First rhinoplasty - SM Plastic Surgery

The nasolabial angle is the angle between the nose and the upper lip. The ideal range is roughly 95°–105° for women and 90°–95° for men. Too narrow an angle makes the tip look drooping; too wide an angle makes it look upturned.

At SM Plastic Surgery, the depressor septi nasi — the muscle that pulls the tip down — is incised to guard against tip droop. When the cartilage strut of the tip (septum, ear cartilage, rib cartilage) is set upright, the anterior nasal spine is raised vertically, building a structure that supports the tip and keeps the nasolabial area from hollowing. How well it holds varies from person to person with the state of the tissue.

Yes — refining the nasolabial angle while keeping the dimension of the nose can make a protruding mouth appear to recede. As the whole midface gains dimension, the protrusion softens naturally.

Yes. Rhinitis can in fact be improved as part of the functional treatment. A deviated septum, nasal valve stenosis, hypertrophic rhinitis and the like can be corrected at the same time as rhinoplasty, and where the operation is classified as treatment for a nasal condition, cover may apply depending on the private or indemnity insurance you hold.

Sutures come out after 7 days, after which daily life can resume. Swelling subsides by 70% or more within 2–4 weeks, and the final result settles after 3–6 months.

An angle of about 95 to 100 degrees is regarded as ideal for women. The angle that suits a given face still varies with facial proportions and features, so it is not decided by the number alone. We analyse the height, length, and width of the nose together to design an angle suited to each person.

When a wide nasolabial angle leaves the tip turned up, the design aims to narrow that angle and bring the tip down. The septum is extended and a cartilage strut is built at the tip so that the lowered position is supported. How far the correction goes depends on the condition of your nasal tissue and is decided after examination.

When a narrow nasolabial angle makes the tip look droopy, the correction widens that angle to raise the tip. At SM Plastic Surgery the depressor septi nasi is incised to reduce the downward pull on the tip. The method varies with the cause and degree of drooping, so it is explained at the consultation.

Autologous cartilage such as septal, ear, or rib cartilage is used to build the strut at the tip. Which one is chosen depends on the support required and on the condition of the cartilage that can be harvested. The size and shape of the septal cartilage are checked at the pre-operative examination before the decision is made.

The anterior nasal spine is the bony projection where the nose meets the upper lip. Setting this area vertically to support the cartilage strut at the tip helps reduce the tip dropping as the nasolabial area sinks. How the support structure is built depends on the condition of the nose.

A drooping tip often contributes to a nose looking long. Widening the nasolabial angle to raise the tip can make the length less noticeable, though the degree of change varies from person to person. We design after assessing the length of the nose together with the facial proportions.

A midface that looks flat or sunken, including the nose, is something we assess at consultation. Adding definition to the nose while correcting the nasolabial angle can make the midface look less sunken. The degree of improvement varies with the skeletal and soft-tissue condition, so we advise after examination.

The design builds a support structure at the tip so the shape is maintained, but how long it holds varies with each person's tissue. Skin thickness, the strength of the cartilage, and the healing process all play a part. The shape and angle are checked together at your follow-up visits.

The operation takes about one to two hours and is performed under sedation anesthesia. Stitch removal is based on about one week, as early as five days and as late as two weeks, followed by two to three visits to check progress. The time can vary with the extent of correction.

A design that focuses on the nasolabial angle and the tip, without greatly changing the height of the bridge, is possible. Correcting the angle as well can make the nose look higher even at the same bridge height. The extent of correction is decided after analysing the height, length, and width of the nose at examination.