The term “deformity” may suggest something disfiguring, but actually, it’s used by medical professionals to describe “normal” anatomy issues. Worries about breathing capability or nose appearance affect many people, and as leading London rhinoplasty and facial surgeon Dr. Ali Alper explains, there are various causes, symptoms and treatments for nasal issues. Whether you’re seeking help for functional or aesthetic reasons, Dr. Ali Alper can help you reach your goal.

The term “deformity”

Sometimes, in people’s minds, the word deformity suggests something quite disfiguring. But in reality, a deformity may not mean something very disfiguring at all. The word can seem too strong for anyone who reads it while doing their research into nose conditions and they may think, “I’m not deformed”.

To clarify, when we (medical specialists) use the word deformity, it’s a way of saying something isn’t quite right, without it meaning disfiguring.  Within the word deformity, there are “normal” anatomy issues.

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The causes of nasal deformities

The cases of nasal deformities can be congenital i.e. genetic, or they can be acquired.

Acquired causes

The most common causes are injuries e.g. sports injuries, accidents, being involved in fights – generally any type of trauma.

Congenital (genetic) causes

The most common reasons for people coming to see a nose specialist is that they say “I have the same nose as my father/mother and I don’t like it”. Patients sometimes don’t like the nose they’re given, which can be influenced by different ethnicities as the general style of noses can differ between them.

• Patients from East Asia tend to have a low nose bridge and some seek to raise it.
• Patients from the Indian continent tend to have thicker skin layer covering the nose and seek to reduce it.
• African noses can have more width to them, and some patients wish to reduce this width.
• Caucasian noses can have a bump, or the nose is too large for the face. This is particularly the case with nose jobs in females. In fact, in London, this is the most common request – to have a smaller and “more feminine” nose.

It can also apply that either with or without an acquired deformity (e.g. from trauma), the nose can be not centred in the face – some genetic asymmetries and deviations can cause it too.

Generally, when considering the look of a person’s nose, it can be difficult to know whether the issue is congenital or acquired because facial asymmetry is very common. Nevertheless, the treatment, for whatever the cause of nasal deformity, is very similar.

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What are the types of nasal deformity?

Female derma rejuvenate treatment. Doctor in gloves touch woman face. Cosmetology pretty portrait. Facial injection patient.

In terms of types, I don’t look at nose deformities as disfiguring. Sometimes, we consider a type of deformity to be dependent on people’s goals:  The type refers more to the look my patient wants to achieve and how they would like to improve the nose’s appearance. For example, if they want a smaller or more feminine nose, if they want a straighter nose or if their goal is to have a higher bridge.

In short, the type depends on what we want to achieve.

To name some common nasal deformities, there are:

• Tension nose – the nose is under tension and this is when there’s an overgrowth of the nasal septum and the nose is over-projected.
• Then there is the opposite – an under-projected nose.
• Sometimes, they have a little bump but the nose fits correctly within the face.
• A deviated nose can occur with or without trauma. This is when the nose directs more to one side rather than straight.
• Saddle nose deformity (when the nose dips and people would like an augmentation to raise the dip)

What are the symptoms of a nasal deformity

In terms of symptoms for non-medical aesthetic issues, it’s quite often the case that people have nasal blockage, particularly when the nose is deviated. When the nose itself is twisted or deviated, almost 100% of the time the septum is deviated – this is the partition of cartilage between the two nostrils. So when the nose is deviated, almost inevitably, it involves a deviation of the nasal septum.

Do all nasal deformities require treatment?

Treatment for nasal deformities isn’t urgent as the situation is very rarely life-threatening, but rather it’s a matter of improving quality of life and being able to breathe better, or being more confident with your appearance. There are treatments to improve both function and form.

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How are nasal deformities treated?

Surgery is generally the option for improving nose function and form, but there are also non-surgical treatments that can temporarily improve the nose’s appearance.

It’s important to have your facial features assessed so that you see a doctor that really specialises in all craniofacial and developmental abnormalities.

As a general rule, there are three main types of nose procedures which are used to meet specific goals. However, it’s important to remember there are exceptions when it comes to the following procedures.

Rhinoplasty FAQs

Rhinoplasty, or nose surgery, is one of the most common plastic surgery procedures performed. During a rhinoplasty, the surgeon is able to reshape, reduce or augment a patient’s nose to improve appearance.

A rhinoplasty may be performed as a reconstructive procedure to correct a birth defect, a repair surgery to remedy an injury like a broken nose, or simply for cosmetic reasons. Sometimes the procedure is performed in conjunction with endoscopic sinus surgery for patients with ongoing sinusitis or with a septoplasty, a procedure to correct a deviated septum. In these cases, the operation effectively treats health and breathing problems, as well as improving the patient’s appearance.

What are the benefits of a rhinoplasty?

Rhinoplasty has several specific goals. Some facilitate breathing as well as improve facial appearance. During a rhinoplasty, the surgeon may make your appearance more pleasing to you by:

• Removing a hump on your nose
• Modifying the bridge of your nose
• Reshaping the tip of your nose
• Reshaping or resizing your nostrils
• Repairing your nose after an injury
• Increasing or decreasing the size of your nose

Are you a good candidate for a rhinoplasty?

In order to be a candidate for a rhinoplasty procedure you must meet the following criteria:

• Be at least 13 years old so that facial growth is complete
• Be in overall good health
• Not be a smoker
• Have realistic expectations about the outcome of the surgery

How is a rhinoplasty performed?

Rhinoplasty is usually an outpatient procedure performed under IV sedation or general anesthesia. It usually takes from 1 to 2 hours to complete. Surgeons use one of two techniques when performing nose surgery. In a closed rhinoplasty, incisions are made within the nostrils. In an open rhinoplasty, the incision is made across the columella, the tissue between the nostrils.

With both methods, the surgeon gently lifts the soft tissues covering the nose. The surgeon sculpts the bone and cartilage to the desired shape. Any additional cartilage needed to augment the nose can often be taken from the septum. If the patient has a deviated septum, the surgeon will adjust the septum and the inner structures of the nose to improve breathing. Then the tissues are re-draped and stitched closed. If the patient desires nostril reshaping, this is done as the final stage of rhinoplasty.

What is the recovery from a rhinoplasty like?

Immediately after surgery, your nose and eyes are usually bruised and swollen. Splints and some packing material will remain inside your nose for a few days. During this period, you may experience some nasal pain or a dull headache, as well as some bleeding and drainage from your nose. Most patients are comfortable enough to return to regular activities in about a week. Contact lenses can be worn immediately after the procedure, but glasses may need to be taped to your forehead or propped on your cheeks for up to seven weeks.

Are there any restrictions in the weeks following a rhinoplasty?

While you will be able to resume normal activities about a week after surgery, you will have to protect your nose while it heals by observing the following directives during the post-operative period:

• Avoid strenuous activities
• Take baths instead of showers
• Avoid blowing your nose
• Avoid constipation
• Avoid making exaggerated facial expressions
• Brush your teeth gently
• Avoid pulling clothing over your head
• Use sunscreen of SPF 30 or higher
• Limit dietary sodium
• Do not use ice packs

Are most patients pleased with the results of a rhinoplasty?

Patients with realistic goals for rhinoplasty are generally very happy with the new shape of their nose. The exact results depend on your nasal bone and cartilage structure, your facial shape, the thickness of your skin and your age. While you will look and feel fine within a week or two, you may have minimal swelling for as long as a year after the rhinoplasty procedure. Although your appearance may not be absolutely optimal until a year has passed, you will more than likely be extremely pleased with the results of your nose surgery soon after the procedure.

?What are the possible risks of rhinoplasty

Complications arising from a rhinoplasty are rare and, when they do occur, usually minor. These may include infection, nosebleed, or a reaction to the anesthesia. Some few patients may experience recurring nosebleed or numbness in or around the nose. On rare occasions, the nasal septum may be perforated, but this can be repaired. In general, a rhinoplasty is considered a very safe surgical procedure.

Will insurance cover your rhinoplasty?

Insurance may cover the cost of your rhinoplasty if the surgery is being done as a reconstructive or medically necessary procedure. If you are having a rhinoplasty for purely cosmetic reasons, insurance will not cover the cost.

What is revision rhinoplasty?

Revision, or secondary, rhinoplasty corrects deformities caused by a previous operation on the nose. It is a more difficult procedure to perform than primary rhinoplasty because there is less cartilage to work with and there may be scarring or tissue contracture. When performed by a highly skilled plastic surgeon, however, a revision rhinoplasty can improve both the appearance and the function of the nose.