Feb 16

A recent patient who wanted to make her whole nose look smaller asked why plastic surgery does not allow noses to be made as small as people want?

We always appreciate patients who present to us having done some homework on their own because it lets us know that they are really preparing for their surgery and more importantly because it allows us to spend more time in really discussing the available surgical options.

We find a lot of our patients, men and women, present with exactly this question and the answer largely depends on each particular patient’s anatomy.

Sometimes, patients present with a large hump which makes their nose look large, and you will often see these pictures on people’s websites because in reality, though they are the most dramatic results, they are relatively easier to accomplish. Occasionally, these patients also have smaller chins and a chin implant goes a long way in balancing their appearance.

The more difficult cases are those patients who like the overall shape of their nose but feel like their whole nose is just too large. In these cases the tip, middle third of the nose and bridge all have to be reduced equally. While we can and often do exactly this procedure for our patients, it is important in these cases to be very cognizant of skin thickness. In those patients who have thick skin, we caution that while the nose can be made smaller, it should still maintain definition and refinement. In our patients with thick skin, we always let them know that if we attempt to make the nose too small the tip can lose its shape and appear amorphous. So while we make the nose smaller, we stress the importance of tip definition and refinement.

Finally, and perhaps most importantly, we must remember that the primary function of the nose is to help in breathing and this function is critical. Unfortunately, a lot of times with all the mass media exposure to airbrushed pictures, we are exposed to images of people who are not real and to noses that cannot be reproduced without causing problems in breathing. And its for this reason that at Profiles, we always admonish that Form must not supercede Function.

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