Male Rhinoplasty (Nose jobs):

Rhinoplasty surgery is becoming increasingly popular among male patients and was the second most popular procedure for males in the US last year. Many men see the benefits of having distinguished and well-proportioned features in both their personal and professional lives. Nearly half of my rhinoplasty patients are male. The reasons for men seeking nasal surgery are varied. Sporting injuries are common and may cause both breathing and cosmetic deformities. Reduction of a nasal bump is a common reason in people of various ethnic backgrounds. Most men seeking nasal surgery desire a natural-looking, manly nose. This means it is important to keep the nasal bridge strong and not lift the tip too much, as this will make the nose look effeminate. The nose can still be narrowed and refined, but generally this is to a lesser extent than surgery on the female nose.

At the time of consultation, digital photographs of the nose are taken and can be transferred immediately to the computer for assessment. Computer imaging is performed to give the patient a preview or prediction of the expected shape of their nose, which is designed to suit their own face. Computer-generated images are not a guarantee, but in my experience it is a valuable tool in conveying patients aesthetic desires with the surgeon. Often the results are predictable and very close.

It is imperative to examine the nose from a functional as well as aesthetic point of view. This is particularly important in male rhinoplasty, especially when reconstructing after an injury. Thorough assessment, internally and externally, is essential. During the initial consultation under local anaesthetic, a fibre-optic telescope is often used to look inside the nose for any deviation of the septum or other blockages. The outside of the nose is also carefully examined and the quality of the skin and other features are documented.

There are two main techniques used by surgeons in nasal surgery: 'closed' rhinoplasty and 'open' rhinoplasty. Closed rhinoplasty involves incisions confined to the inside of your nose, just inside the rim of each nostril. Working through these incisions, the surgeon can shave away excess bone and cartilage to reduce a hump, reposition cartilage or narrow the nasal bones. Open rhinoplasty involves a small incision across the columella, between the nostrils, in addition to incisions on the inside of your nose. Open surgery is usually preferred in more complicated cases.

Patients are fully briefed about the process and eventual outcomes prior to surgery. A careful history, assessment, meticulous planning and the use of the most advanced surgical equipment all contribute to rhinoplasties that result in patient satisfaction and improved facial balance. The surgery may take several hours to perform and is usually done under a general anaesthetic. Most patients can go home the day of surgery, but some patients may stay one night in hospital. Downtime is usually two weeks, after which time patients can return to work and normal activities (except contact sport).
Although the final result for any rhinoplasty should be viewed after one year, the nose looks better than the pre-operative shape after two weeks and should continue to improve over several months. If continuing to play contact sport, it may be better to delay definitive surgery until the patient decides to stop playing. However, broken noses should be dealt with immediately as it is better to reduce the fracture early.

Men's greatest fears after rhinoplasty surgery include that their nose will collapse in or look artificial or 'operated on'. With meticulous planning and assessment, a 'natural philosophy' and techniques based on conservative rhinoplasty, these fears can be allayed.

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