The esthetic appearance of the nose is important for the entire face, particularly because it is the central and most prominent feature. The size of the nose is directly proportional to the upper and lower third of the face, especially the chin. Therefore, one must take these areas into account when considering increasing or decreasing the chin, as necessary.
The esthetic treatment of the nose relates to the nose axis, the height and length of the nose, the position of the tip and the septum, and the size and shape of the nostrils. The surgery is performed with internal incisions, through which the cartilaginous skeleton and osseous structure of the nose is exposed, and treated as necessary. In cases where there is need for greater exposure, especially of the cartilages at the tip of the nose, the internal incisions are connected via a cutaneous incision along the width of the septum, similar to some of the procedures where corrective or complex surgery is performed on the nose. These surgeries are performed after the age of 16 in women and 17 in men, usually at the same time that the end of the growth period is reached.
The surgical treatment of respiratory obstructions by way of the nose are either performed separately or integrated with esthetic repair. The air passages of the nose are influenced mainly by the position of the septum, the size of the turbinates, and the size of the internal and external air openings. The optimal surgical approach is achieved by endoscopy, and usually includes an ENT surgeon.
Corrective surgery, when required after prior esthetic surgery of the nose, is generally performed one year later, in order to allow for the finalization of the results of the first surgery, and to improve the quality of the internal scars. Corrective surgery generally requires wide exposure, and there is frequently a necessity to use cartilage grafts taken from the septum, the cartilage of the ears, or the ribs for the purpose of rebuilding the skeleton of the nose and regaining proper appearance and function.
Dr. Aharon Amir: Nose Reconstruction surgery