Procedures

Rhinoplasty (Nose Reshaping)

Rhinoplasty (Nose Reshaping)

Park Cities Cosmetic Surgery

“By virtue of location, the nose is very important to facial aesthetics. My goal in rhinoplasty is to create better balance between the nose and face. Some patients only need small changes while others desire more dramatic changes. It’s considered among the most challenging operations in plastic surgery because every millimeter counts. That’s why few surgeons specialize in rhinoplasty – I do, and if I cannot do a great job, few people can.” — Michael Lee, M.D.


Video

Discussion

We look at our nose every day. Even if what we perceive as an abnormality is relatively small, it can weigh heavily on our self-confidence. It might be too large, too small, too wide or crooked. Perhaps there’s a bump or hump or a tip that droops. There is also a functional component that is crucial to overall health. Nasal obstructions can interfere with breathing and cause serious chronic distress.Sometimes patients will have difficulty articulating exactly what bothers them about their nose. They only know “it doesn’t fit my face.” Dr. Lee is an expert in assessing the ratios and proportions of what constitutes the ideal nose for each individual patient.

Dr. Lee believes there is a significant relationship between how a nose looks and how it functions. A deviated or crooked nose won’t be aesthetically pleasing, but may also indicate that the nasal valves are compromised. Correcting these problems can dramatically improve both the look and function of the nose. The best time to consider rhinoplasty is after the facial skeleton has stopped growing. Dr. Lee advises this is a bit different for men and women, but younger patients are usually 16 to 18 years of age. There is no age limit for older adults. In fact, those in their 40’s and 50’s are great candidates provided there are no extenuating medical concerns.

What Patients Should Consider

Finding a qualified surgeon.

Understand that there are varied skill levels even among Board Certified Plastic Surgeons. Not all are created equal because not everyone gets extensive training in rhinoplasty. Rhinoplasty demands a complete understanding of nasal aesthetics and function. Dr. Lee is double board certified in both Otolaryngology-Head and Neck Surgery and Plastic Surgery. Surgeons with this distinction are knowledgeable in both nasal function and aesthetics. Prospective patients might not know the difference or even the questions to ask. Dr. Lee emphasizes taking the time to understand a surgeon’s qualifications when assessing credentials. Is the surgeon board certified? In what specialty are they certified? Do they do a high volume of rhinoplasty? Is he a declared specialist who has dedicated time and research to publishing, teaching and lecturing on the subject? There is a hyper brand of vigilance in your selection of a nose surgeon. Your nose will be on constant display. Interview the doctor carefully to be sure you are in experienced hands.

Dr. Lee’s Surgical Priorities

The nose is the most important feature of the face and it directly influences overall facial balance. The nose must be viewed in context with all the surrounding facial features. A nose that is disproportionate to the face can significantly detract from an individual’s inherent beauty. The bottom line is when people look at us we don’t want them to notice our nose. The goal is to blend your nose aesthetically and provide balance and harmony to your facial features so it never detracts from the overall facial aesthetic. A beautifully done nose is one that improves not only the nose itself but enhances the features surrounding it as well.

Dr. Lee’s Techniques

Dr. Lee prefers the open versus the closed approach for the majority of his rhinoplasty procedures. The difference is a small incision on the columella (bridge between the nostrils) that is inconspicuous when healed. This approach provides ultimate control and visibility where the stakes are highest. Dr. Lee believes the risks are too great to practice “blind maneuvers” and leave the result to chance. Without benefit of full vision, you can inadvertently disrupt bone, cartilage and soft tissue attachments. Being a procedure involving millimeters, control is essential to feel confident everything humanly possible was accomplished. Dr. Lee is not only technically superb, but a visionary as well. Every dimension and proportion is planned ahead of time. It is not the same surgery for every patient. Every alteration influences another structure, so a precise operative plan is essential. Dr. Lee is a frequent lecturer and teacher at the Dallas Rhinoplasty Symposium. Surgeons around the world have benefited from the research and techniques presented at this annual symposium. He has been invited to speak both nationally and internationally on rhinoplasty, presenting both cutting edge research and surgical techniques. He is extensively published on the topic of rhinoplasty and continues to advance this subspecialty of plastic surgery.

A conversation with Dr. Lee on…

Surgical revisions…Revision rhinoplasty can be a much more difficult operation for both the surgeon and patient. It is no longer a virgin nose. Essential tissue may have been destroyed and restructuring may require grafts from other parts of the body. I’m often referred secondary and tertiary rhinoplasties. These surgeries are very complex and may require cartilage grafting from the ear or rib. This underscores the benefit of getting it right the first time. My advice is to do your homework and feel confident that your surgeon a knowledgeable specialist in rhinoplasty. Fortunately (or unfortunately), I get quite a few referrals for those patients whose first operation was unsuccessful. Find someone dedicated to the pursuit of perfection so you can minimize the chance of facing a second operation.

How nose reshaping has changed in the last 10 years…Thanks to social media, patients are hyper aware of how they look from every angle. Where it used to be a question of addressing the profile, patients now expect to look great from every angle. This requires meticulous attention to the entire nose—profile, tip, straight on, above and even below. One example is correcting the Basal Aesthetic Lines (BALS) —looking up into the nostrils. This is a term we coined in a series of research papers several years ago. The goal of our articles was to draw attention to an area of the nose that has long been ignored.

Men vs. women… Men have different expectations than women when describing their perfect nose, so communication is important when developing the surgical plan. It’s critical to maintain a masculine aesthetic while making the changes the patient desires. Usually the changes are intentionally more modest in men. Improving their appearance and function without feminizing the outcome takes a balanced approach. Injectable Rhinoplasty…There is a small patient population who are seeking very subtle changes and are not convinced they want surgery. Using temporary fillers will simulate the changes they can expect with surgery to a certain degree. As the product slowly dissipates over perhaps a year, the patient can determine if a more permanent correction would make them happy. It’s a low risk way to “try on” a result, but the vast majority of rhinoplasty patients would not be candidates.

“I want Angelina Jolie’s nose”… Years ago noses were fashion statements. A “Roman” nose, a “bobbed” nose. To copy a celebrity nose may not be the right thing for you considering your other facial features. Your nose is the most prominent part of your profile, and it should be highly individualized and in relation to your overall appearance. Noses are not interchangeable. There was a time you could actually tell what surgeon did a person’s nose, because every patient got the same nose. Fortunately that is no longer the norm. Adding Angelina Jolie’s nose to your face may actually be less aesthetic pleasing, considering your facial features, than the nose you are trying to alter. This is why a consultation is so important. A great rhinoplasty surgeon isn’t running a parts factory. The true art of rhinoplasty is about establishing harmony. The best results enhance and improve what’s out of proportion without changing someone’s total appearance.

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Contact our office to schedule a private consultation with Board Certified Plastic Surgeon, Dr. Michael Lee. This is the next step to determine which Park Cities Cosmetic Surgery procedure is the best option, giving you the desired outcome after surgery. Dr. Michael Lee will spend time with you to learn about your medical history and your expected outcome for surgery, as well as explaining the procedure in detail and answering all of your questions.

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