Consider the purpose and limitations of the surgery.
Nose shape, it affects the impression as likely to eyes. It locates the center of your face and higher than other parts of the face, it is easy to change personal image with changing shape of nose bridge and tip.
When you think about rhinoplasty, normally you imagine the surgery which make higher nose bridge and change the blunt nose to be sharp. There are various rhinoplasties which are for bent nose, hooked nose, arrow nose, but changing nose shape surgery is the most common.
It is needed to divide the procedure for the nose bridge and nose tip. Mostly, doctors operate the nose tip first and then operate nose bridge according to the height of the nose tip. It is easy to adjust the nose bridge, but the nose tip is not easy to adjust like the nose bridge.
Dr. Jung-Hyoek Choi, the director of Apgujeong Seoul Plastic Surgery, explained, “The nose tip has relatively poor skin due to sebum, etc., is hard, and has many restrictions because it is greatly affected by gravity. Thus, the height of the nose bridge is decided according to the height of the nose tip.”
The certain way to make the nose bridge and tip higher is using silicone implant. However, the nose tip is not good enough condition to use silicone implant. So, it is better to use autologous cartilage.
There are 3 cartilages, nasal septal cartilage, ear-cartilage, costal cartilage which can use for the nose tip. Nasal septal cartilage is the most common one because it is thin and flat and relatively elastic and hard, so it is suitable to serve as a support for higher nose tip. It has additional benefit that it can get during rhinoplasty naturally. There is no additional incision for cartilage.
Ear-cartilage is soft and curved, so it is not suitable for the nose tip, but when you want to gain additional height, it can be used by adding it to the end of the nose tip.
Costal cartilage is the last one to use for rhinoplasty when you spent nasal septal cartilage and ear—cartilage already or the nasal septal cartilage is too small to use for the surgery. It is very hard, the nose tends to become stiff after surgery, and if you use donated costal cartilage instead of autologous one, it has a high probability of being absorbed into autologous tissue. Also, it leaves a scar on the chest.
For the nose bridge, an implant of an appropriate height and design is required. Since autologous cartilage is not easy to mold, there is a limit to designing it as desired, so artificial implants, especially silicone implants, are often used to elevate the nose bridge.
The silicone implant is easy to design as desired, does not change shape or absorb as time goes by. It retains its shape well and is relatively easy to replace in any issue. Occasionally, Gore-Tex, which is soft to the touch and has a natural surgical result, is used, but it may decrease slightly as time goes by and has the disadvantage of being difficult to remove during re-operation, according to Dr. Choi, for this reason, silicone implants are the trend.
The beautiful dorsal line of the nose comes from the well-balanced design and height of the nose bridge and the nose tip. However, the size, the shape and skin thickness of the nose are different for each person, even if the same implant is performed in the same method, the success of the surgery may vary by person. Therefore, it is better to select the implant that is most suitable for you and undergo surgery by an experienced plastic surgeon. Above all, the nose is a very important part not only cosmetically but also functionally it is important to clarify the purpose for which you want to undergo surgery and to judge the limitations of surgery before undergoing blind surgery.
Dr. Choi emphasized, “As important as choosing the material used for rhinoplasty is, it is also important to set the purpose of the surgery and determine its limitations. I think it is necessary to decide how much you want your nose high or what part you want to correct additionally. when that decision is made, it is necessary to consider whether it can be corrected surgically and how much whether it can be corrected surgically and how much effect can be seen.