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The Nature of Nose Projection Adjustment

The Nature of Nose Projection Adjustment

shutterstock 106471349 300x200 - The Nature of Nose Projection Adjustment | Beverly Hills | Los AngelesNose projection refers to the distance that it protrudes outward from the point where it joins the upper lip to its tip. In case this tip is too protuberant, it can significantly impact the overall nasal appearance.

On the other hand, noses that are under-projected appear too shallow and may make the nose look too small relative to other facial features.

A surgeon can shave away a portion of the cartilage at the nasal tip to reduce the projection of the nose. In order to increase the nose projection, the surgeon may separate and realign the cartilage.

They will push it forward and suture it into a refined position. In case there is insufficient cartilage in the tip of the nose, the surgeon may use a cartilage graft to build it up.

Double board certified plastic surgeon Dr. Geoffrey R. Keyes provides rhinoplasty to patients in Beverly Hills, Los Angeles, Bakersfield, California, and surrounding locations.

 

Treating an Over Projected Nose

People with over projected noses, which stick too far out from their face, can undergo corrective surgery involving shaving away the nasal cartilage at the tip. This procedure moves the nasal tip back to provide it with a more appealing look. It is known also known as nasal de-projection or retro-displacement.

 

Treating an Under Projected Nose

The re-projection of a nose which is under-projected involves extending the nose cartilage. This can be accomplished with two approaches depending on the nasal structure. One technique involves trimming the nose cartilage and suturing it up again to attain a better nasal projection.

In the second technique, the surgeon will source a cartilage graft from another area of the body where there is sufficient cartilage availability and use it to improve the nose projection. This cartilage graft is typically taken from the nasal septum in primary rhinoplasty. If necessary, the cartilage can also be sourced from the ears or the ribs as well.

 

Types of Cartilage Grafts

Depending on the location and method of cartilage graft use, they may be called columellar struts used to offer support to the columella which bifurcates the nostrils. There may be insufficient septum cartilage if the patient is undergoing revision rhinoplasty. In such cases, the surgeon will usually take bone from the rib cage for the cartilage graft.

The ear cartilage is considered beneficial in offering support to the nose tip due to its elasticity. A common cartilage transplant from the ear will be thicker in comparison to cartilage from the septum. However, the outcome could be a nose tip that feels more natural instead of one that is rigid and solid because of the elasticity.

If cartilage is required for primary rhinoplasty, costal or rib cartilage is also considered as a feasible option. In general, septal or ear cartilage is used in nose tip refinement. On top of this, sometimes rib cartilage may be used.

 

Considerations for Male Patients

Male patients considering nose projection surgery may harbor concerns regarding their nose appearing too feminine following the procedure. But a skilled, sagacious, and experienced plastic surgeon can ensure that the masculinity of the nose is preserved while enhancing the nose projection at the same time.

A nose projection procedure can be an effective way to improve the nose shape while preserving its masculine aesthetic for men who do not want to undergo a “full” rhinoplasty. Reliable double board certified plastic surgeon Dr. Geoffrey R. Keyes receives patients from Beverly Hills, Los Angeles, Bakersfield, California, and other towns and cities in this part of America for rhinoplasty.


For more information on the surgical and non-surgical procedures and treatments by Double Board Certified Cosmetic Plastic Surgeon, Dr. Geoffrey R. Keyes, please contact us at (800) 859-7509. Offices in Los Angeles and Bakersfield, CA. 

Serving Greater Los Angeles, Beverly Hills, Orange County and surrounding areas of California.

Nose Projection Adjustment

shutterstock 106471349 300x200 - Nose Projection Adjustment | Beverly Hills | Los AngelesNose projection refers to the distance that it protrudes outward from the point where it joins the upper lip to its tip. In case this tip is too protuberant, it can significantly impact the overall nasal appearance.

On the other hand, noses that are under-projected appear too shallow and may make the nose look too small relative to other facial features.

A surgeon can shave away a portion of the cartilage at the nasal tip to reduce the projection of the nose. In order to increase the nose projection, the surgeon may separate and realign the cartilage.

They will push it forward and suture it into a refined position. In case there is insufficient cartilage in the tip of the nose, the surgeon may use a cartilage graft to build it up.

Double board certified plastic surgeon Dr. Geoffrey R. Keyes provides rhinoplasty to patients in Beverly Hills, Los Angeles, Bakersfield, California, and surrounding locations.

 

Treating an Over Projected Nose

People with over projected noses, which stick too far out from their face, can undergo corrective surgery involving shaving away the nasal cartilage at the tip. This procedure moves the nasal tip back to provide it with a more appealing look. It is known also known as nasal de-projection or retro-displacement.

 

Treating an Under Projected Nose

The re-projection of a nose which is under-projected involves extending the nose cartilage. This can be accomplished with two approaches depending on the nasal structure. One technique involves trimming the nose cartilage and suturing it up again to attain a better nasal projection.

In the second technique, the surgeon will source a cartilage graft from another area of the body where there is sufficient cartilage availability and use it to improve the nose projection. This cartilage graft is typically taken from the nasal septum in primary rhinoplasty. If necessary, the cartilage can also be sourced from the ears or the ribs as well.

 

Types of Cartilage Grafts

Depending on the location and method of cartilage graft use, they may be called columellar struts used to offer support to the columella which bifurcates the nostrils. There may be insufficient septum cartilage if the patient is undergoing revision rhinoplasty. In such cases, the surgeon will usually take bone from the rib cage for the cartilage graft.

The ear cartilage is considered beneficial in offering support to the nose tip due to its elasticity. A common cartilage transplant from the ear will be thicker in comparison to cartilage from the septum. However, the outcome could be a nose tip that feels more natural instead of one that is rigid and solid because of the elasticity.

If cartilage is required for primary rhinoplasty, costal or rib cartilage is also considered as a feasible option. In general, septal or ear cartilage is used in nose tip refinement. On top of this, sometimes rib cartilage may be used.

 

Considerations for Male Patients

Male patients considering nose projection surgery may harbor concerns regarding their nose appearing too feminine following the procedure. But a skilled, sagacious, and experienced plastic surgeon can ensure that the masculinity of the nose is preserved while enhancing the nose projection at the same time.

A nose projection procedure can be an effective way to improve the nose shape while preserving its masculine aesthetic for men who do not want to undergo a “full” rhinoplasty. Reliable double board certified plastic surgeon Dr. Geoffrey R. Keyes receives patients from Beverly Hills, Los Angeles, Bakersfield, California, and other towns and cities in this part of America for rhinoplasty.


For more information on the surgical and non-surgical procedures and treatments by Double Board Certified Cosmetic Plastic Surgeon, Dr. Geoffrey R. Keyes, please contact us at (800) 859-7509. Offices in Los Angeles and Bakersfield, CA. 

Serving Greater Los Angeles, Beverly Hills, Orange County and surrounding areas of California.

Describing Nose Width Reduction

shutterstock 64825393 300x205 - Describing Nose Width Reduction | Beverly Hills | Los AngelesUpon viewing the nose from beneath, the nostrils and nasal tip form a triangle known as the pyriform aperture. A surgeon will adjust the pyriform aperture to reduce the width of the nose tip.

The width of the nose can be made narrower by making the angles of this triangle steeper at the juncture where the nostrils connect to the face.

Prudent double board certified plastic surgeon Dr. Geoffrey R. Keyes provides rhinoplasty to patients in Beverly Hills, Los Angeles, Bakersfield, California, and other neighborhoods and suburbs in this region of SoCal.

 

Nasal Base Reduction

A nasal base reduction is a rhinoplasty technique that reduces the width of the nose base in cases where it is excessively broad relative to the facial structure. In general, nasal base reduction in some variation is a routine component of rhinoplasty and revision rhinoplasty.

The reduction of the nose base is even more common in ethnic rhinoplasty. Rhinoplasty candidates with African American, Asian, and Middle Eastern ancestry often need to undergo nasal base reduction. These ethnicities usually have a broader nose base which requires a reduction of this area to enhance the nose appearance.  

The main complaint of a large number of patients seeking rhinoplasty or revision rhinoplasty is that their nose looks excessively broad or large at the base. The base is typically measured from the outer margin of one nostril to the outer margin of the other.

In an ideal case, the nose base width should not be more than the distance between the eyes. If there were an imaginary line running vertically down from the corner of the eyes (inner canthus) on either side, the nasal base should lie between these two lines.

However, it is paramount to understand that this adjustment is a cosmetic ideal for a Caucasian nose. This standard may not be suitable for ethnic noses. In most ethnic rhinoplasty candidates, a nasal base that is slightly broader than this ideal measurement will offer optimal results.

 

Anatomy Involved in Nasal Base Reduction

It is important that the surgeon has a detailed understanding of the structure of the nasal base region to decide on the surgical treatment of particular nose surgery patients. The columella refers to a column-like structure located in the middle of the nose base.

This separates the nostrils into right and left portions. The alar base insertion refers to the part of the nostril side wall that connects to the upper lip-cheek point. The nasal sill region is the area that lies between the alar base insertion point and the columella.

 

A Wide Sill Region

Some rhinoplasty patients with a wide nose base also tend to have a broad sill area that creates extra nose width. If this sill is too broad, it could cause a more horizontal type nostril shape. This occurs commonly in patients with a wide nasal sill.

 

What to Expect after Reduction Rhinoplasty Surgery?

Reduction rhinoplasty entails the same recovery duration and strategies as any other nose reshaping surgery. After the surgery, the patient will experience inflammation and discomfort for many days as the nose, and the surrounding tissues start to heal.

The bruising will gradually fade, and the inflammation will resolve as the healing progresses. The outcomes of the rhinoplasty will manifest gradually, and the patient will be able to resume their normal routine after the recovery phase.

Double board certified plastic surgeon Dr. Geoffrey R. Keyes receives patients from Beverly Hills, Los Angeles, Bakersfield, California, and nearby areas across the horizon for rhinoplasty.


For more information on the surgical and non-surgical procedures and treatments by Double Board Certified Cosmetic Plastic Surgeon, Dr. Geoffrey R. Keyes, please contact us at (800) 859-7509. Offices in Los Angeles and Bakersfield, CA. 

Serving Greater Los Angeles, Beverly Hills, Orange County and surrounding areas of California.

Nose Tip Rotation and Reduction

shutterstock 136446527 300x200 - Nose Tip Rotation and Reduction | Beverly Hills | Los AngelesThe nasal tip may lack proper rotation if the tip lacks definition or is too defined. Rotation is the upward or downward turn of the nasal tip.

The plastic surgeon will modify the tip of the nose by cartilage reshaping. During this procedure, they will pay careful attention to the base of the nose as this impacts the rotation and tension.

Considerate double board certified plastic surgeon Dr. Geoffrey R. Keyes provides rhinoplasty to patients in Beverly Hills, Los Angeles, Bakersfield, California, and other cities and towns in this region of SoCal.

 

What is Nose Tip Rhinoplasty?

Nasal tip rhinoplasty refers to any surgery undertaken on the lower third part of the nose. Nose tip is an intricate procedure. The operating surgeon should be skilled and experienced in nose surgeries as well as have a deep understanding of the anatomy of the nose and how the cartilage and other tissue affect the process of nose refinement.

The refinement of the nasal tip is not necessarily an aesthetic surgery. In certain cases, it may be a medical requirement. For instance, the patient may sometimes experience breathing issues due to an abnormally-shaped nose tip either in routine life or even while sleeping (causing breathing issues and snoring among other problems).

An abnormal tip can also lead to sinus infection. Sometimes patients may also experience speech problems as a consequence of their abnormal nasal tip.

 

Reasons to Undergo Tip Refinement

Patients choose tip refinement (individually or as a rhinoplasty alternative) for various reasons. However, it is usually performed to rectify a “bulbous” or fuller nasal tip.

Some patients may find their natural nose structure to be unappealing (for instance, patients with noses that sag at the tip, “hooked” noses, or upturned noses).

A tip refinement surgery can affect the overall nasal and facial appearance as these surgeries are typically undertaken to create a slimming look.  

 

Wide Tip Correction

A bulbous or wide nose typically occurs due to a combination of thick skin on the nose and substantial nasal domes that are spaced apart widely. The nasal domes are the tip defining points of the tip cartilage.

In many cases, a thick ligament or fat separates the nasal domes.

The surgeon will need to work on the soft tissue and move the domes closer to correct this condition. The surgeon may place a graft on the nasal tip itself for patients with thick skin. This approach will offer a better nasal tip definition.

The tip of the nose can also be made narrow by trimming off or tweaking the cartilage structure beneath the skin.

 

Less Invasive Procedure

The nasal tip refinement surgery is significantly less invasive than a complete nose job. A typical rhinoplasty involves substantial modification of the inner structure of the nose. This may involve breaking of bones as well which will increase the recovery duration.

But tip refinement usually entails two to three incisions to offer the surgeon access to the underlying cartilage in that area. The surgeon will seal the incisions after reshaping the nose. The recovery period involved in tip refinement surgery is relatively brief.

When a tip refinement surgery is appropriate for a patient’s unique anatomical objectives, it can usually offer an effective alternative to a “complete” rhinoplasty procedure.

Reliable double board certified plastic surgeon Dr. Geoffrey R. Keyes receives patients from Beverly Hills, Los Angeles, Bakersfield, California, and nearby areas across the landscape for rhinoplasty.

For more information on the surgical and non-surgical procedures and treatments by Double Board Certified Cosmetic Plastic Surgeon, Dr. Geoffrey R. Keyes, please contact us at (800) 859-7509. Offices in Los Angeles and Bakersfield, CA. 

Serving Greater Los Angeles, Beverly Hills, Orange County and surrounding areas of California.

Nasolabial Angle Adjustment

shutterstock 110261057 300x200 - Nasolabial Angle Adjustment | Beverly Hills | Los AngelesWhen viewing the facial profile, it is apparent that the nasolabial angle comprises two lines. The first line runs from the tip of the nose to the area above the upper lip, and the second line goes from the upper lip to the bottom of the nose where the nostrils bifurcate.

The nose projection and rotation of its tip impacts the degree of the nasolabial angle. For most patients, the surgeon will try to create a 90- to 95-degree nasolabial angle in men and a 100- to 105-degree angle in women. An adjustment in the projection and rotation of the nose can refine this angle.

Focused double board certified plastic surgeon Dr. Geoffrey R. Keyes provides rhinoplasty to patients in Beverly Hills, Los Angeles, Bakersfield, California, and surrounding communities.

 

Adjusting the CLA

The columella-labial angle (CLA) is a vital parameter to be assessed in rhinoplasty patients to achieve aesthetically desirable outcomes. If there is an increase in this angle, it causes an upward tilt of the nasal base along with a concomitant reduction in the nose length. Due to the differences in the anatomies of the noses, this aspect is often overlooked resulting in sub-optimal surgical outcomes.

There exists a complex relationship between the columella and upper lip. It is challenging to maintain a specific angle in rhinoplasty patients, and this involves the use of various methods such as suturing techniques, nasal cartilage adjustments, and cartilage grafts.

The nasal spine, caudal septum, and medial crura of the lower lateral cartilage are instrumental in shaping the columella. Therefore, these aspects are contributory factors in determining the CLA.

The most cosmetically appealing columella-labial angle is 95° to 100° in males and 100° to 110° in females on profile view. The normal columellar display ranges from 2 mm to 4mm. An extensive of hanging columella can majorly disrupt the cosmetic appearance of the nose.

 

Tent Pole Grafting

The ‘tent pole graft’ is an advanced technique used to set and preserve the columellar lip angle. This graft works in a way similar to the septo-columellar interpositional grafts.

However, there is no requirement to dissect or delineate the upper lateral cartilages from the septum to place the grafts. This type of graft is used in challenging secondary nose surgeries as well as cases where the tip projection undergoes a significant increase.  

This technique involves fixing a cartilage fragment to the columellar strut in the desired position. After that, the optimal angle is determined by fixing the posterior end of graft temporarily with a needle to supratip cartilaginous dorsum.

Upon determining the angle, the surgeon sutures the graft to the dorsum. The tent pole grafts enable the extensive columellar strut to be stable and does not allow the tip to fall back. In addition to the advantages in the maintenance of the nose tip, it also allows the creation of the desired CLA.  

A surgeon may employ this technique when the tip requires support in secondary rhinoplasty procedures and cases where tip or columella lengthening is performed as well as to preserve the nasal length in patients who have short noses. This graft can be maneuvered to adjust the nasolabial or columella-labial angle conveniently.

The tent pole graft technique is especially useful in cases where the septal extension graft is not possible or very challenging to fix. (For instance, it can help patients who have a mild to moderate short nose.)

Caring double board certified plastic surgeon Dr. Geoffrey R. Keyes receives patients from Beverly Hills, Los Angeles, Bakersfield, California, and other towns and communities in this part of California for rhinoplasty.  


For more information on the surgical and non-surgical procedures and treatments by Double Board Certified Cosmetic Plastic Surgeon, Dr. Geoffrey R. Keyes, please contact us at (800) 859-7509. Offices in Los Angeles and Bakersfield, CA. 

Serving Greater Los Angeles, Beverly Hills, Orange County and surrounding areas of California.