A. Aesthetic standards of the nose
The nose is located in the center of the face and rises forward in the shape of a long triangular cone, playing an important role in the composition of the appearance. The shape of the nose is mainly determined by the external nose, which can vary greatly according to race.
The Caucasian nose is high and thin, the Black nose is flat and wide, and the Yellow nose is in the middle. Due to the different ethnic groups, geographical environment, living habits and cultural traditions in the world, the aesthetic standards of the nose are also very different, the Caucasian people are beautiful with a high nose, which looks straight and handsome; the Chinese people are beautiful with a nearly straight nose for men and a slightly concave arc for women with a slightly curved tip.
Chinese women have a slender face, and the ideal nose should be a line with the tip of the nose, the lower lip and the chin; the bridge of the nose should be small and narrow, and the tip of the nose should be slightly curved, which is softer. The specific aesthetic parameters have been counted by scholars, and the values are as follows.
1.Position: the center of the nose root, the distance from the root to the outer canthus as the radius to draw a circle, the arc should pass through the nasal small column and nasal wing edge.
2.Length: the length of the nose is 1/3 of the length of the frontal surface, the normal human nose length is generally 6-7.5 cm, the saddle nose nasal length are shorter, often less than 5.8 cm, greater than 1/3 of the length of the frontal surface is a long nose, less than 1/3 is a short nose.
3.Width: the distance between the lateral edges of the two nostrils, generally equivalent to 70% of the length of the nose, the width of the root of the nose about 1 cm, the tip of the nose about 1.2 cm.
4.Height: generally cannot be lower than 9 mm, basically in 7-11 cm, generally 12 mm for men and 11 mm for women.
5, nasal facial angle: forehead to the incisal line, and forehead to the angle between the dorsal line of the nose that is the nasal bridge and the intersection of the face plane, the ideal for 30 ° ~ 33 °, China Ling statistics for 23 ° ~ 38 °, women slightly less than 30 °.
6, the nasolabial angle: the front of the nasal column to the bottom of the nose, and the bottom of the nose to the upper lip between the red lip intersection angle, generally 90 ° ~ 120 °, saddle nose deformity of this angle increased significantly, the nostrils appear to face the sky deformity characteristics. Angle is too large, the length of the nose is significantly shortened.
7, frontal nose angle: nose root and frontal bone meet the part of a beautiful curve angle, called nasal frontal angle, the angle of about 120 ° most beautiful, this angle is related to the beauty of the curve of the nose shape.
8, nasal tip height: nasal tip height refers to the nasal tip to the nasal base distance, the ideal height of the nasal tip is 1/3 of the length of the nose, 26 mm for men, 23 mm for women. Lower than 22 mm is a low nose.
9, nasal tip curve radius: the normal shape of the nasal tip is spherical, the ideal nasal tip curve radius of 8 to 12 mm. The nostril is an oval sloping to the tip of the nose, with bilateral symmetry.
Second, who are suitable for rhinoplasty
People who are suitable for rhinoplasty are those whose face lacks dimension and is not aesthetically pleasing because of a low nose. If you are physically healthy, psychologically normal and your expectations are realistic, then you may be a suitable person for rhinoplasty.
A collapsed nose is the main target of rhinoplasty. A collapsed nose makes the face sunken and lacks dimension, affecting one’s temperament and poise. A collapsed nose not only affects the shape of the face, but also gives the impression that the nose is shortened and the facial features are out of tune.
Some people do not have low nasal bridge, but the back of the nose is wide and flat, not handsome, lack of line beauty, can also be beautified through rhinoplasty.
If the head of the nose is high and the root of the nose is low, it can also be corrected by partial rhinoplasty, the key to successful surgery lies in the design and sculpture of the prosthesis.
In addition, the best age for rhinoplasty is after 18 years old.
Third, the modern commonly used rhinoplasty – two-stage cartilage rhinoplasty
For a person with a low nose whose tip is not in good shape, the general rhinoplasty cannot get satisfactory results, and the tip of the nose needs to be reshaped.
The good look of the nasal tip is determined by the amount of scaffolding structure and local soft tissue that supports the tip. The scaffold structure includes the nasal cartilage (divided into the medial and lateral pedicles and the fornix), the lateral nasal cartilage, and the cartilage part of the nasal septum; the soft tissues include: skin, muscle, and some fibrous connective tissue. Generally speaking, the ideal nasal tip has the appropriate prominence, angle and some delicate points and surfaces. Aesthetics believes that the height of the tip of the nose is 1/2 of the length of the nose, while the height of the tip of the nose of oriental people and black people often does not reach 1/2 of the length of the nose, which is rounded and low and flat, one of the racial characteristics.
Therefore, oriental rhinoplasty generally has several important purposes as follows.
First, to make the dorsal part of the nose appear higher.
Secondly, the nose should not be too wide at the tip.
Third, not to make both sides of the nose appear too large
Fourth, the tip of the nose should be at a slight angle.
Fifth, the angle between the tip of the nose and the root of the nose should be maintained at a proper angle with the angle between the root of the nose and the lips.
Traditional rhinoplasty will generally have quite good results, but the problems it may have are.
1. The area of the nose will have the feeling that the prosthesis is topped under the skin. Not only does it look unnatural, but the skin on the head of the nose becomes too thin and there may be a risk of breaking out.
2. The tip point of the silicone prosthesis is different from the patient’s own nose tip point, which will also affect the appearance.
In order to avoid the complications that may be caused by traditional rhinoplasty in the nasal head area (stemming from the use of silicone implants for nasal augmentation), modern rhinoplasty uses autologous cartilage (septal cartilage or ear cartilage) to sculpt the nasal head, while silicone or tumescent materials are used at the nasal bridge, i.e. combining artificial prosthesis and autologous cartilage, discarding their shortcomings and uniting their advantages, called bipartite cartilage rhinoplasty.
Fourth, other commonly used nasal tip cosmetic surgery
1.Hawk-like nasal tip correction surgery
It is mainly caused by the overdevelopment of nasal wing cartilage and septal cartilage, the surgery can be performed in the nasal vestibule incision, remove part of the cartilage and mucosa, to be corrected.
2.Blunt and flat nasal tip correction
For low nasal tip, nasal edge incision can be made in the nostril, several incisions can be made on the surface of the fornix of the bilateral nasal cartilage, and the soft tissue between the medial feet of the nasal cartilage can be removed, and the two medial feet can be pulled together with mattress sutures, and cartilage can be transplanted to elevate the nasal tip.
3.Correction of hypertrophic nasal tip
People commonly call this kind of nose as “garlic nose”. The reason is that the skin is thicker, the amount of subcutaneous tissue is more, the cartilage support is thicker and has the tendency to expand outward. The nasal tip correction is called a nose reduction procedure, in which an incision is made at the nasal margin and the muscles and connective tissue on the surface of the nasal cartilage and lateral cartilage are evenly cut out. The lateral 1/2-2/3 of the nasal cartilage head is excised, and the lateral foot is rotated medially and cephalad, at which point the nasal wing is visible as an inversion. The cartilage is intermittently cut in the fornix of the nasal cartilage, not cut off, and the cartilage is sutured with mattress sutures. If the tip of the nose is not high, the cut cartilage can be placed on the surface of the fornix to elevate the tip of the nose.
V. Rhinoplasty materials
After a long period of experimental research and clinical practice, it is now considered that medical silicone rubber and polytetrafluoroethylene and other polymer materials are the most ideal materials, which are extremely stable, chemically inert, will not react with other substances, non-toxic, non-carcinogenic, non-teratogenic, and the most significant advantage is that they can be removed intact, becoming the most commonly used rhinoplasty materials. Especially silicone rubber is the most commonly used material for rhinoplasty because of its proper texture and easy sculpting and shaping, as well as its cheap price and no side effects after decades of clinical practice.
Six, surgical pain and scarring
Rhinoplasty is one of the most common, safe and reliable surgeries in plastic and cosmetic surgery, generally using local anesthesia, injecting anesthesia is like injecting other drugs, there will be pain when entering the needle, when the anesthesia takes effect after the operation, some people will have local soreness and swelling but will not feel pain. There is usually no need to take pain medication after rhinoplasty.
The nasal prosthesis will be designed and sculpted according to the shape of the nose, generally take the nostril margin incision, separate and implant the nasal prosthesis under the nasal dorsal fascia, the operation will take about half an hour, and the stitches will be removed 7 days after the operation, no scar will be left; if the nostril reduction operation is done, a less obvious scar will be left at the base of the nose after the operation.
Seven, pre-operative preparation
Rhinoplasty can improve the appearance of the nose and thus increase self-confidence. Before deciding to have rhinoplasty, it is important to carefully consider the expected results and discuss them with a plastic surgeon who is experienced in rhinoplasty and who will also explain to you some of the factors that affect the procedure and the outcome. These factors include the structure of your nasal bones and cartilage, the shape of your face, the thickness of your skin, your age and your expectations.
In addition to the general preparation for cosmetic surgery, the special preoperative preparation for rhinoplasty includes three areas.
1. Cure inflammatory lesions such as colds, rhinitis, sinusitis, and nasal boils.
2.Stop taking aspirin and other drugs that affect coagulation function for 1 week.
3.Cut short nasal hair and clean the nasal cavity.
Eight, post-operative care
After rhinoplasty, the wound is coated with antibiotic ointment, exposed, not bandaged, and there will be a small amount of blood oozing, which can be gently applied with sterile cotton swabs. If the wound accumulates blood crust can be gently washed away with 3% hydrogen peroxide within 24-48 hours after surgery, then wash again with saline, apply a small amount of ointment, or sprinkle anti-inflammatory powder to keep the wound dry, and so on to heal by themselves, 7-9 days to remove the stitches.
After surgery, take rest in semi-recumbent position and do not lower your head for the first three days to prevent bleeding. Do not eat stimulating food. Swelling starts 1-2 hours after surgery, reaches its peak around 24 hours and starts to subside in 72 hours. Due to the rich blood circulation in the face, swelling is more dramatic after trauma, but swelling is not painful and subsides quickly. Severe swelling is related to rough operation, trauma, bleeding, defective coagulation mechanism of the patient, etc. However, most people’s post-operative swelling is not heavy, and generally becomes more natural in about 10 days, and it is not even obvious that they have had rhinoplasty; for slower recovery progress, it takes roughly 2-3 weeks before the nose becomes completely the same as that of a normal person. It is forbidden to rub the nose for two weeks after surgery to prevent the incision from healing badly, and to wear frame glasses for one month to prevent the stent from deflecting. If there is prolonged redness, swelling or discomfort, you should follow up with the hospital in a timely manner.
IX. All surgeries have risks and some uncertainties
Postoperative complications such as infection, bleeding or reaction to implants are very rare but can occur. Choosing a surgeon with experience in rhinoplasty and carefully following medical advice before and after surgery will reduce the risk of complications.