Rhinoplasty for small nose can mean a lot of things. Does the patient want to augment the bridge of his/her nose? Or does he/she want to correct the upturned tip, a feature that can make the nose appear too short or small in relation to the face?
To achieve results that will satisfy the patient long term, leading Los Angeles plastic surgeon Dr. Tarick Smiley highlights the importance of candid discussion with a rhinoplastic surgeon.
Dr. Smiley says the right candidate for rhinoplasty, or nose job in layman’s term, is someone who can explain his/her goals in detail, adding that vague or generalized description is a big no-no for this surgery in which the success or failure is determined by a few millimeters.
To further shed light on the issues involving rhinoplasty for small nose, the renowned plastic surgeon explains the two most common goals of patients.
- Augment the dorsum or bridge
Some ethnic patients ask for rhinoplasty augmentation to make their nose appear more proportionate to their face. The goal is to create results that are ethnically consistent with the face and so over-augmentation must be avoided.
To augment the dorsum, most surgeons prefer autologous cartilage graft, meaning the patient’s own tissue is used instead of synthetic materials such as silicone or silastic. Possible “sources” include the nose itself, ear, hips, and ribs.
Patients having their primary rhinoplasty (no previous nose surgery) and are only seeking for a conservative amount of augmentation are generally good candidates for autologous cartilage graft, therefore avoiding the potential risks that come with artificial implants.
- Correct the over-rotated [upturned] nose
Sometimes referred to as Miss Piggy (in reference to the Muppet character), an overly rotated or upturned nose can make it appear too short for the face. Some people have this as an inherited feature, while in some cases it occurs from trauma or a botched nose surgery.
To correct the short and over-rotated appearance, the most important thing is to create a strong support to the tip, allowing it to maintain its counter-rotated position.
Because the tip requires significant reinforcement, most surgeons use septal cartilage, which is collected from the nose itself. Rib cartilage is also a good option to create a strong support and to lengthen “visible” wall of tissue between the nostrils. Ear cartilage, meanwhile, is rarely used in this surgical maneuver due to its insufficient strength.