Rhinoplasty is a large part of my practice. We see primary, revision, and ethnic cases. The fundamental principles are all applicable to each patient. Achieving the best looking goes for that phase is always the major goal. To achieve that we need to have a window into the brain of the patient. That means what does that patient like to see in their new nose. I’ve given up on computer imaging because I think it’s misleading and not as accurate for the decision-making process as nose job pics or wish pics and evaluation by the patient of the before-and-after gallery.
Which pics are usually in my practice similar? Most patients who wish their nose to be improved have an apparent aesthetic sense and vision for their result. So, wish pics are used to give me a vision of what that patient would like to see. And, then we discuss with that in hand how can this be achieved. It’s important that patients understand that the nose is made of skin, bone, cartilage, and mucosal lining inside. I’m able to modify the bone and the cartilage and if needed the mucosa internally. But what we have little control over is how the skin will shrink over the new internal structures.
Nose Job Pics
It’s important that patients understand that wish pics are only a tool to give me the opportunity to understand as clearly as possible what their aesthetic taste consists of about their notes.
Most patients show me pictures with a slight supra-tip break which is a differential between the dorsal and the tip. The tip should be just slightly higher than the dorsum. This is a feminine look. Furthermore, men, usually show me photos of other men with a straighter dorsum and usually thinner middle third than they have. Rhinoplasty is a very complicated and demanding procedure. Therefore, I prefer the close technique for all procedures and often combine/add cartilage grafting to achieve the best aesthetic result.
In summary, wish pics are useful but rarely can they be copied entirely and reproduced on any given patient.
THOMAS TREVISANI, MD
BOARD-CERTIFIED PLASTIC SURGEON
MEMBER OF AMERICAN SOCIETY OF AESTHETIC PLASTIC SURGERY
