Would you like to improve your nose by giving it a more desirable shape? Do you find your nose to be too short or long, lacking a nasal bridge, or too wide? There is a solution to help you improve your profile.
What Makes Dr. BYUN’s Rhinoplasty Approach Different?
World famous plastic surgeon Dr. BYUN, an architect of beauty, is an expert in hiding all incisions and sutures. In most cases, all incisions are made inside of the nose and along the nasal area. Dr. BYUN can use your own cartilage for projection and height. Often times, a reduction/addition of the tip in height and projection will make your face more balanced. The corrected tip will be more proportionately appealing. Dr. BYUN also uses a personalized approach, which means your rhinoplasty will be specific to you, addressing your detailed concerns and solutions. Dr. BYUN’s rhinoplasty technique varies and depends on the anatomy, as well as the patients’ goal. A good rhinoplasty is when the nose becomes part of your face. Your new nose should disappear into your pretty face.
Open Versus Closed Rhinoplasty
Rhinoplasties are one of the most complex procedures that plastic surgeons perform. It improves the position of oversized, crooked, or asymmetrical noses, and refines specific features of the nose like the nasal bridge, nostrils, or tip.Plastic surgeons can perform a rhinoplasty two different ways: the open technique and the closed technique. Though the open and closed approaches are similar, they differ in how the surgeon accesses and exposes the nasal framework (e.g., the bone and cartilage of the nose). This important distinction affects the ease of the procedure and the quality of the result. Each approach has its own set of advantages and drawbacks.
To help you become more informed about the available rhinoplasty options, Dr. Michael BYUN breaks down the differences between open rhinoplasty and closed rhinoplasty here.
Open technique rhinoplasty is performed through a small incision across the columella, the strip of skin separating the nostrils. The nasal skin is carefully separated from the underlying bone and cartilage before making the necessary surgical modifications. Visible scarring across the columella is possible with open rhinoplasty. However, as long as the incision is precisely planned, and the patient takes good care of the incision, and the incision heals well, scarring across the columella should fade significantly over time. Once the scar has completely healed, it should be barely visible. The biggest benefit to an open rhinoplasty pertains to the surgery itself. An open technique allows great visibility and access to the structures of the nose that need to be reshaped.
Closed technique rhinoplasty is performed through incisions created within the nostrils. No part of the incisions can be seen externally. Because the incisions offer less exposure and access to the underlying bone and cartilage, closed rhinoplasties require a particularly experienced plastic surgeon with a specific skill set. As stated earlier, there are no visible scars from closed rhinoplasty because the incisions are hidden within the nostrils. In addition to no visible scarring, closed rhinoplasties can result in slightly less swelling after surgery than open rhinoplasty. These are also a few of the reasons why skilled plastic surgeon Dr. BYUN almost always performs a closed technique rhinoplasty.
Whether you undergo an open or closed rhinoplasty, it is important that you feel completely confident in the expertise and skill of your surgeon. You can rest assured that you are in good hands with Dr. BYUN. Recognized as one of the leading plastic surgeons in Chicago, Dr. BYUN is extremely talented and respected. He would be happy to explain your rhinoplasty options during an in-person consultation. Contact our plastic surgery practice to request a private consultation.
Rhinoplasty Procedure Details
We have provided a sample copy of an Operative Report. The procedure is subject to change per the patients needs.
Patient Case Study
PREOPERATIVE DIAGNOSIS: Nasal Asymmetry
POSTOPERATIVE DIAGNOSIS: Nasal Asymmetry
OPERATION: Rhinoplasty, infracture of the nasal bone through a silicone augmentation and the spreader graft, the lower lateral cartilage through the intranasal closed technique.
INDICATION: The patient is ___ year old male who once to improve the nasal features. He has a slightly bulbous tip with a low dorsum and then a wide spreading nasal bone.
After induction of local anesthesia in a supine position, the patient was prepped and draped in the usual sterile fashion. 5 ml of 1% Lidocaine with epinephrine was injected to the area and a throat pack and nasal pack were utilized. Intracartilaginous incision was made bilaterally intranasally where the subperiosteal dissection was done along the nasal bone. Using the Converse scissors, the tip of the nose was also dissected retrograde from the incision where the customized soft silicone was inserted to the dorsum of the nose. The strut was also intruduced in between the medical crura of the lower lateral cartilage where 1.5 cm with the 0.5 small strut was insterted to give him better projection. Infractures were done bilaterally using the 3 mm osteotome with the fenestrated technique and the ostectomy was performed with good hemostasis obtained. The nasal symmetry was good where the supratip and infratip break angle was acceptable with good increase in height which balances his face well and this was closer to the size that we discussed prior to the surgery. The incision was closed using 4-0 Vicryl. Good hemostasis was obtained. Aquaplast was applied to stabilize the infracture. He was extubated and transferred to the Recovery Room in good standing.
Gauze packing in the nose can be removed after 24 hours by gently pulling it out, unless instructed differently by Dr. BYUN. Avoid hanging your head forward. Do not remove any cast or tape on the surgical area. These will be removed by Dr. BYUN at your post operative check up. Cleanse any uncovered incisions 3-4 times a day using clean gauze soaked in saline water. (found at your local pharmacy). If you do not have a cast and only bandages covering your nose then it is acceptable to get your face wet, but avoid doing so if possible. If there is a cast, do not allow the cast to get wet.
You must not blow your nose for two weeks. You may gently clean just inside the nostril with a moist Q-tip and saline water. If you have to sneeze, do so with your mouth open. Bruising alone the lower eye area is expected and is normal. Do not wear eye glasses or sun glasses until after receiving permission from Dr. Byun. Failure to adhere to this precaution may result in adverse effects following surgery.
What Is The Recovery Time For Rhinoplasty?
Many sutures inside the nasal are dissolvable. Some sutures will be taken out during your one week follow up. You may endure some swelling, which will decrease 100% in 4-6 weeks. You will experience some redness, bruising, and minimal pain for about 8-10 days. Although, you may return to work 2 weeks following the date of the procedure.
Am I a Candidate for a Rhinoplasty?
Rhinoplasty may be right for you if you are dissatisfied with the appearance of your nose, have a realistic expectation of what modern surgical techniques can do, and are excited to share your vision in a close collaborative partnership with your doctor. Dr. BYUN knows that achieving a beautiful, satisfying result requires listening closely to the patient, and matching expectations with outcomes.
What Can a Rhinoplasty Change?
Rhinoplasty is effective at addressing a wide range of cosmetic concerns and medical issues. The profile of your nose can be changed dramatically by making it smaller, larger, narrower, more symmetrical, or simply more aesthetically pleasing. The tip and nostrils can also be resized. Conditions such as a deviated septum, injury or problems breathing through nasal passages can also be addressed. Sometimes the most noticeable change results from a subtle surgical modification. That is why extraordinary skill and a meticulous attention to detail are essential traits in any plastic surgeon performing rhinoplasty.
Is a Rhinoplasty the Same For Male and Female Patients?
In general, men seek a more prominent nose, and women a smaller and more refined version. Some of this has to do with basic anatomy. Women’s features and bone structure provide the skeletal context for a petite nose. The prominent chins and more expansive facial dimensions of men make a longer, larger nose feel at home. Male noses tend to feature higher bridges, larger nostrils and thicker skin. Female noses typically have a delicate slope from the bridge and a slightly greater upward angle at the end.
These are characteristics that patients usually want to enhance, rather than reverse. For example, men may want to highlight straight, sleek lines, while female patients routinely prefer to accentuate naturally graceful arcs and inclines, along with a subtle upturn of the tip.
When it comes to the actual surgical procedure, these gender differences are mostly irrelevant. The thicker skin of the male nose slightly affects healing, but surgical techniques are the same for men and women.
What Other Variables Need to be Considered for a Rhinoplasty?
Very thin skin is not well suited to hiding the underlying structure of the nose; grafts and changes to the bone may be visible. Conversely, very thick skin may not be sufficiently elastic to conform to the sleeker profile of a smaller nose. If you have had a rhinoplasty before, the earlier reshaping of cartilage and bone, along with the accumulation of scar tissue, will make the surgery more challenging.
Age is also a factor. Physiologically, surgeons are able to perform successful rhinoplasties on males around the age of 16 and older, and females by about age 15. Psychologically, it is prudent to wait longer to allow time for greater emotional maturity. In cases of medical necessity, however, a procedure to address a serious functional impairment should be performed as soon as practical, whatever the age of the patient.
At the other end of the age spectrum, changes in skin, cartilage and even the way your body heals are correlated with aging, and are complicating variables to consider. By age 60, optimal rhinoplasty outcomes are more difficult to achieve. The ideal age for the procedure ranges from the late teens through the early 30s.
Should I Consider Rhinoplasty Revision?
Patients who had a disappointing experience with rhinoplasty often turn to Dr. BYUN to achieve the desired aesthetic result. The first step in the revision process is to wait until swelling has subsided. This will require several months. Only then will you be able to observe the final result, as inflammation distorts the appearance of your nose and surrounding tissue. Tissue is also less likely to heal properly when it is inflamed.
In general, Dr. BYUN suggests that a patient waits at least a year after the initial rhinoplasty before undertaking a revision. This waiting period can be longer for patients with thick skin, or it can be much shorter for patients whose nose suffered serious deformities in the original surgery, such as twisting, pinching, collapse or retraction. This type of structural damage may actually worsen with time and become harder to reverse the longer revision surgery is delayed.
In The Media
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