So you don't regret rhinoplasty—what I, as a physician, want to convey: the truly important things
The nose is located at the center of the face and enters the eye from both the front and the profile. Precisely because a slight change changes the impression of the whole face, the damage when you cannot be satisfied with the surgical result is not small. Among the patients who come to the clinic, those who say "I had a procedure at another clinic but can't accept it" or "I wish I had researched more carefully before deciding" are not few.
In this article, based on what I feel in my daily practice, I have organized a way of thinking so as not to regret rhinoplasty. The comparison of techniques, how to discern a physician and clinic, the content you must confirm in a consultation—I will explain step by step.
Three viewpoints to grasp first
Not limited to rhinoplasty, this can be said of cosmetic surgery in general: whether you are conscious of the following 3 points before surgery greatly changes postoperative satisfaction.
(1) Confirm the "conditions" of the case photos
When you look at the Before/After posted on a clinic's website or social media, confirm whether the angle, lighting, and presence or absence of makeup in the photos are uniform before and after. A comparison photo whose conditions are not aligned cannot be said to accurately convey the actual change. On the other hand, a clinic that continuously publishes cases under the same shooting conditions can be judged to be confident in its results.
(2) Whether they consider not just the nose but the balance of the whole face
For the request "I want to raise my nose," merely inserting an implant is sometimes insufficient. Whether they are a physician who can propose a technique after comprehensively evaluating the shape of the contour, the distance between the eyes and nose, the thickness of the skin, and the strength of the cartilage directly leads to the naturalness of the result.
(3) Whether a postoperative support system is in place
No matter how experienced the operator, revision can sometimes become necessary due to individual differences in tissue or the postoperative course. It is important to confirm whether it is a clinic that explains in advance how it will respond when a problem occurs, and its policy and cost for reoperation.
9 points to discern a trustworthy clinic
Referring to the following items, try comparing clinics before visiting.
- Case photos are abundant, and the shooting conditions (angle, light level, presence or absence of retouching) are uniform
- The attending physician specializes in rhinoplasty, and the annual case count is clearly stated
- Septal extension, nostril reduction, hump correction, and other multiple techniques are handled
- There is an explanation of risks and anatomical limits in the consultation
- They themselves explain the possibility of complications and revision surgery
- The costs of anesthesia, drugs, and aftercare are clearly presented
- Multiple reviews and testimonials by actual patients can be confirmed
- Unless necessary, they do not casually recommend the use of a foreign body (implant)
- They also handle the revision surgery of patients who had procedures at other clinics
I in particular emphasize "whether they accept revisions from other clinics" as an indicator showing confidence in technique and a breadth of clinical practice.
The characteristics and risks of each technique—correctly knowing is the first step of choice
Although collectively called rhinoplasty, the purpose and indication differ greatly by technique. After understanding the characteristics of each, please examine the method that suits your state or wishes together with a physician.
Augmentation rhinoplasty with an implant
A surgery that inserts a silicone implant into the bridge and arranges the height and shape of the dorsum. It is a technique whose effect is stable and which easily produces a natural line. However, in people with thin skin, the contour of the implant can sometimes show through over time. Infection and displacement (deviation) are also conceivable risks. The downtime is roughly 1–2 weeks.
Hyaluronic acid injection
A method of making the bridge look high or fine-tuning the shape without using a scalpel. While it can be tried easily, the effect is temporary and periodic injection becomes necessary. The risk that requires the most caution is vascular embolism. Mistakenly occluding a blood vessel at the injection site can cause skin necrosis or visual impairment. Procedures by a physician with skill and anatomical knowledge are indispensable.
Nasal tip plasty
A surgery that, by suturing and shaping the cartilage of the nasal tip (the tip area), reduces the roundness and creates a sharp impression. It is used to improve a bulbous nose. In people with thick skin, the change can be hard to show, and hardness may also be felt after surgery. Cases of combining auricular cartilage grafting are also common.
Nostril reduction
A surgery that narrows the width of the ala (nostril wing) and adjusts the size of the nostrils. It is effective for improving the balance of the whole face, but because it involves incision, a scar may remain. To finish it symmetrically, the operator's experience and precision are important.
Septal extension surgery
A surgery that grafts and fixes cartilage onto the septal cartilage and greatly changes the height or direction of the tip. While the effect is large, the technical difficulty is also high, and compared with other techniques the risks are also varied. Deformity, infection, resorption of the grafted cartilage, and postoperative hardness are possible complications. The difficulty of revision surgery is also high, so please carefully select the surgeon.
Hump correction (hump reduction)
A surgery that, by shaving the protrusion (hump) of the dorsum, makes both the front and side a smooth line. Because it processes both bone and cartilage, the operator's three-dimensional anatomical grasp is required. Caution is needed for the flattening (saddle nose) caused by shaving too much.
* The guideline for downtime all have individual differences. There are also cases where it takes 1–3 months until swelling and bruising completely settle.
What to confirm in the consultation
No matter how excellent the physician, if they cannot accurately grasp what the patient wants, they cannot approach the ideal result. Please use the consultation as "a place to decide the policy together with the physician," not "a place to listen to an explanation."
What to prepare in advance
- Prepare multiple reference photos of your ideal nose (celebrities, models, etc.)
- Put into words which part of your nose you want to change and how, in advance
- Write out the things you are concerned about and anxious about on a memo
4 questions you should be sure to ask in the consultation
There are also times when you get nervous and can't speak well. It is fine to write down the following as is on a memo and bring it.
- "With my skin thickness and the state of my cartilage, to what extent can I approach my ideal image? If there is a limit, where do you draw the line?"
- "How will you create the support structure of the tip? Please tell me about the differentiated use of septal cartilage, auricular cartilage, and costal cartilage, and the future deformity risk of each."
- "If revision surgery becomes necessary, what will the difficulty, cost, and timing be?"
- "Is the 3D simulation done after reflecting the limits of the technique? So that I don't have excessive expectations, is an accurate sharing of the image possible?"
If they are a physician who answers these questions carefully and concretely, that itself becomes evidence of trustworthiness.
If you feel something is wrong after surgery, visit immediately
The postoperative course is smooth in most cases, but if strong pain, a sudden increase in swelling, a change in the color tone of the skin, fever, or the like appears, contact the clinic without hesitation. Early response prevents the worsening of complications. A judgment of "let me watch and wait a bit" can sometimes lead to regret.
Frequently asked questions
Which is better suited, hyaluronic acid or an implant?
It differs depending on the size of the change you want and your tolerance for risk. If you want to change greatly and long-term, an implant; if you want to try first or fine-tuning is enough, hyaluronic acid becomes an option. However, as mentioned above, hyaluronic acid injection has a vascular embolism risk, so it cannot be said across the board that "it's safe because it's easy."
From when can I receive revision surgery?
Until the tissue is sufficiently stable, you need to wait at least 3–6 months. Evaluation at the stage when swelling has not subsided is inaccurate, and reoperating early in a hurry can further complicate the state.
Are there cases where rhinoplasty cannot be performed?
In the active phase of a severe allergy, autoimmune disease, skin disease, or infection, the procedure can be difficult. In addition, in the case of minors, because growth may not be complete, careful judgment is needed. Please confirm in detail at the prior examination.
How long is the downtime?
It also depends on the technique, but swelling and bruising often last about 1–2 weeks, and the guideline for returning to social life is that period. However, please build your schedule foreseeing that it takes 1–3 months until the tissue completely settles.
Finally—to undergo surgery with conviction
Rhinoplasty, with the correct knowledge and a trustworthy physician, can become an effective means of arranging facial balance and regaining confidence. However, that is, after all, "only with appropriate judgment and preparation."
Understanding the technique, discerning the physician, and dialogue in the consultation—only when these 3 are in place does it lead to a highly satisfying result. I strongly recommend gathering information until you are convinced, without rushing or being impatient, before deciding.
If you have any concerns, please consult us without reserve.
References
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The author of this article
Tetsu Shaku Physician
Medical Corporation SUNSET, Director ― Zetith Beauty Clinic Ginza / Osaka / Fukuoka
Specializing in rhinoplasty based on anatomical grounds, with an annual case count among the top in the industry. Known for technique design that emphasizes structural support and an approach that pursues long-term stability.