Together with the modification of the adam´s apple (trachea), nose reshaping and feminization is one of the most common procedures in facial feminization surgery.
The nose is the most prominent feature of the face. Many patients believe that refinement of the nose can make a significant improvement in their appearance by making the eyes seem larger as well as emphasizing the cheeks. A rhinoplasty can have an overall complementary effect, making a face more delicate.
Usually the male nose is larger than the female nose because it has a greater component of bone, as evidenced by more prominent ridges. The forehead also plays an important role here, because of the transition between the nose and forehead. This transition in males tends to be sharp and prominent, making the decision as to whether the nose and forehead should be approached simultaneously, an important one. This decision is based on each patient’s individual needs.
Also, female noses are normally less prominent than males in all aspects, tending to be more narrow and straight or with a gently curved tip. On the other hand, the tip of the nose is often sharper in females than males. Finally, the nostrils tend to be smaller in females.
Feminization of the nose
Standard rhinoplasty techniques can be used to make the nose smaller and give it a more feminine contour with proportions that will be in harmony with the rest of the face and forehead. A reduction rhinoplasty consist in, generally, making the back of the nose smaller and the tip discreetly lifted. The correction of the brow prominence softens the angle between the nose and the forehead.
The type of skin in the nasal area can determine the final result on the procedure. The reduction can be entirely completed if the skin type is thin; however, if the skin is thicker, as is more common in males, the reduction, although noticeable, may have some limitations.
Rhinoplasty or nose surgery is a procedure highly individualized and requires an exhaustive evaluation of the bone and cartilaginous structures that form the nose.
In general, a rhinoplasty is performed under general anesthesia. In some minor cases, it can be done under local anesthesia or sedation. The surgery lasts between one to two hours.
Depending on the individual needs of the patient, the following procedures are possible:
- Refinement of the tip: By removing a small section of the cartilage of the tip we achieve the improvement or -narrowing- of the nasal tip.
- Feminization of the profile: The excess of bridge composed of bone and cartilage is removed and a nasal file is used to smooth for a more optimal result.
- Narrowing of the nasal bone: If the bridge is wide, it can be reduced by a nasal bone fracture on each side and posterior approximation of both towards the midline.
- Narrowing of the nostrils: Removing the base of the alar cartilage can reduce the volume of the nostrils.
Structured rhinoplasty: A long term philosophy
Nose surgery, statistically, is one of the procedures worldwide that present larger complication rates in the mid and long term (assimetry, deviation, tip collapse). This happens mainly when only aesthetic problems of the nose are addressed by the surgeon, without considering the nose’s inner structure and support. In these cases, the immediate results are satisfactory but in time the nose tends to suffer the above mentioned problems.
Our approach is always based both on Structure and Aesthetic. For example, the main areas of collapse (tip and dorsum) in our rhinoplasty technique are always reinforced with cartilage grafts which avoid undesirable postoperative changes on the mid and long term.
Postoperative and possible complications of a rhinoplasty
After surgery, in some cases, we will use a nasal splint in order to maintain the shape obtained. In addition, we will place Vaseline plugs inside the nostrils to stabilize the internal structures. The incisions made during the surgery are closed using small stitches.
One of the main discomforts is the feeling of not being able to breathe through the nose until the plugs are removed 24-48 hours after surgery. In addition, there is a tendency of dry lips or some difficulty swallowing food. The external splint will be removed 5-7 days after surgery.
Most of the patients who undergo surgery experience bruising around the eyes and cheeks, which will change color and finally disappear over a period of two weeks. Your nose will recover a normal appearance very soon, but the definitive results will not be noticeable until at least 6 to 12 months after surgery. The tip of the nose takes longer to achieve the new shape.
The nose is the most visible facial feature, so any imperfection, although very small, is noticeable to our eyes. Although the surgeon tries to achieve the best results, sometimes some asymmetries can be detected. According to international statistics, rhinoplasty procedures have the highest incidence of re-operation. These re-operations, if needed, are always done at least 12 months after the former surgery.