Reduction rhinoplasty is a plastic surgery procedure intended to reduce a big nose three-dimensionally, and make it more proportional and harmonious with other elements of the face. Reduction rhinoplasty that gives extremely satisfactory results when performed properly requires vast accumulation of knowledge and experience.
In this surgery, care should be taken not to impair the breathing function. It should be known that every big nose cannot be reduced to the same extent. The thickness of the nasal skin is an important factor determining the limits of a reduction rhinoplasty operation.
What Are Causes of Big Nose?
During the period of facial development, over-development of a nose compared to any other facial element is only a consequence of genetic and structural factors. The size of the nose tends to vary depending on races.
For example, a retrousse (upturned) nose is an ordinary image in northern European countries, while the nose structure in the Middle East, where our country is located, tends to be more prominent and larger than normal.
In some cases, a nose in normal size is perceived as larger than it is due to the inadequate development of other elements of the face, especially the cheekbones and the tip of the lower jaw.
In such cases, reducing the nose alone would not correct the appearance, so it would be necessary to make the cheekbones and the tip of the jaw more prominent in the same session. In this way, the nose will look relatively more normal and it will be possible to achieve an aesthetic facial appearance, in which all facial elements are harmonious with each other.
Is It Necessary to Have A Nose Reduction Operation?
Not everyone with a nose larger than normal need to have a reduction rhinoplasty operation. For people who have a large nose but not nasal breathing difficulties, the most important factor that determines whether it is necessary to have surgery is the way they perceive their nose. If the person is at peace with himself/herself and having a big nose does not cause any psychological problem, there is no need to undergo a surgical operation.
On the other hand, it would be beneficial to have a reduction rhinoplasty operation for people with a big nose who try to avoid having their photos taken due to their big noses, who are being mocked by their friends, who don’t find themselves beautiful or handsome, in other words, those who have a self-confidence problem in terms of aesthetic appearance and feel uncomfortable in front to the mirror.
Benefits of Reduction Rhinoplasty
Reduction rhinoplasty is a surgical correction procedure intended to resize a nose that attracts attention with its dimensions bigger than normal. After this procedure, the person with a nose proportional to his face will no longer attract attention in public, and will no longer be ridiculed by people.
Moreover, after this surgery, the person will feel more handsome or beautiful, as he has a nose that looks more esthetic than an average nose. After this positive change, individuals with improved self-confidence will begin to live as individuals who are more at peace with both themselves and their environment.
On the other hand, patients who have other problems in their life and think that all of these problems are a result of the deformity in their nose, and who expect that their entire life will change positively after surgery, as if a magic wand had touched it are likely to experience disappointment after the operation.
Planning before Reduction Rhinoplasty
During the preoperative examination, a detailed evaluation also involve other structures of the face such as the nose, forehead, cheekbones and chin tip; and the proportions of these structures to each other are measured. The dimensions of the nose, the width and height of the nasal tip, the structure of the nasal wings, the size of the nostrils, and the width of the nasal base are evaluated and noted one by one.
The thickness and structure of the nasal skin are evaluated in particular. In addition, intra-nasal examination is performed. The midline partition of the nose is checked for any curvature and concha hypertrophy to see the condition in terms of the respiration function.
After all these evaluations, the following questions are answered;
- How much should the nose be reduced?
- Is there a need for aesthetic intervention on other elements of the face besides the nose?
- Is there a need for additional procedures to improve the respiratory function in the nose?
The patient is informed of the answers to these questions, and then a joint decision is reached.
There are some issues that need to be taken care of in the preoperative period, in order for the reduction rhinoplasty to be performed in a safe environment. For example, blood thinners and nutritional supplements with blood thinning effect should not be consumed. For more comprehensive information on this issue, I recommend that you read carefully the article entitled “Before Surgery” on our website.
How is Reduction Rhinoplasty Performed?
The reduction rhinoplasty procedure is performed under general anesthesia. This surgical procedure involves the followings
- Nasal humps are rasped.
- Flat and wide nasal tips are narrowed
- The height of the nasal tip protruding forward is reduced
- Nose wings curving towards the sides are shortened and straightened
- Nostrils bigger than normal are reduced
- The nasolabial (nose-upper lip) angle is reformed as it should be.
- The wide nasal base is narrowed
- If there is a nasal septum deviation or concha hypertrophy that prevents breathing, they are treated in the same session.
During all these procedures, the ideal proportions of nose the structures to each other are maintained, and care is taken not to exceed esthetic and functional limits. It should be remembered that breathing problems may occur in a nose that is has been reduced excessively. On the other hand, in case of excessive reduction of the nasal bones and cartilages, the nasal skin cannot shrink enough and adapt to this reduction and accumulates like a ball on the nasal tip, causing the deformity called “pollybeak deformity”
How Is A Big Nose Reduced?
The answer to the question “how is a big nose reduced” is discussed in the previous paragraph under the heading “How is Reduction Rhinoplasty Performed?”
Can Reduction Rhinoplasty Involve Additional Aesthetic Procedures?
Although some people do not have excessively large nose sizes, their nose looks as if it is alone and too large in the middle of the face, due to the cheekbones and chin slightly weaker and smaller than normal. In such cases, augmenting the cheekbones and the chin with the implant placement or fat injection procedure performed in conjunction with reduction rhinoplasty in the same session makes the nose look relatively smaller.
These additional aesthetic interventions provide a more harmonious and esthetic appearance between the nose and other areas of the face. “Bird Face Deformity” is a good example of the type of face that requires such additional interventions.
Which Techniques Are Used In Reduction Rhinoplasty?
This procedure is performed with open or closed rhinoplasty technique. In my own practice, I prefer the “open rhinoplasty “technique” as it enables me to get more controllable and predictable results.
How Many Hours does Reduction Rhinoplasty Take?
The duration of the procedure varies from 2 to 4 hours, depending on the surgical technique to be used and the number of procedures to be performed in the same session.
Postoperative Healing Process Following Reduction Rhinoplasty
The first postoperative night is spent in the hospital. Cold is applied when the patient is in a semi-sitting position. Antibiotics and pain relievers are administered intravenously. The patient discharged the next day is taught how to clean his/her nose. The patient should lie in a semi-sitting position and not move too much in the first postoperative week.
Postoperative edema and swelling subside from the eyelids downwards day by day. After one week, the silicone stents in the nose are removed and the mold on the back of the nasal ridge is replaced. You can get more information about the dos and don’ts after surgery at https://cengizacikel.com/ameliyat-sonrasi-nelere-dikkat-etmeli
What Conditions Make Reduction Rhinoplasty Difficult?
In reduction rhinoplasty, the nasal skin is lifted and the bone and cartilage structures underneath are reduced, while the nasal skin is not involved in the reduction.
When the surgery is completed, the reduced bone and cartilage structures are closed with the nasal skin. The nasal skin that become loose as a result of the reduction of the previously large bone and cartilage structures, adapts to the new condition by shrinking over time, that is, by reducing its surface area.
Aesthetic problems are encountered in the following cases:
- If the bone and cartilage structures of the nose are reduced more than the shrinkage capacity of the nasal skin; or
- If excessive reduction has been performed on a nose with a thick and greasy skin that does not have adequate capacity for shrinkage.
The nasal skin that cannot shrink enough to adapt to the new condition remains relatively larger than normal, accumulates at the nasal tip, and results in an aesthetically unacceptable deformation. Therefore, the surgeon who will perform the reduction rhinoplasty operation should evaluate these limits appropriately during the preoperative examination, and perform the reduction accordingly.
In addition, during nose reduction and narrowing processes, excessive narrowing and reduction should not be performed to such an extent that it will make nasal respiration difficult or impossible.
Is Reduction Rhinoplasty Risky?
As with all surgical procedures, reduction rhinoplasty has its own risks and difficulties. During the preoperative examination, the person’s overall physical and mental health is evaluated to ascertain whether the patient is a suitable candidate for such a surgical intervention, and then the necessary precautions are taken.
Aesthetic risks of reduction rhinoplasty may include aesthetic problems arising from excessive or disproportionate reduction. Undesired and unsightly aesthetic results are likely to be observed unless the nasal framework, nasal tip, nasal wings, and nostrils are proportionally reduced so that they become harmonious with each other.
What Is Nasal Tip Reduction?
In some special cases, it is possible to reduce the nasal tip by intervening only on the nasal cartilages, without touching the nasal bones. During this procedure, the nasal wings and nostrils are also reduced proportionally with this reduction. During the same session, the nasolabial (nose-upper lip) angle can also be reformed as it should be.
Some procedures are introduced under the title “Nonsurgical rhinoplasty”. Among them, the primary procedures are ready-made and temporary filler injection into the nasal ridge and Botox injection into the nasal tip.
A straighter nasal ridge can be obtained by injecting ready-made temporary fillers in to the nasal ridge and nasal tip, but I don’t perform this procedure because I consider it inappropriate. This is because temporary ready-made fillers are synthetic materials, so there is a risk of allergy to a certain extent.
In addition, the effect of these fillers is temporary. Even if you are satisfied with the aesthetic result, you need to have this procedure every year. When it is performed inappropriately, necrosis on the nasal skin and extremely bad aesthetic results may be encountered.
Worst of all, when a wrong technique is used, the filler that passes into the blood vessels can even cause blindness by reaching the eye vessels.
I advise you not to have such procedures performed on your nose. If the appearance of your nose demoralizes you, it would be right for you to have rhinoplasty surgery that gives permanent results.
Botox injection into the nasal tip is a relatively more innocent procedure compared to filler injection. It is possible to correct this appearance to some extent, albeit temporarily, by injecting Botox into the muscles which pull down the nasal tip while laughing.
What is Non-Surgical Rhinoplasty?
“Nonsurgical rhinoplasty”, also known as nonsurgical nose job, is the injection of ready-made fillers underneath the nasal skin. I expressed my opinion on this issue under the heading of nonsurgical rhinoplasty.
Another procedure performed for this purpose is to lift the tip of the nose by placing stitches under local anesthesia. These procedures have not been widely performed by aesthetic surgeons, as their results are temporary and unpredictable.
What is Laser Rhinoplasty?
Laser rhinoplasty is based on the evaporation of tissues by applying very high energy in a controlled manner. The concept of “laser rhinoplasty” is literally quackery.
It has nothing to do with the surgical procedure performed for the purpose of rhinoplasty.
Laser can only be used as an alternative to surgical incisions in procedures performed to reduce overlarge adenoids or conchas. These procedures are intended to open the respiratory passages, but there is no area of application for laser in rhinoplasty.
I believe it is unethical to call procedures that way with intent to attract people who do not know what a laser is and what it is not.
More Information about Rhinoplasty
For more information about rhinoplasty and the answers to frequently asked questions about this subject, I recommend you to visit the “Rhinoplasty” page in our website.
Reduction Rhinoplasty Prices in 2023
Prices vary depending on the plastic surgeon who will perform the reduction rhinoplasty operation, the hospital where the operation will be performed, the degree of difficulty of the operation and the additional aesthetic interventions to be made in conjunction with this procedure.
I recommend that you visit your physician and get examined to get up-to-date information on this subject.