No-implant revision rhinoplasty for an unnatural, operated-looking nose

Hello.

I am Dr. Peter C. Kang, medical director.

Today, I would like to talk about what it means to look "natural."

When looking at this type of nose, it is certainly not an unattractive nose. However, it does not look natural. It has an obvious, operated-looking appearance, feeling somewhat excessively high. Of course, there are many people who suit this style well or prefer this shape. However, a significant number of people prefer a look that appears less operated. This is the essence of "natural" that we are discussing today.

• "The radix is too high."

• "The nasal bridge line is too sharp and defined."

• "The implant looks too obvious."

• "The nasal tip is too pointed."

• "The nostrils are too long and asymmetric."

• "My eyes look close-set."

These were the concerns the patient shared with me during the preoperative design consultation. Every observation was correct. The patient wished to tone down the overly dramatic appearance.

• We decided to remove the nasal bridge implant and lower the radix (no-implant approach).

• The plan was designed to slightly reduce the nasal tip height and thereby decrease the vertical height of the nostrils.

• We planned to soften the area where the nasal bridge appeared unnaturally narrow as much as possible.

• The awkward angle at the columella would be smoothed out.

• The overall plan was to lower the height and improve the excessively elongated appearance.

Let us compare how the nose changed immediately after surgery on day 0. Immediate postoperative photos show swelling and may differ from the final result.

The radix between the eyebrows was lowered naturally, and the awkward angle at the columella was eliminated. The elongated appearance of the nose was improved.

Overall, the nose appears slightly smaller.

The sharply defined contour of the implant along the bridge was significantly softened, and as the radix was lowered, the shadows on both sides of the glabella were reduced.

The excessively long nostrils and the rightward tilt of the columella were corrected.

Basal (nostril) view immediately after surgery (Day 0)Immediate postoperative photos show swelling and may differ from the final result.

This is a question I continually contemplate as a surgeon. In particular, dramatic and natural styles are highly sensitive to trends. When a dramatic nose goes out of style, natural noses become the trend, and as time passes, the opposite shape often becomes popular again.

However, performing many surgeries shows that dramatic noses suit some individuals well, while for others they do not. Because personal satisfaction is paramount, I perform surgery according to what patients desire, but a nose shape that does not harmonize with one's features rarely feels satisfying over time. It is always regrettable when patients undergo revision rhinoplasty on a nose that had no structural issues simply because the style did not suit them.

Therefore, while it is very good to bring reference photos of the shape you like and desire, I recommend consulting thoroughly with a specialist to determine whether that shape truly harmonizes with your facial features, taking your surgeon's professional opinion into account before deciding.

Today, we explored the differences between dramatic and natural nose shapes.

This was Dr. Peter C. Kang. Thank you.