A large or prominent nose may manifest characteristics such as excessive length, width, or notable over-projection. While strategies to reduce the nose's length and width during a rhinoplasty procedure are relatively well established and straightforward, addressing over-projection often presents more intricate challenges.
Understanding Nose Over-Projection
In essence, over-projection occurs when the nose appears to jut out excessively from the face, creating a pronounced profile. It can be due to excessive septal height , excessive length of the alar cartilages (specifically the medial crura) and or excessive prominence of the anterior nasal spine.
Addressing Over-Projection During Rhinoplasty
The term "de-projection" refers specifically to the surgical process of minimizing the extent to which the nose protrudes from the face. Undertaking this Rhinoplasty procedure can be notably complex due to several contributing factors.
One of the primary challenges lies in the intricate task of delicately cutting and reshaping the alar cartilages—small cartilages located in the nose's lower region. Specific techniques used to reduce projection by altering the shape of the alar cartilages include vertical alar resection (VAR) or medial crura overlap. In addition to cutting and shaping the alar cartilages part of the upper jaw bone called the anterior nasal spine into which the septal cartilage is attached, may need to be reduced.
The key goal of de-projecting the nose is to do these manoeuvres without dramatically altering the natural appearance of the nasal tip and nostrils. Over-aggressive resection of cartilage or bone, often pursued in an attempt to decrease projection more markedly, can lead to nostril distortion. This can manifest as asymmetrical nostrils or the undesired "notched" nostril effect. Furthermore, an aggressive approach might result in the nasal tip's skin appearing overly lax, given that the underlying cartilage is now considerably reduced. The body may respond to this disparity by producing excess scar tissue beneath the skin, potentially distorting the position and shape of the nasal tip. Owing to these potential complications, the utmost de-projection that's typically considered safe and aesthetically pleasing during rhinoplasty is approximately 3mm. Attempts to exceed this can risk a "botched" appearance.
Post-Operative Rhinoplasty Care
Efficient post-operative care is paramount to achieving optimal outcomes. To mitigate excessive scar tissue formation following a rhinoplasty aimed at reducing projection, two common practices are implemented. Firstly, medical tape is strategically applied to exert gentle pressure on the nasal skin, minimizing the "dead space" during the healing phase. This method effectively compresses the nasal skin, preventing excessive scar tissue formation. Secondly, steroid injections directly into the nasal tip can be beneficial. These injections not only dissolve any pre-existing scar tissue but also proactively inhibit further scar tissue development.
Revision or touch up surgery to reduce projection
Sometimes, if the desired de-projection isn't achieved during the initial surgery, a second operation might be necessary. This subsequent operation is usually performed after about 8 months. The interval between the surgeries allows the nasal soft tissues to adapt and contract around the smaller underlying cartilaginous structure, ensuring the nasal tip and/or nostrils aren't distorted. The second operation allows for additional de-projection without the risk of deforming the nasal tip or nostrils.
Deprojection of a nose
Deprojection of a nose, while often critically important, stands as one of the more intricate facets of rhinoplasty. Our dedicated team of rhinoplasty surgeons at New You Harley Street are distinguished super-specialists in the domain. Armed with a wealth of expertise, they adeptly address even the most challenging nasal structures, including those that are notably over-projected.
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Revision rhinoplasty, also known as secondary rhinoplasty, is a corrective surgical procedure performed to address issues that persist or arise following an initial nose job. For many patients in London and across the UK, the decision to undergo a second nose surgery isn't taken lightly. Approximately 5-10% of primary rhinoplasty patients eventually seek revision procedures, highlighting the complex nature of nasal surgery. Revision rhinoplasty is typically more challenging than primary procedures due to altered anatomy, scar tissue, and potentially compromised structural support. The procedure requires advanced surgical techniques to address both aesthetic concerns and functional issues that may have developed or persisted after the first surgery. Common scenarios warranting revision include asymmetry, over-resection of nasal structures, persistent breathing difficulties, or simply results that don't align with the patient's expectations. The timing of revision surgery is crucial—most surgeons recommend waiting at least 12 months after the initial procedure to allow for complete healing and resolution of swelling before considering secondary intervention. It's worth noting that revision rhinoplasty often requires more extensive planning, including detailed imaging, comprehensive consultations, and sometimes the harvesting of additional cartilage grafts from areas like the ear or rib to rebuild nasal structures. This makes selecting a surgeon with specific expertise in revision cases particularly important for patients considering this path.
Turkey has emerged as a premier destination for rhinoplasty procedures, attracting patients from across the globe seeking high-quality nasal surgery at competitive prices. This remarkable rise to prominence in the aesthetic surgery world isn't coincidental but rather the result of several converging factors. Firstly, Turkey boasts a rich heritage in plastic surgery, particularly rhinoplasty, with surgical techniques that have evolved over decades to address diverse nasal structures and aesthetic preferences. The country's strategic location bridging Europe and Asia has contributed to the development of unique surgical approaches that harmoniously blend Eastern and Western aesthetic ideals. The Turkish medical education system produces exceptionally skilled surgeons who frequently pursue additional training internationally before returning to establish practices in their homeland. This combination of rigorous domestic training and international exposure creates surgeons with comprehensive skill sets and global perspectives on facial aesthetics. Furthermore, significant government investment in healthcare infrastructure has resulted in state-of-the-art facilities that meet or exceed international standards. Many Turkish clinics are accredited by prestigious organisations such as JCI (Joint Commission International), ensuring adherence to stringent quality and safety protocols. The economic advantage cannot be overlooked—the favourable exchange rate and lower operating costs allow Turkish surgeons to offer world-class rhinoplasty procedures at a fraction of the cost found in Western Europe, North America, or Australia, without compromising on quality or safety.
Revision rhinoplasty, also known as secondary rhinoplasty, is a corrective surgical procedure performed to address unsatisfactory results from a previous nose job. For many patients in London and across the UK, the decision to undergo revision rhinoplasty comes after experiencing functional issues, aesthetic concerns, or both following their primary procedure. Common reasons for seeking revision rhinoplasty include breathing difficulties, asymmetry, collapsed nasal structures, or simply dissatisfaction with the cosmetic outcome. Unlike primary rhinoplasty, revision procedures are inherently more complex due to altered nasal anatomy, scar tissue, and potential structural weaknesses from the previous surgery. The complexity increases with each subsequent procedure, making it crucial to select a highly specialised surgeon for revision work. Approximately 5-10% of rhinoplasty patients seek revision surgery, highlighting the technical challenges of primary rhinoplasty. Timing is essential when considering revision rhinoplasty. Most specialists recommend waiting at least 12 months after the initial procedure to allow for complete healing and resolution of swelling. This waiting period ensures that the surgeon can accurately assess the final result and develop an appropriate surgical plan for revision. Patients experiencing severe functional issues such as nasal obstruction may be candidates for earlier intervention, but this is evaluated on a case-by-case basis by experienced revision rhinoplasty surgeons.
