How Realistic are My Rhinoplasty Goals?
Q: Dr. Eppley, I am interested in getting a significant augmentation rhinoplsty done using rib cartilage. I have a very specific goal and look that I am after and I have attached a powerpoint presentation to show what I want to achieve. I have chosen many noses that I look and don’t like. I want to be as specific as possible as I want to avoid a revisional surgery at all costs and don’t want to be disappointed in the result. Please review these presentation and tell me what you think.
A: Thank you for sharing the powerpoint presentation. I don’t think anything you could say says it better than these pictures. My general comments about achieving these aesthetic goals are important for you to understand.
Rhinoplasty surgery is nor like Photoshop and there are a lot of other variables, other than how much cartilage graft you insert, that influences how the result will look. There is the thickness of the nasal skin, how well it reacts to injury and shrinkage, the fact that there is an internal cavity with two skin-lining openings, how well any grafting shapes and takes etc. Nasal goals are much more difficult to achieve particularly when the goal is model pictures that have been photoshopped. (most plastic surgeons cringe when they see a photo album of model pictures) While it is important to have ideal goals, the variables of the nose make that a difficult challenge particularly when the changes are going to be dramatic. I think it is important to realize one of the realities of rhinoplasty surgery…the need for revisional surgery is not rare. No one wants to have it…the patient doesn’t, the plastic surgeon doesn’t…it is disappointing for all involved. But the simple reality is that no matter how well planned and executed any rhinoplasty surgery is done…it does not always turn out perfect. The more lofty the goal, the harder it is to achieve. Rhinoplasty surgery is simply not a 1:1 ratio of change to result in every case. I emphasize this point to you, not exclusively because of your attention to detail, but because the tip area of the nose can be very unpredictable as to how refined it can become…and that is a very important aesthetic goal of yours.
Dr. Barry Eppley