appearance of the nose by altering the size or shape of the nose, the span of the nostrils, or the angle between the nose and the upper lip. In addition, nose reshaping procedures may be performed to correct a nasal birth defect or injury as well as chronic breathing problems.
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Nasal Anatomy Before you learn how nose reshaping procedures work, it is important that you understand the anatomy of the nose. The framework of the nose is primarily made of bone and cartilage. The upper portion of the nose is supported by bone. Dorsal humps, which are areas of built up cartilage or bone, can form along the dorsum, or ridge of the nose. The lower portion of the nose is supported by different plates of cartilage that extend laterally from the centre of the nose, determining the shape and appearance of the nasal tip.
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How a Closed Rhinoplasty Works During an open rhinoplasty procedure, Dr Miroshnik makes small incisions across the columella and inside each nostril. In contrast to a closed rhinoplasty, these incisions allow him to lift the skin away from the bone and cartilage of the nose. In doing so, Dr Miroshnik can clearly examine the nasal framework and make precise adjustments to its shape and structure. Using very small instruments, he will reshape the nose by removing or adding bone, cartilage, or tissue to achieve the desired appearance.

Due to the greater access and direct view that is obtained by open rhinoplasty, it is the preferred choice for nasal surgery if complex tip reshaping is required.
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Surgery Preparation An open rhinoplasty procedure may last approximately two to four hours. Prior to the start of your procedure, the treatment area will be cleansed and an anesthesia will be administered. Dr Miroshnik may occasionally choose to administer a local anaesthetic and a sedative, in which the nose and surrounding areas are numb and you are in a relaxed state during the procedure. However, usually the procedure is performed with general anaesthesia in which you are asleep.
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Incisions To begin the procedure, Dr Miroshnik will generally make two incisions. A small incision is made across the columella, which is the tissue that lies between the nostrils at the base of the nose.

Using a retractor to expose the inside of your nose, he will then make a second incision, known as a marginal incision, which extends from the columella incision into each nostril. With a pair of surgical scissors, Dr Miroshnik will carefully dissect the skin along the columella incision to begin lifting the skin away from the underlying framework.
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Lifting the Skin Using surgical scissors and a series of retractors, Dr Miroshnik continues to carefully dissect the skin away from the underlying cartilage. The skin is also dissected away from the nasal bone, in order to fully expose the framework of the nose.

This allows Dr Miroshnik to make precise adjustments to its shape.
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Reshaping the Tip of the Nose An open rhinoplasty often best allows alteration to the shape of the tip of the nose. In patients whose nasal tip is wide or bulbous, Dr Miroshnik may choose to remove a portion of the alar cartilage from the tip of the nose. Depending on your anatomy and the extent of treatment necessary, he may choose to use sutures to bend or pull the alar cartilages inward to create a narrower tip or adjust its position.
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Removing the Dorsal Hump One of the primary goals of nose reshaping is often to reduce the appearance of a dorsal hump. The dorsal hump usually consists primarily of cartilage and some bone. In order to remove the dorsal hump, Dr Miroshnik may choose to use an osteotome, which is a chisel-like device used to cut bone. Alternatively, the hump may be removed using a series of fine surgical nasal rasps.

Here the animation shows an osteotome carving away areas of cartilage and bone. Following the removal of the dorsal hump, your nose will usually have what is known as an 'open roof', which is an open space between the nasal bones. Dr Miroshnik may use a fine surgical rasp to smooth the ridges of the nasal bones before performing additional osteotomies to reposition the nasal bones and close the open roof.
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Osteotomy An osteotomy involves breaking the nasal bones in order to reposition them. Although it is not always necessary, an osteotomy can be performed to correct a high nasal dorsum with a dorsal hump, close an open roof after the removal of a dorsal hump, or create a narrower base of the nose.

Using an osteotome, Dr Miroshnik will carefully create breaks in the nasal bones by tapping the device gently along a designated path. Once broken, the nasal bones are shifted upward to close the open roof.
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Incision Closure Once Dr Miroshnik has finished reshaping the nose, the incisions inside the nose will be closed with dissolvable stitches. He may place nasal airway splints inside your nostrils that provide support and stabilise the nose as it heals. Steri-strips will be applied to the outside of your nose. If the nasal bones were manipulated during the procedure, a nasal splint will be applied as well. The bandages and splint help the tissues heal and conform to the new cartilage and bone structure.
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Recovery As with any surgical procedure, you will likely experience some pain, bruising, and swelling, particularly in the upper portion of your face and around your eyes. These symptoms will begin to dissipate within the first few days following surgery.

The nasal splint usually stays in place for approximately seven days. Although the majority of the swelling will subside within a few weeks, some minor swelling may persist for a few months.

In general, recovery time and residual swelling is a little longer for open rhinoplasty procedures when compared to closed.
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Nose Reshaping Results Depending on your rate of recovery, the bruising will begin to fade and you will be able to return to work within seven to ten days following your procedure. As you begin to heal and the swelling in your face subsides, you will start to notice the effects of your nose reshaping procedure. However, like other surgical procedures, the final results may continue to evolve for up to one year.

By adjusting the proportion and profile of your nose, nose reshaping can help to significantly enhance your self-confidence and appearance.
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Closed Nose Surgery

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This type of nose reshaping surgery involves small internal incisions only, so there are NO visible scars at the end of the procedure. Skin is not lifted away from the framework of the nose and the recovery time is shorter than an open rhinoplasty. As the nose tip is not visualised at all, it is less suitable for those that need any nose tip refinement or complex shape changes.

image description
Introduction Nose reshaping, or rhinoplasty, is one of the most common plastic surgery procedures performed today. Often, the structure or size of the nose is not proportionate with the other features on the face. Nose reshaping procedures can help to correct the disproportionate appearance of the nose by altering the size or shape of the nose, the span of the nostrils, or the angle between the nose and the upper lip. In addition, nose reshaping procedures may be performed to correct a nasal birth defect or injury as well as chronic breathing problems.
image description
Nasal Anatomy Before you learn how nose reshaping procedures work, it is important that you understand the anatomy of the nose. The framework of the nose is primarily made of bone and cartilage. The upper portion of the nose is supported by bone. 'Dorsal humps', which are areas of built up cartilage or bone, can form along the dorsum, or ridge of the nose. The lower portion of the nose is supported by different plates of cartilage that extend laterally from the centre of the nose, determining the shape and appearance of the nasal tip.
image description
How a Closed Rhinoplasty Works During a closed rhinoplasty procedure, Dr Miroshnik makes small incisions inside the nostrils to gain access to the bone and cartilage. In contrast to an open rhinoplasty, the skin is not lifted away from the framework of the nose.

Using very small instruments, Dr Miroshnik will reshape the nose by removing or adding bone, cartilage, and tissue to achieve the desired appearance.

If only minimal nasal tip reshaping is required, then a closed rhinoplasty is often the procedure of choice for nasal surgery due to its shorter recovery time.
image description
Surgery Preparation A closed rhinoplasty procedure may last approximately two hours. Prior to the start of your procedure, the treatment area will be cleansed and an anaesthetic will be administered. Dr Miroshnik may occasionally choose to administer a local anaesthetic and a sedative, in which the nose and surrounding areas are numb and you are in a relaxed state during the procedure. However, usually the procedure is performed with general anaesthesia in which you are asleep.
image description
Reshaping the Tip of the Nose To begin the procedure, Dr Miroshnik will generally make two small incisions inside each nostril in order to gain access to the cartilage and bone. In patients whose nasal tip is wide or bulbous, Dr Miroshnik may choose to remove a portion of the alar cartilage from the tip of the nose. Depending on your anatomy and the extent of treatment necessary, he may choose to use sutures to bend or pull the alar cartilages inward to create a narrower tip or adjust its position.
image description
Removing the Dorsal Hump One of the primary goals of nose reshaping is often to reduce the appearance of a dorsal hump. The dorsal hump usually consists primarily of cartilage and some bone. In order to remove the dorsal hump, Dr Miroshnik may choose to use an osteotome, which is a chisel-like device used to cut bone. Alternatively, the hump may be removed using a series of fine surgical nasal rasps.

Here the animation shows an osteotome carving away areas of cartilage and bone. Following the removal of the dorsal hump, your nose will usually have what is known as an 'open roof', which is an open space between the nasal bones. Dr Miroshnik may use a fine surgical rasp to smooth the ridges of the nasal bones before performing additional osteotomies to reposition the nasal bones and close the 'open roof'.
image description
Osteotomy An osteotomy involves breaking the nasal bones in order to reposition them. Although it is not always necessary, an osteotomy can be performed to correct a high nasal dorsum with a dorsal hump, close an open roof after the removal of a dorsal hump, or create a narrower base of the nose.

Using an osteotome, Dr Miroshnik will carefully create breaks in the nasal bones by tapping the device gently along a designated path. Once broken, the nasal bones are shifted upward to close the open roof.
image description
Incision Closure Once Dr Miroshnik has finished reshaping the nose, the incisions inside the nose will be closed with dissolvable stitches. He may place nasal airway splints inside your nostrils that provide support and stabilise the nose as it heals.

Steri-strips will be applied to the outside of your nose. If the nasal bones were manipulated during the procedure, a nasal splint will be applied as well. The bandages and splint help the tissues heal and conform to the new cartilage and bone structure.
image description
Nose Reshaping Recovery As with any surgical procedure, you will likely experience some pain, bruising, and swelling, particularly in the upper portion of your face and around your eyes. These symptoms will begin to dissipate within the first few days following surgery.

The nasal splint usually stays in place for approximately seven days. Although the majority of the swelling will subside within a few weeks, some minor swelling may persist for a few months.
image description
Nose Reshaping Results Depending on your rate of recovery, the bruising will begin to fade and you will be able to return to work within seven to ten days following your procedure. As you begin to heal and the swelling in your face subsides, you will start to notice the effects of your nose reshaping procedure. However, like other surgical procedures, the final results may continue to evolve for up to one year.

By adjusting the proportion and profile of your nose, nose reshaping can help to significantly enhance your self-confidence and appearance.
BACK TO TOP