It is my strong belief that the result from Rhinoplasty depends on the pre-operative nasal assessment. To create controlled change it is absolutely essential to have a detailed plan that is followed during the surgery.
This plan describes the ideal nasal dimensions based on facial proportions. It also identifies any matters of concern.
A good analysis not only determines the ideal nasal tip projection, but also identifies problem noses that are at risk for a poor result.
Examples of the at risk noses include a nose with :
Low radix/Low bridge
Narrow (weak) middle vault
Inadequate tip projection
Alar cartilage malposition
When recognised special techniques that enhance the structure are necessary to avoid secondary deformity in these noses.
Nasal assessment begins by determining the ideal nasal tip projection point. This point is where the ideal nasal length meets the ideal projection.
The Ideal nasal length is equal to two thirds of the mid facial height (MFH), measured from the lower forehead to the alar bases, and is exactly equal to the jaw line to mouth angle (SM) distance.
This Ideal nasal length not only serves as a reference for whether the nose needs to be shortened or lengthened, but also serves as the key proportion for determining the ideal projection of the nose.
Ideal nasal tip projection is two thirds the ideal nasal length while radix projection is 9-12 mm in front of the cornea..
Ideal chin projection is determined by a line drawn from a point on the nasal dorsum at 1/2 along the Ideal nasal length and passing across the upper lip. The ideal chin in the female will project 3mm back of this line while in the male it will touch the line.
An important point to remember is that while nasal proportion is based on chin vertical, The position of the chin influences the nasal appearance. A small or underdeveloped chin gives the illusion of a too large nose. Care must be taken not to over-reduce the nose and to consider enlarging the chin in these situations.
Based on communications with Dr Steve Byrd , Dallas Plastic Surgeon, and his published methods of rhinoplasty analysis.
If you are seeking nasal change and desire a result that is in balance and hormony with the face there are answers to your questions available here Rhinoplasty "Making the right choices."
