Is Choosing Based Only on Before-after case Photos Dangerous? 3 Perspectives for Finding a Skilled Nose Surgery Specialist
Patient satisfaction with nose surgery is actually not determined by the "beauty of before-after case photos."
- What You'll Learn in This Article
- Key Points in Preoperative Analysis Considered in Nose Surgery
- Reference Indicators That Determine Overall Facial Balance
- How to Choose a Doctor Who Preserves Long-term Beauty
Are you struggling, wondering "I've looked at before-after cases from various clinics, but ultimately I can't tell which doctor is best"?
Why Can't Before-after case Photos Alone Determine a Doctor's Skill?
Many people prioritize the "beauty of before-after case photos" or "immediate postoperative changes" when choosing a cosmetic clinic. Certainly, photos are extremely important reference materials for imagining postoperative results.
An experienced doctor never designs based solely on the shape of the nose in isolation. They meticulously calculate overall facial balance (facial proportions) and derive the optimal shape tailored to each patient's contours and skeletal structure.
For example, evaluation from a basal view (looking up at the nose from below) is becoming increasingly important in modern smartphone photography. In this downward-facing angle, some research describes the ideal shape of nostrils as "teardrop-shaped," and also discusses the ratio between the nasal septum (the column between the left and right nostrils) and the nasal tip lobule (the prominence at the tip of the nose).
Rather than simply performing surgery to fulfill requests like "I just want a higher nose" or "I want to make my nostrils as small as possible," the important criterion for choosing a doctor is whether they can propose "the appropriate ratio for you" while considering harmony with your entire face.
Perspective 2: Do They Have Objective Indicators? Preoperative Analysis Based on Data
The concern "My nostrils are too wide" is extremely common. However, whether that wideness is "actually requiring removal (Nostril reductionThere are not many physicians who can judge, from an objective perspective rather than intuition, whether the level requires "surgery).
Some research evaluates "alar flaring" as a condition in which the most protruding part of the ala (outermost part of the nostril) protrudes beyond a certain distance outward from the alar base (the part where it contacts the face)1. Experienced physicians determine surgical indications based on such objective indicators.
Furthermore, there is the "nasolabial angle (びしんかく: the angle formed between the base of the nose and the upper lip)" as an indicator that determines the beauty of the lateral profile. According to research, reference ranges for the nasolabial angle have been mentioned2, and these indicators become important elements of preoperative planning.
Excellent physicians conduct detailed preoperative analysis based on such research data and anatomical standards. Rather than simply saying "let's make it a bit higher" during a consultation, a physician who explains with specific evidence, such as "in your case, considering the angle of your nasolabial angle, these kinds of changes can be expected," can be said to possess high professional expertise.
Perspective 3: Are you considering changes years down the line? Maintaining "function" and "structure"
It is important to consider long-term changes, not just the immediate post-operative results.
The nose is a complex three-dimensional structure where skin, cartilage, bone, and mucous membrane are intricately interwoven. Even if surgery temporarily reshapes the nose, if the internal support structure (foundation) is insufficient, cartilage may deform or the nasal tip may sink due to skin tension or the passage of time. Therefore, to achieve successful nose surgery, it is essential not only to pursue aesthetic beauty but also to maintain and rebuild the nose's "structural integrity" and "ease of breathing (function)."
Particularly in revision surgery or nose surgery for Asians with naturally small cartilage, nasal septal cartilage alone may provide insufficient tissue volume. In such cases, reconstruction using autologous rib cartilage (costal cartilage from the rib cage) is considered. Rib cartilage has sufficient volume and strength and is being researched as a useful material for robustly reconstructing the nasal framework and achieving long-term support.3.
Additionally, if the nasal valve (the passageway of the nostrils) becomes narrowed, it may cause serious functional impairment such as "difficulty breathing" after surgery.4。 Experienced physicians plan surgery while pursuing aesthetic design and simultaneously treating the maintenance of nasal airflow as one of the important surgical objectives. By creating anatomically correct structures without excess, you can expect a beautiful nose that remains stable long-term as a result.
Specific questions to ask during consultation to evaluate your surgeon
So, how do you actually determine which surgeon to trust?
This is the most common question asked during consultations."Doctor, how much higher will my nose become?"
In fact, the surgeon's answer to this question contains clues to identifying a trustworthy physician. An excellent surgeon will not make hasty promises. This is because the factors determining nasal tip height are not limited to the surgical technique alone—the patient's own skin thickness, elasticity, and cartilage strength play a significant role.
"Considering your skin thickness and cartilage strength, you can expect changes like this," — a trustworthy surgeon will respond by taking into account anatomical conditions and overall facial proportions.
Also, try asking questions such as: "Will there be any impact on breathing?" and "What measures do you take to address the risk of shape changes several years later?" If the surgeon can logically explain the internal cartilage management and functional preservation using specialized terminology in an easy-to-understand way, you can judge that they possess trustworthy standards.
"What about my situation?"
Book a free consultation
We do not engage in high-pressure sales. Please feel free to contact us.
Summary of this article
- Does the surgeon consider facial proportions as a whole: Rather than looking at the nose in isolation, does the surgeon use reference indices such as inter-inner-canthus distance to assess overall harmony?
- Is there objective analysis: Does the surgeon have reference indices based on research, such as nasal ala width and nasolabial angle?
- Does the surgeon prioritize function and long-term structural stability: Beyond just aesthetic beauty, does the surgeon consider airway maintenance (ease of breathing) and building a stable foundation using costal cartilage and other materials that will remain stable years later?
First, resolve your questions through a specialist consultation
Rhinoplasty is a surgical procedure that demands highly developed anatomical knowledge and aesthetic sense from the surgeon. Since many aspects cannot be judged from internet information or before-after photos alone, the first step is to engage directly with the surgeon and have your condition analyzed objectively.
If you have any concerns, please feel free to consult with us. At Zetith Beauty Clinic, we provide consultations based on medical evidence.
References
- Apaydin F. Nasal Valve Surgery. Facial Plastic Surgery. 2011 (DOI)
- Chen Y, Kim S, Jang Y. Centering a Deviated Nose by Caudal Septal Extension Graft and Unilaterally Extended Spreader Grafts. Annals of Otology, Rhinology & Laryngology. 2020 (DOI)
- Rohrich R, Shanmugakrishnan R, Mohan R. Rhinoplasty Refinements: Addressing the Deviated, Overprojected Nose. Plastic & Reconstructive Surgery. 2020 (DOI)
- Byrd S, Salomon J, Flood J. Correction of the Crooked Nose. Plastic and Reconstructive Surgery. 1998 (DOI)
- Chauhan N, Alexander A, Sepehr A, et al. Patient Complaints With Primary Versus Revision Rhinoplasty: Analysis and Practice Implications. Aesthetic Surgery Journal. 2011 (DOI)
About the author of this article
Tetsu AkiraPhysician
Executive Director, Medical Corporation SUNSET — Zetith Beauty Clinic Ginza, Osaka, Fukuoka
Specializing in anatomically evidence-based rhinoplasty with industry-leading annual case numbers. Known for surgical design emphasizing structural support and an approach pursuing long-term stability.