Last updated date: 15-May-2023
Originally Written in English
The nose is one of the most noticeable features of the face. It physically shapes your look and influences how others perceive you.
If you have a flat nose, you may be unhappy with it for a variety of reasons, including the fact that it can make your profile appear more masculine, that it makes breathing harder, or simply because you don't like how long or wide it appears.
Men and women who are unhappy with one or more aspects of their nose may benefit from simple rhinoplasty, also known as augmentation rhinoplasty, to improve the nose form and rebalance the face.
A flatter, lower nasal bridge and a lower nose tip are characteristics of Asian cultures. Simple rhinoplasty involves raising the bridge with an implant and reshaping the tip with part of the patient's own ear cartilage. To improve the overall finish of the nose profile from bridge to tip, the nasal bridge and nose tip should be augmented together.
Simple Rhinoplasty can help people who have a low, flat nasal bridge, a low nasal tip, asymmetry, or whose eyes appear to be too far apart.
Types of Flat Noses
- The Saddle Nose:
Saddle nose, also known as the boxer's nose, is a nose shape in which the tip of the nose has height but the center region is flat, resembling the form of a saddle when viewed from the side.
To attain the desired effect, the rhinoplasty specialist must lift the center region, which is commonly accomplished by inserting a dorsal implant. This might be cartilage from other regions of the body or a synthetic transplant.
- The Asian Nose:
The population of several Asian nations has a flatter nose shape than those from other continents. This might comprise both the central region and the tip of the nose.
To get a balanced, sharper appearance, the surgeon must operate on both contouring the midsection and raising the tip at the same time.
Types of Rhinoplasty Techniques
Your plastic surgeon can employ one of two flat nose surgery techniques: open rhinoplasty or closed rhinoplasty. The invasiveness of these methods distinguishes them. We'll go over each one in detail here so you can decide which one is best for you and discuss it more during a rhinoplasty consultation.
- Open Rhinoplasty
The columella, the tissue that divides the nostrils, is incised during open rhinoplasty. This incision makes it more invasive than a closed rhinoplasty, but it offers your plastic surgeon better access and visibility. An open rhinoplasty allows for more comprehensive reconstruction.
- Closed Rhinoplasty
During a closed rhinoplasty, your plastic surgeon makes all incisions within the nostrils, ensuring any scarring won’t be visible. However, this limits the visibility of your surgeon and thus restricts them to more minor nasal adjustments.
What Causes a Flat Nose?
When your child is small, you may observe a low nasal bridge. Low nasal bridge is common in some people. However, some potential reasons include:
- Cleidocranial dysotosis. This is a hereditary disorder that results in abnormal bone growth and development. Loose joints, short arms and fingers, and increased bone fractures are further symptoms of this condition.
- Syphilis. If you infect your kid with syphilis before birth, the virus might damage their bone growth. It can also result in an enlarged liver or spleen, as well as fever, irritability, and a rash, among other symptoms.
- The Williams Syndrome. This hereditary condition is distinguished by facial characteristics such as a broad nose, a big mouth, a round face, and round cheeks. People suffering from this illness may also experience intellectual difficulties and delayed development.
- Down Syndrome. This happens if you have an extra chromosome. Down syndrome patients have a wide, flat nose, almond-shaped eyes, and are lower in stature.
- Polychondritis. This condition causes cartilage inflammation.
- Granulomatosis associated with polyangiitis. This disorder affects your blood arteries, causing blood flow to organs and other parts of your body to slow. This decrease in blood flow might result in granulomas, which are inflammation-related growths. These are frequently seen in the lungs, sinuses, and throat.
- Previous Surgery. Prior septoplasty or septorhinoplasty surgery may result in nose saddling. If an aggressive septoplasty is performed that eliminates the entirety of the septum, the nose may weaken and potentially collapse over time. Furthermore, any septoplasty surgeries performed on kids who are too young might result in nose saddling later in life as individuals mature.
- Trauma. The most common cause of nasal saddling is trauma. Any damage to the nose might result in saddling or sagging. When the septum is cracked after trauma, it shrinks, resulting in nasal height decrease.
- Septal Abscess and Septal Hematoma. Blood or pus accumulation in the septum, caused by trauma, surgery, or septum manipulation, may impair blood flow to the septum, resulting in flat nose.
- Autoimmune and Vascular Conditions. Autoimmune and vascular illnesses can also cause septal vasculitis (inflammation of blood vessels). This inflammation reduces blood supply to the septum, resulting in tissue necrosis and loss. As the disease progresses, the septum weakens and the nasal height decreases. Wegener's Granulomatosis and Relapsing Polychondritis are two examples of ailments.
- Cocaine Abuse. Long-term cocaine usage reduces blood supply to the nasal septum, resulting in tissue necrosis and loss. This eventually results in nasal septum shrinkage and loss of nasal height.
- Infections. Chronic infections such as syphilis may also compromise blood flow to the nose and septum, leading to nasal saddling.
What Materials Used to Augment the Nose?
Adding volume to the nasal bridge necessitates the use of material. Many different materials have been utilized over the years, but the three kinds listed below are the most popular. The greatest plastic surgeons will employ a range of materials and tailor the treatment to each patient's specific demands.
- cartilage – patient’s own (septum, ear, rib) or cadaveric (ex. irradiated rib, acellular dermis)
- synthetic solid implant – silicone, ePTFE (expanded polytetrafluoroethylene, Gore-Tex®)
- synthetic gel implant – filler injections (hyaluronic acid, Restylane®)
When possible, plastic surgeons (and patients) prefer natural results and use the patient's own cartilage. During septoplasty, cartilage is extracted from the inside of the nose, the ear, or the rib. Each of these cartilage transplants has its own set of benefits and drawbacks.
Silicone nasal implants are available in a variety of forms and sizes, and your cosmetic surgeon may mould them as needed. The L-shape (augments bridge and tip) and the I-shape or dorsal-shape are the two most prevalent forms (augments bridge only). One reason silicone is a popular solid implant material is its ease of placement and removal. The drawback of silicone is that the implant might become apparent and is susceptible to scar capsule development, infection, or extrusion.
ePTFE, like silicone, is utilized in a range of medical treatments, including cosmetic surgery. ePTFE, unlike silicone, contains microscopic pores that allow for tissue ingrowth without the formation of a conventional scar tissue capsule. After implantation, the substance is permanent and does not deteriorate. ePTFE, unlike silicone, is not known to protrude from the nose. However, this implant is prone to infection and is extremely difficult to remove if necessary.
The most recent materials available for dorsal augmentation rhinoplasty are hyaluronic acid-based synthetic gels (Restylane® and Belotero®). For years, plastic surgeons have used gel injections to repair wrinkles, plump lips, and improve cheeks, but more lately, they have used it on the nose for nonsurgical rhinoplasty.
How to Prepare For Your Nose Job?
What should you do when preparing for rhinoplasty? Below, we have mentioned all the things you should do before your nose surgery.
- Consider Your Diet and Lifestyle: When your body is healthy, you have less risk and a higher chance of recovering quickly. We also recommend include more fiber-rich foods in your diet to assist prevent the digestive symptoms, such as constipation, that may occur after getting anesthetics. To promote good recovery after surgery, you should also avoid alcohol and consider taking vitamin C, zinc, and, in certain situations, iron.
- Plan Your Transportation Ahead of Time: Your surgical team will also most likely advise you to prepare for suitable transportation following your treatment. However, another reminder is never a bad thing. It is always a good idea to be prepared. Request that a friend or family member drive you to and from surgery. You could also think about having a friend or family member remain with you during the first 3 or 4 days after your operation.
- Book At Least 10 Days Off Work: For rhinoplasty, we recommend planning to take two weeks off from work. This can help facilitate healing and prevent you from partaking in any strenuous activity that may disrupt the healing process.
- Ensure You Have Cold Compresses At Home: You shouldn't have to rush out to purchase these products following surgery. Purchase sleep aids and ice packs in advance of your rhinoplasty so that they are available for you when you return home. You may also want to stock up on food, such as easy-to-digest products, to consume following your rhinoplasty.
Along with a list of recommendations regarding what you should do, there are equally as many items that you shouldn’t do leading up to your rhinoplasty.
- Don’t Wear Any Make-Up Or Apply Cosmetics: This is only limited to the day you are having your surgery on. Applying cosmetics can increase your risk of infection. You want to ensure your face is clean of debris and bacteria.
- Avoid Certain Medications: When preparing for your rhinoplasty, do not take NSAIDs, vitamin E, aspirin, or herbal supplements or medications within two weeks of your surgery. Specifically, herbs may disrupt how anesthesia works and are best to be completely avoided.
- Steer Clear of Smoking: This may be tough for some. However, smoking has adverse effects on the healing process, as well as detrimental impacts on your overall health. Smoking tends to disrupt blood flow, which can prevent proper healing. Thus, it is best to avoid smoking two weeks before your procedure and two weeks after your surgery.
- Address Any Concerns Before Your Surgery: Got questions? Make sure you ask them before the day of your rhinoplasty. Also, ensure you do your own research and that you don’t go into the day of surgery with doubts. You should feel confident and ready.
Flat Nose Surgery – Procedure
The top section of the nose is bone, while the bottom part is coated with cartilage. Flat nose surgery involves altering the structure of the nose's skin, cartilage, and bone. Anesthesia is used in the initial stage. Depending on your medical condition, the complexity of the surgery, and your endurance, you may be given local or general anesthesia. You may lie down and relax while our trained specialists recommend the best option for you.
An open or closed method may be used for flat nose surgery. The open approach involves cutting an incision through the tapering strip of tissues that links the nostrils. The wounds are subdued within the nose in the closed approach. These incisions are done to gently lift the skin covering the nasal bone and cartilage, allowing the remodelling surgery to continue. A flat nose can be fixed by transplanting cartilage from the ear, septum, or even a section of the rib.
The surgery involves neatening and straightening a crooked septum. As a result, the general structure of the nose becomes more visible. Correction of the septum greatly improves breathing comfort.
The tissues and skin of the nose are wrapped and the wounds are closed once the structuring is completed precisely. To modify the form and size of the nose, marginal slits can be created in the nasal folds. To offer substantial support to the nose, gauze and splints are used. These should be retained for a few days since they help the healing process.
You will be under strict observation and monitoring by our team in the observation cabin after the surgery. This is crucial to see if you are safe and reacting to the treatments expected.
After the surgery
To decrease bleeding and edema after surgery, you must rest in bed with your head higher than your chest. Swelling or splints put inside your nose after surgery may create congestion in your nose.
Internal dressings are usually left in place for one to seven days after surgery. In addition, your doctor will apply a splint on your nose for protection and support. It's generally there for approximately a week.
Slight bleeding and mucus and old blood discharge are usual for a few days following surgery or after the bandage is removed. To absorb drainage, your doctor may insert a "drip pad" — a little piece of gauze secured in place with adhesive — beneath your nose. As advised by your doctor, change the gauze. Do not press the drip pad on your nose.
Your doctor may advise you to take measures for many weeks following surgery to reduce the possibilities of bleeding and edema.
Your doctor may ask you to:
- Avoid strenuous activities such as aerobics and jogging.
- Take baths instead of showers while you have bandages on your nose.
- Not blow your nose.
- Eat high-fiber foods, such as fruits and vegetables, to avoid constipation. Constipation can cause you to strain, putting pressure on the surgery site.
- Avoid extreme facial expressions, such as smiling or laughing.
- Brush your teeth gently to limit movement of your upper lip.
- Wear clothes that fasten in the front. Don't pull clothing, such as shirts or sweaters, over your head.
For two to three weeks following nasal surgery, you may have transient swelling or black-and-blue discoloration of your eyelids. Nasal swelling takes longer to diminish. Limiting your salt intake will help the edema decrease faster. After surgery, avoid using ice or cold packs on your nose.
Whether you had surgery or not, your nose changes with time. As a result, determining when you have gotten your "final result" is difficult. However, the majority of the swelling goes down within a year.
Does Insurance Pay for a Rhinoplasty?
Rhinoplasty is sometimes covered by insurance, although it depends on the policy. Your doctor's office will assist you in obtaining prior written authorization from your insurance company before scheduling surgery. Although this is not a guarantee of coverage, it is the only way to know if rhinoplasty is a covered benefit. Sometimes insurance will cover a portion of a nose surgery but not the rest. In certain circumstances, you can acquire a price for the surgery by contacting the business office.
Asians, in general, have flat noses that are too subtle to generate a distinct facial profile, creating the appearance of a flat or "average" face. The nose is the most prominent feature of the face. A straight, protruding nose with an appropriate ratio and angle can assist define the complete facial profile. The good news is that you may design and acquire your perfect nose shape with cosmetic procedures. The nasal root, nasal bridge, and nasal tip all contribute to a flat nose.
Nasal root and nasal bridge are separate parts of the nose that are close together. The nasal root is the area between your eyes' inner corners. The nasal bridge is a bony portion of the nose that extends from the nasal root to the nasal tip. The contouring of the nose is defined in part by the form of the nasal tip.
Whatever the cause, rhinoplasty surgery can help by increasing the length and height of the nose, making its shape more feminine and appealing.