Noble Surgery and Cat Surgery—A Procedure Guide for Refining the Face Without an Obvious Surgical Look
In recent years, patients who value a natural result are increasing. For wishes such as "I want to avoid changes that obviously look surgical" and "I want it to look like it was always this way," noble surgery and cat surgery can be one option. Below, we provide accurate information on the content, effects, risks, and cost of the procedures.
* About Individual Variation (Important):In all cosmetic surgery, "whether it looks natural" and the amount of change differ greatly from person to person. This is because numerous factors are involved, such as bone structure, the state of skin/soft tissue, asymmetry, the chosen technique/material, the operator's skill, and the post-op course. Please read the following explanation with this as a premise.
What Is Noble Surgery—A Procedure to Refine the Dimensionality of the Mouth and Midface
The Mechanism of the Procedure
Noble surgery is a procedure that inserts/injects a medical implant, fat, hyaluronic acid, or the like beneath the skin of the alar base (the sides of the base of the nostrils) to lift the depressed area. By three-dimensionally supplementing this area, a "visual effect" can be expected in which the protrusion of the mouth (so-called mouth protrusion) becomes relatively less conspicuous, and the shadow of the nasolabial folds may also become less noticeable.
* Important:This is not a procedure that treats mouth protrusion (the bone structure, dentition, or lip protrusion itself). It is a procedure that aims to make the mouth protrusion appear less emphasized by lifting the alar base to supplement midface dimensionality.
By creating height in the midface, the balance of the entire face is refined whether viewed from the front, an angle, or the profile. It is not a procedure that changes the bone structure or contour but one that corrects the gradation of contours, so it is characterized by giving a change while not readily giving the impression of a "dramatic change."
Addressing These Concerns
- Concerned about an impression of the mouth jutting forward (mouth protrusion)
- The shadow of the nasolabial folds looks deeper than one's age
- The midface is flat, giving a flat impression
- Don't want surgical osteotomy or orthodontics, but want to refine the mouth
Changes You Can Expect
- The mouth protrusion eases, and it may look refined and composed
- The shadow of the nasolabial folds fades, and it may look more youthful
- Facial dimensionality increases, and some people feel the way light hits has become balanced
What Is Cat Surgery—A Procedure to Refine the Philtrum and Subnasal Angle to Create an E-Line
The Mechanism of the Procedure
Cat surgery is a colloquial name used in Japan, and medically it is positioned as a technique equivalent to columellar-base augmentation or anterior-nasal-spine augmentation. By supplementing the support around the columellar base to the anterior nasal spine (nasal spine), it adjusts the angle between the columella and the upper lip (the nasolabial angle) and the appearance from below the nose to the upper lip.
Specifically, approaching from the oral vestibule (the inner side of the upper lip) or inside the nasal cavity, a method of fixing a small implant above the periosteum (near the anterior nasal spine) to add support, or a method of grafting autologous cartilage such as septal cartilage into the columellar base (within the soft tissue) to supplement thickness and support, is chosen. The indication, risk, and durability differ depending on the layer chosen (above periosteum / within soft tissue) or the material (artificial / autologous tissue).
Through this adjustment, the elongation of the philtrum may look less conspicuous, or the curve of the upper lip may look emphasized. Regarding the profile's E-line as well, the appearance changes depending on the balance with the overall facial skeleton (chin, dentition) and nasal-tip shape, so how the change appears varies by individual.
It can be done alone, but combining it with rhinoplasty (nasal tip plasty・augmentation rhinoplastyetc.) yields a more natural, harmonious result. Merely raising or refining the nose can look unnatural if the philtrum is long, and adding cat surgery achieves overall balance.
Addressing These Concerns
- Want to refine the E-line and sharpen the profile
- The philtrum is long, and concerned about a sense of facial elongation
- The mouth looks like it juts forward (mouth protrusion)
- Want to refine it overall together with rhinoplasty
Changes You Can Expect
- The impression from below the nose to the lips is refined, and the face may look tightened
- The profile's E-line may look refined, and the balance of the profile may look good
- The elongation of the philtrum becomes less conspicuous, and it may look more youthful
About Risks and Points of Caution
For any procedure, the physician's skill and understanding of the patient's features determine the result. In cosmetic surgery, "which physician performs it" is one of the most important factors directly tied to the outcome.
Short-Term Risks
- Downtime (swelling, bruising):For about 1–2 weeks post-op, swelling or bruising may appear
- Infection:Rarely the insertion site may become infected. It can be prevented by performing post-op care appropriately, but if redness, pain, or fever persists, please contact us immediately
- Foreign-body sensation, odd feeling:Some people feel a foreign-body sensation right after the implant is placed, but most subsides over time
Long-Term Risks
- Positional shift, asymmetry:If the implant shifts, revision surgery may be needed
- Capsular contracture:The surrounding tissue hardens, and symptoms such as the contour showing through or being palpable may appear
- Implant exposure:Rarely it may show through the skin or become exposed
- Changes in surrounding tissue:Depending on the site and fixation conditions, changes in the surrounding bone (such as bone resorption) may occur
Characteristics and Risks by Material
- Autologous tissue (fat, cartilage):Foreign-body reaction is low, but absorption, asymmetry, lumps, and the like may occur
- Hyaluronic acid:Has reversibility (dissolvable), while there are injection-specific risks such as vascular embolism
Other Important Points of Caution
- Gap from the imagined result:Even if agreed upon in simulation, the actual three-dimensional change has parts that are hard to convey in photos
Things Important for Avoiding Failure
Clarifying the goal of the procedure in the pre-op consultation, confirming the clinic's tendency in results through case photos, and properly receiving post-op care all contribute to reducing risk.
Please confirm at the consultation stage "whether the imagined result can be shared" and "whether your anxieties and questions are answered carefully." We strongly recommend not signing the consent form while the explanation of the procedure remains vague.
A Rough Benchmark for Downtime
Both noble surgery and cat surgery follow roughly the following post-op progression.
- Days 1–3 post-op:The peak of swelling. Cool the area and rest.
- One week post-op:Swelling begins to subside, the period when most people can return to daily life.
- 2–4 weeks post-op:Bruising almost disappears, reaching a state hard for others to notice.
- 3–6 months post-op:The result stabilizes. The state at this time is the final result.
Behaviors that boost circulation, such as alcohol, vigorous exercise, and sauna, worsen swelling, so please avoid them for a while post-op.
A Rough Benchmark for Procedure Cost
The cost of noble surgery and cat surgery differs by the material used, the complexity of the surgery, and the clinic's facilities and location. The specific cost will be presented in detail at the consultation.
If you choose by cheapness of cost alone, there's a risk of choosing a clinic with insufficient skill or aftercare. It's important to judge comprehensively by the procedure track record, the quality of materials used, and the content of post-op support. Also, when combined with rhinoplasty it may be a set price, so please confirm at the consultation.
About Handling at Zetith Beauty Clinic
Our clinic handles numerous rhinoplasties and mouth-area procedures, including noble surgery and cat surgery. In performing procedures, we draw up a plan considering each person's bone structure, skin thickness, and overall facial balance, rather than a uniform design.
In the consultation, we explain in detail from setting the goal for the change, the explanation of risks, to how to spend downtime. We also welcome those who "just want to consult," so please feel free to book first. Post-op, we continuously perform follow-up observation and have a system in place to respond immediately if anything concerns you.
If You're Wondering "What About My Case?"
Book a Free Consultation
No pushy sales. Please feel free to reach out.
Summary
Noble surgery corrects midface depressions to improve the mouth's protrusion and the shadow of the nasolabial folds, and cat surgery refines the columellar angle to adjust the E-line and philtrum balance. Both are procedures with the direction of "refining the original features" rather than "dramatically changing," so they suit those who pursue a natural result.
However, the more natural it looks, the more delicate adjustment by the physician is required. Choosing a trustworthy physician and clinic through consultation is the shortcut to a result you'll be satisfied with.
If anything is unclear or worrying, please feel free to consult us.
References
- Plastic and Aesthetic Research. DOI: 10.20517/2347-9264
About the Author
Hiromitsu Nakamura M.D.
Zetith Beauty Clinic Ginza, Osaka, Fukuoka
Has a track record of research presentations at domestic and international conferences, and is also involved in technical guidance and education across Zetith Beauty Clinic. Specializing in precise rhinoplasty based on anatomical evidence, he pursues natural results tailored to each person's bone structure and tissue.