hi i'm dr rajani thanks for joining me
today i'm taking you through
a rhinoplasty and giving you an
explanation of
what it is what's an open a closed
hanging columella too wide of a nose
dorsal hump
the nose is sought after and i think
roughly everyone i never can say
everyone
but such a high percentage of hollywood
has had a nose job
some are subtle and some are more
obvious and some people like
singers or people who depend on their
voice a lot
they can't change the septum so much or
the part that's in the middle or even
the the
width of the nares because it's all
dependent upon
the great voice that they have and how
they make a living so sometimes it's
really subtle
and you are like did they have one done
did they not maybe they had a chin
implant because
changing the projection of the chin in a
convex space
is sometimes all that's needed uh lady
gaga would be an example
if you look at the side profile of the
chin
the nose and if you're thinking about
uh what was done and if something was
done it was so
subtle and i covered that one of my
prior videos but let's go into a
rhinoplasty or
surgical nose job and i'll show you
what's involved because
when you go and you watch my pdo nose
threads or nose jobs or my
filler nose jobs you'll be able to
understand
what they're doing and why maybe 30
percent of the people that walk in
for threads or for fillers are real
candidates the rest need to have surgery
and keeping in mind
a lot of people that have rhinoplasties
are not happy with them people are into
symmetry
people want them a specific perfect
shape and it might be more
dramatic or less dramatic than what they
had surgically
as well it takes six months to a full
year
to see what it looks like the end result
so it's although there's an immediate
effect
it takes six months to a year to fully
go yes i'm happier no i'm not happy by
that time
their mindset has changed let's look at
an animation let's look at a surgical
rhinoplasty now three seconds
[Music]
so if you see here several things can
happen with the nose
number one is going to be a dorsal hump
and if you look here this is kind of a
rounded shape like this
and some people would also say
what they don't like is maybe it was
straight here
but there was a hump here and then it
straightens out so there could be a
central hump something from an old
traumatic injury
this is the columella so some people
will say they have a
hanging columnal and they'll want that
fixed some will feel like the opening of
the nose
is too wide now let's move on here
and take a little look at what we have
so that's one issue people might present
with
the next is the hanging tip that i just
kind of mentioned and talked about
and then if we look forward here the
wide nose
so this is worth looking at for a second
uh the reason is
we always are wondering uh what should
the width
be so if we're if we're wondering
if is this kind of too wide here
we use what the brows if you come down
from the brows they can
make a difference into the width that
people think their nose are so
if you come this way with the brows it
does make the nose
look narrower immediately but a good
rule of thumb
is the inner canthus and coming down
that should give you this width here
and we can look at that at the
superstars of the world
and see that that that does hold true on
the width
some people are narrow here but then
have a bulbous tip
and when you're doing fillers really
what you're trying to do then is
or threads you're trying to narrow the
look of the nose
or even the nostrils there's a few
things you can do
but you're somewhat creating illusions
at that point
so let's go forward and check it out
wide rounded tip we talked about that
now this is good to stop and just
discuss something here
because if we look here's the upper
alar cartilage and here's the lower
these can be manipulated
cut grafted you can put silicon implants
in here but they're important to know
the anatomy and of course here's your
nasal bone your arteries by the way run
your angular down the side
but if someone's had surgery there's no
way of knowing exactly what the arterial
supply is
and of course we have aberrancies as we
know
so let's keep going through the video
the nose can be narrowed and the tip can
be narrowed you can see it's quite
complex
uh through let's stop here for one
second
because if the sutures are kept inside
the nose and
that is then called a closed rhinoplasty
and then an
open would be if there's visible scar
or visible cut on the outside at the
columellar
and then the dissolvable sutures can be
used oftentimes you can do
a dorsal hump can be do that can be
treated in a closed fashion the tip can
be lifted you see this
angle is an important angle too
so let me demonstrate that and clear
that screen the angle of the nose a lot
of people want that button
uh tip nose and this angle here
is important to know and that plays a
role so you can lift
that tip and that's something that
people look for when they get
surgery when they want their nose
altered with whatever
treatment okay so here you can see
instruments are have gotten pretty
amazing what you can do inside
this if they just left it there on
either side would be a
a closed rhinoplasty this will be open
because the coursers are cut along the
column and then what that can happen is
that in an open
it can be retracted to reveal the layers
of cartilage that we talked about
and then they can be manipulated
cut essentially sometimes of course the
nasal bone there can be a hump
there that we want removed to narrow we
would
have to then go and cut the cartilage
and
narrow and suture the
bone and cartilage together and so what
happens is then
it's narrowed and you can see that here
often grafts can be placed
this would be more at the tip the lower
alar cartilage here
you can see the tip is then can be
narrowed a graft can be placed
in a graft at the tip to shape it and or
straighten it and the sutures keep it
narrow
and then of course everything's closed
up and at that point
the sutures are placed and the recovery
time
ensues so there you go that's
rhinoplasty
that gives you a rough idea so many
things can be done
uh and so many things can't be done it's
one of the highest dissatisfaction
procedures depending
in whose hands it is and what the
expectations were what the patient
wanted
the septal cartilage we didn't talk a
lot about can be deviated side to side
it has a memory it'll want to go back to
where it was
so it's complex and revision rhinoplasty
when people aren't happy want to have it
redone
is when they'll often come for fillers
but watch my video
on nose fillers pdo nose threads
and what can be done and of course the
skin on the nose for pores for reds
the bulbous tip rosacea it's complex it
all plays a role have you had a
rhinoplasty
do you see them all over hollywood the
nose
should be straight it should have a nice
tip all those things
to make and create beauty let us know
stay tuned here keep your skin and body
beautiful healthy
and vibrant