Rhinoplasty Finesse

Sydney plastic surgeon Dr Darryl Hodgkinson explains the finer details of ‘Finesse’ rhinoplasty

The goal of “Finesse” Rhinoplasty is to achieve a final result which complements the patient’s appearance, giving ideal proportion to the profile, so that the other more expressive features of the face such as the eyes, the brows and the mouth are emphasized. I believe Rhinoplasty is probably the most challenging of all aesthetic facial surgical procedures and I have been performing Rhinoplasty for 30 years and still find it very demanding.

Selecting the ‘Appropriate’ nose

Each patient has a particular image of what they want their nose to look like although they may find it somewhat difficult to verbalize this. We use Alter-Image which is a very accurate computer digital imaging program to help us not only show the possible result but to communicate with the patient. With my input as to what is surgically possible and the patient’s input as to what they would like to achieve, we are able to come up with the most ideal, individualized nose for each patient.

Before and after rhinoplasty by Dr Hodgkinson
Before and after rhinoplasty by Dr Hodgkinson
Before and after rhinoplasty by Dr Hodgkinson

By communicating using the imaging system, both the surgeon and the patient design together a nose that looks natural and “right” for the patient’s face. Making a nose simply smaller is not the answer as every nose must be as unique as every face. A successful rhinoplasty does not just change the size of the nose but nearly always changes the shape of multiple aspects of the nose: the tip, the bridge, the position of the nostrils and the width of the nose.

Breathing problems addressed as well

At the Cosmetic and Restorative Surgery Clinic in Double Bay, we test patients for the function of their breathing when they are considering a rhinoplasty as they may require septal surgery or turbinate surgery in order to improve the breathing. The breathing tests point to what is causing the nasal obstruction if one exists. The septal surgery or septoplasty can be done at the same time as the rhinoplasty.

Groups seeking nose surgery

In my experience, there are three groups of Rhinoplasty patients: Caucasians who often have a large bump on their nose and the tip is over-projecting or too broad, Asians who have a too flat and broad nose and Middle Eastern patients who have a hump, the tip is not supported and droopy. All procedures to correct the nose and the breathing are carried out under light general anaesthesia, usually taking about 1 to 1½ hours. A small splint is placed on the nose and there might be a splint also internally if work has been done on the septum.