Understanding Rhinoplasty: Anatomy, Procedure, and Considerations

Rhinoplasty

No matter the reason why you may dislike your nose, in today’s world of scientific advancements, there is always help at your fingertips. You can have it “fixed”. Rhinoplasty, commonly known as ‘nose job’, is the procedure that can do this magic for you. This surgical/ non-surgical procedure  helps alter the shape, size, proportions or even help correct that problem of not being able to breathe well that has bothered you. Let’s now deep dive into the world of Rhinoplasty together. 

A quick description of what the procedure entails would be – the surgeon makes an incision in the nasal area, reshapes the bones or cartilage and surrounding soft tissues to correct numerous concerns that bother the patient, such as dorsal hump (that strange hump like thing on the bridge of your nose that you feel), asymmetrical nostrils, bulbous tip, downturned tip (the one where the tip looks like a beak), breathing difficulties caused by a deviated septum or just a nose too big for your face, etc. The end goal is of course to create a harmony of the facial features and alleviate any physical conditions if any. 

One of the most commonly known corrective procedures, Rhinoplasty is often deemed as the cornerstone of cosmetic surgery for the following reasons:

  • Enhances a balance of facial features- such as the dorsal hump, bulbous tip, broad nose, asymmetrical nostrils etc. to restore facial harmony and proportions. 
  • Helps boost self-confidence
  • Correction of nasal deformities
  • Personalisation of the outcome- by tailoring unique aesthetic ideals to the surgical plan for natural-looking results, taking the individual’s facial features into account.
  • Nasal function improvement- to optimise nasal airflow and restore nasal breathing.
  • Advanced surgical techniques- such as computer assisted planning and 3D imaging advancements to ensure the safety, precision and predictability of outcomes, natural-looking results and minimal recovery downtime.
  • Long lasting results

Anatomy of the Nose

Structural components of the nose

To fully appreciate the realm of rhinoplasty and why or how we do what we do during these transformative procedures as well as the potential impact of rhinoplasty on both appearance and breathing; one needs to understand the anatomy or the internal structure of the feature in question – your nose.

1. External nose

It consists of skin, subcutaneous tissue and a bone and cartilage frame that gives it shape and support.

2. Nasal bones

These are a set of symmetrically paired bones on either side that form the upper portion of the bridge of the nose; to make up the height of the nasal dorsum and overall structure and stability of the nose. 

3. Nasal cartilage

A flexible connective tissue that gives shape and supports various parts of the nose. The major cartilages of the nose are- 

  • Septal cartilage that forms the nasal septum
  • Lateral cartilages that form the sidewalls and tip of the nose
  • Alar cartilages that add to the shape and support of the nostrils

4. Nasal septum

A thin, vertical structure composed of bone and cartilage that divides the nasal cavity into its right and left sides, giving structural support to the nose and also plays a crucial role in the nasal airflow and breathing. This is the most important structure that contributes the straightness of the nose.

5. Nostrils (nares)

These are the openings at the base of the nose through which we breathe – therefore their main function is to allow the entry and exit of air into the nasal passages. Bordering the nostrils are the Alar Rims (supported by alar cartialges) and surrounded by soft tissue called Ala. 

6. Nasal cavity

The hollow space within the nose that extends from the nostrils to the nasopharynx (the upper part of the throat), lined by a mucous membrane to aid in humidifying, filtering and warming the inhaled air before it reaches the lungs. 

7. Turbinates (nasal conchae)

Turbinates are the bony structures covered with a mucous membrane that protrude into the nasal cavity from the sides or lateral walls of the nose, to increase the surface area of the cavity while inhaling, air filtration, humidification and warming the inbound air.

8. Paranasal sinuses

The facial bones surrounding the nasal cavity have pockets of air-filled cavities known as paranasal sinuses-

  • frontal sinuses 
  • ethmoid sinuses
  • sphenoid sinuses
  • maxillary sinuses

These sinuses serve various functions such as reducing the weight of the skull, resonating the voice and producing mucus.

How does the anatomy affect Rhinoplasty options

Here’s how the anatomy of your nose affects the availability of options for any alterations as well as the final outcomes to be expected:

1. Bone structure and cartilage framework

Prominent nasal humps may require bone reduction to smoothen the dorsal profile; whereas those with weak or asymmetrical cartilage may need cartilage grafting to improve the nasal symmetry and definition.

2. Nasal septum and other internal structures

With septoplasty, any deviation present can be easily corrected while improving nasal airflow. At times, part of the septal cartilage may be used as graft material in rhinoplasty. 

3. Shape and size of the nostrils

With rhinoplasty techniques such as alar base reduction or alar repositioning, nasal width symmetry deviations may be addressed easily, to create a more proportionate nose. 

4. Nasal tip 

Rhinoplasty surgery in this region involves reshaping and refining the tip by suturing, cartilage grafting or cephalic trim to give it the desired position, rotation or definition.

5. Elasticity and thickness of the skin covering the nose

Rhinoplasty surgeons always take into account the elasticity and thickness of the skin while planning the procedure to help preempt any risk of complications or poor wound healing, due to irregularities of the skin.

Functional considerations

To optimise nasal airflow and improve respiratory function as well as retain or enhance nasal aesthetics, functional rhinoplasty procedures include- 

  • Septoplasty
  • Turbinoplasty
  • Internal nasal valve reconstruction 

It is my hope that with the knowledge of the anatomy and how it may affect and what to expect from the procedure will help you make an informed decision regarding your rhinoplasty procedure. 

FAQs About Anatomy of the Nose

1. How does the nose contribute to our sense of smell?

Olfaction or the sense of smell is associated with the nose through the following features:

  • Olfactory epithelium:

This layer of skin is located at the roof of the nasal cavity. It is characterised by specialised nerve cells that detect the odour molecules.

  • Olfactory bulb:

The signals picked up by the nerve cells are sent to the olfactory bulb in the brain which processes and identifies the smells.

This sensory procedure allows us to detect a wide range of odours as well as contributes to our ability to taste. 

2. What are the main functions of the nasal septum?

As a vital structure of the nasal cavity, the nasal septum divides the cavity into two halves. It’s functions include:

  • Nasal structure support
  • Regulating air flow into and out of the nasal cavity
  • Humidify and filter the air breathed in

3. What are the paranasal sinuses and their functions?

These are air-filled spaces within the nasal cavity and surrounding areas, around the nose and eyes:

  • Maxillary sinuses in the cheeks
  • Frontal sinuses in the forehead
  • Ethmoid sinuses between the eyes
  • Sphenoid sinuses behind the nasal cavity

The sinuses contribute mostly to:

  • Lighten the weight of the skull
  • Produce mucus to moisturise the inside of the nose
  • Enhance the voice resonance

4. How does a deviated septum occur and how does it affect breathing?

When the nasal septum is not aligned at the centre of the nasal cavity, it is termed as a deviated septum. This may be cause by:

  • Congenital conditions or present from birth
  • Injury or trauma to the nose
  • Aging

The main effects of a deviated septum are:

  • Obstruction in the airflow through one or both nostrils
  • Difficulty breathing through the nose
  • Risk of sinus infections due to poor drainage of the mucus 

5. What are the functions of the turbinates?

Turbinates are the tiny bony structures in the nasal cavity, covered by soft tissue. Their functions include:

  • Air filtration
  • Humidification of inhaled air
  • Regulation of air temperature
  • Improved air-flow
Profile photo of Dr Venkata Ramana

Dr. Venkata Ramana

MS, DNB, M.Ch

Dr. Venkata Ramana, MS, DNB, M.Ch, is a board certified Plastic and Cosmetic Surgeon of great repute in Hyderabad. Over the past 15 years of innumerable nasal transformations, Dr. Ramana has created his niche in the field of Rhinoplasty Surgery in Hyderabad, where his gold medal winning background in ENT goes a long way in ensuring that the problem is dealt with in the best possible light. His attention to detail in the realm of deformities such as low nasal bridge, hump nose deformity, wide nasal pyramid, bulky nose tip, wide nostrils and crooked or deviated nasal structure amongst others has earned him the trust of patients and ensured phenomenal end results. Dr. Ramana holds the unique distinction of aesthetic as well as functional prowess of rhinoplasty surgery. To book an appointment, call +918790049911 or email: contact@nosecontour.com
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