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When we try to identify the facial features that make us look the way we do, it’s the nose that is often seen as our most prominent characteristic. This is because the nose is situated in the centre of the face and draws just as much attention as other features, such as the mouth and eyes. If the nose is misshapen or overly prominent, it takes an enormous toll on your appearance because it is in the middle of your face. If you’re bothered by the way your nose looks, it’s likely to have a negative effect on your how you feel about yourself. For this reason, our patients who undergo rhinoplasty, or surgical nose contouring, find the results to be extremely rewarding.

Call Briarwood Cosmetic Surgical Centre at 905-849-4282 to book your medical consultation with Dr. Stephen Brown. In addition to training budding plastic surgeons in their residency programme at the Department of Medicine at McMaster University in Hamilton, Dr. Brown serves as an Expert Witness for the College of Physicians and Surgeons of Ontario (CPSO).

Regardless of the features of the nose you wish to have addressed, Dr. Brown always takes care to preserve its primary characteristics. All changes are made in accordance with the balance and character of your face. This is incredibly important in any cosmetic rhinoplasty surgery, since a “blanket” approach to the surgery can lead to results that don’t suit your face and, ultimately, look unnatural. Dr. Brown performs a very thorough examination during your consultation in order to best understand how to plan your treatment. He identifies your most attractive features and, by leveraging more than 25 years experience in performing rhinoplasty, works to enhance your appearance by bringing your nose into proper balance with the rest of your face. If you experience trouble breathing, Dr. Brown will also ask questions regarding your allergies, previous injuries, family history, and response to seasonal or emotional changes during the consultation process for a more effective solution.

You may be an ideal candidate for rhinoplasty if your problems are related to one or more key features of the nose. Complaints regarding aesthetic issues like wide or drooping nostrils, nasal bumps, and large nose tips can be corrected through nose reshaping surgery. The procedure not only fixes cosmetic problems, but also internal ones related to troublesome breathing as well. Dr. Brown’s approach involves treating the interior and exterior of the nose, making treatment an ideal solution to a wide range of problems.

Customizing Your Nose Reshaping Procedure

Dr. Brown understands just how delicate the nose reshaping process is. As a result, your initial consultation will involve a thorough discussion of how you’d like your nose to look like. Some patients find that bringing pictures of noses they like also helps illustrate their expectations. Dr. Brown strives to identify exactly what you want in advance, so that your surgery reshapes your nose the way you desire.

Since your nose is one of the facial features most responsible for determining what you look like, he is extremely careful to preserve its best features while subtly correcting problem areas. The rhinoplasty procedure typically requires Dr. Brown to make small changes to the nose. These usually include widening and strengthening the nasal bones, correcting the extent to which the bridge projects, defining the tip of the nose, and altering its length (or nasolabial angle). He may also reduce the general size of the nose, remove unsightly nasal humps, or narrow the nostrils as part of the surgery.

Every precaution is taken before, during, and after the rhinoplasty procedure in order to ensure an exceptional outcome for you. A careful approach, combined with Dr. Brown’s experience and surgical skill, makes it possible for you to enjoy an improved, natural-looking nose that contributes to the overall balance of all of your facial features.

Open Rhinoplasty vs Closed Rhinoplasty

There are two primary approaches to rhinoplasty: “closed” or “open”. These refer to the manner by which the surgeon accesses the nose’s skeletal framework, where adjustments are made to achieve the desirable expectations of the patient. Both approaches have unique advantages and disadvantages that are carefully considered before planning the procedure.

Closed or Endonasal Rhinoplasty

A closed rhinoplasty takes its name from the limited amount of operating area exposure provided to the surgeon. All incisions are placed inside the nostrils. There are no visible scars, which is the biggest advantage of this approach. The downside is that repositioning the skin of the nose is difficult due to the fact that the nostril incisions cannot be connected. This makes it necessary for the surgeon to work in a small area without much visibility. Stretching and distortion of the nasal cartilage can also occur when gaining surgical access to the skeletal framework.

Open or External Rhinoplasty

Open rhinoplasty broadens the operating area with the creation of a small incision that bridges those made in each nostril. This connected incision allows Dr. Brown to fold the nasal skin upward and more easily see the skeleton of the lower nose. While the external approach leaves behind a tiny visible scar (usually measuring a couple of millimetres) it also makes it possible to perform the operation without the risk of distorting the nose’s cartilage. The other main advantage is that the structure of the surgical site is undisturbed and can be adjusted with greater precision.

Weighing The Pros and Cons

Some patients (particularly those with straightforward nasal anatomy) can be treated through closed rhinoplasty, enjoying an improved appearance without scarring. However, the open approach is preferred. The advantages of a clearly visible operating area can lead to aesthetic results that outweigh the minor problem of a visible, but tiny, scar.

Using the open technique allows for the treatment of complex deformities and intricate issues, such as twisted noses, cleft lip, or post-rhinoplasty complications. These tend to be difficult to correct using a closed approach. In addition, the open approach is better suited for the correction of the nose tip since it causes so little damage to the internal structures of the area and achieves long lasting results. For these reasons, the open approach is the preferred rhinoplasty approach in the majority of cases.

Dr. Brown will help you determine which technique is best to achieve your desired results.

Asian Rhinoplasty

Having performed rhinoplasty for over 25 years, Dr. Brown has developed a profound understanding of facial proportion and harmony, regardless of the patient’s ethnic background. In addition to discussing your goals during your pre-surgical consultation, he also examines the width and shape of your nose, the thickness of your skin and the bone structure of your face as well as other facial features to determine how much modification is required to achieve optimal improvement. It’s all about balance and harmony, and that can only be achieved by assessing your entire face.

While Dr. Brown customizes the surgical experience for every one of his patients, he has found that all seek an improvement that appears natural and harmonious with the rest of their facial features. Nobody wants to look like they’ve had something “done”. This is of particular concern for patients who want to preserve their ethnicity, which is the case for patients seeking Asian rhinoplasty.

Even the smallest changes to your nasal bridge or the reshaping your nose can potentially alter your ethnic identity if not done properly. Dr. Brown understands how to improve your imperfections as a patient of Asian descent while still allowing your natural characteristics to remain.

Although every patient is different and unique, there are some general characteristics of the nose that may be shared amongst Asian patients. Asian patients, in general, have a broader nasal bridge due to shorter nasal bones. The nostrils and nasal tip may also be wider. Thicker skin is also a common trait that many share. These traits all impact the surgical techniques that are applied during the rhinoplasty procedure.

The Nostrils: Dr. Brown reduces the size or narrows the shape of the nostrils (alar base narrowing) without sacrificing the ethnic qualities of the Asian face. In alar base narrowing, restructuring the nostrils to create natural curves is performed with incisions that are placed into discreet areas of the nostril folds, leaving invisible scarring. Because no patient is exactly the same, the extent of correction depends on your preferred results.

The Nasal Tip: Often times, Asian patients express concerns about their nasal tip. They seek more projection and definition. Lack of projection is primarily due to weak or lack of cartilage. Dr. Brown can address this concern by reshaping the cartilage in the nose, or adding to it with a graft. The skin may also be modified.

The Nose Bridge: Due to a lack of cartilage or a short nose bone, the nasal bridge in some Asian patients may be broad and low. Dr. Brown can thin the bridge out slightly and redefine it by reshaping the bone.

Scarring: Scarring can be a concern for Asian patients who have thicker and more inelastic skin. Dr. Brown performs incisions inside the natural folds and creases of the nose, and if needed, inside the nose itself. This minimizes visible scarring.

One of the most important aspects of your Asian rhinoplasty is the pre-surgical consultation. You will have plenty of time to discuss your expectations at length with Dr. Brown. He always takes the time to answer all of your questions because he never wants you to rush into any procedure without being confident that you’re making the right choice.

Dr. Brown knows that your ethnic features are what make you unique and beautiful. Your face tells your story. He will stay true to who you are by using the latest techniques, his extensive experience and knowledge to keep any changes looking natural and beautiful.

African American Rhinoplasty Specialist

Being such a prominent feature of your appearance, your nose contributes greatly to the aesthetic quality of your face. For this reason, a major concern with rhinoplasty, or cosmetic nose surgery, is controlling the extent of correction your plastic surgeon performs. You don’t want to “over correct” your perceived flaws, as the results may appear artificial and not in harmony with your overall facial proportions. This is something all rhinoplasty patients express concern about during their pre-surgical consultation with Dr. Brown, and it is of particular concern for patients who want to preserve their ethnic appearance, such as those who are African Americans. One of the best things about you and your face is the distinguishing factors that are connected with your ethnic identity. So, how can you improve your appearance without negatively impacting your natural facial proportions?

Common Features That Characterize the African American Nose

Please note that the following characteristics are very generally speaking. Not all patients who are African Americans may possess these characteristics. In addition, these characteristics may be shared by patients from other backgrounds.

In general, African-Americans have a broader nasal bridge. Their noses tend to have wider nostrils and a broad nasal tip. A frequent request Dr. Brown receives is to thin the nostrils just a bit and add more definition to the nasal tip. Knowing that African-Americans tend to have thicker skin and weaker cartilage means being strategic in correcting issues. Dr. Brown will listen to your concerns and make the wanted changes with just a slight modification of the cartilage or bone in such a way that stays true to your cultural identity.

For those African Americans who are concerned with having wide nostrils that flatten out when they smile, Dr. Brown can reduce or narrow their nostrils (alar base narrowing). In alar base narrowing, common practice is usually to cut into parts of the nostril to thin them out. Dr. Brown will discuss with you if he will actually be reshaping the entire nostrils to reduce visible scarring. Because each nose is different, the technique used will depend on your needs, concerns and the best surgical technique to achieve the results you want.

Due to weak cartilage and lack of definition, some African Americans have a wide nasal tip and are looking to improve its prominence and definition. Dr. Brown can address this concern by remodeling the existing cartilage or grafting cartilage from somewhere else (usually the ear or septum) to modify the tip.

Another common concern is a wide nose bridge. This can be caused by cartilage that is weak or insufficient. To thin out a wide nose bridge, Dr. Brown may narrow the bridge bone. To keep this change looking natural, there may be a need to define the nasal tip, as well.

Dr. Brown considers the placement of any incisions carefully before proceeding with surgery, and applies advanced surgical techniques to allow for invisible or “barely there” scars. Patients with thicker skin prone to abnormal scarring appreciate this, and it is something that has contributed to the high satisfaction rate for which Dr. Brown is renowned.

Discuss your concerns and wishes with Dr. Brown in depth as you plan for your nose job. His careful consideration, experience and talent will ensure that your wants and needs are met while never detracting from your unique cultural beauty.

Getting Back to Normal After a Nose Job

When you first return home from your rhinoplasty you may be upset with your appearance. Your nose will probably look and feel worse before it begins to get better. You’ll most likely experience bruising, swelling, some numbness, congestion, and a certain degree of pain. Your nose may also appear crooked or generally uneven at first. A nasal splint is used to help the nose keep its shape during healing and needs to stay in place until removed by Dr. Brown. In some cases, you may also have packing or internal splints in order to keep the septum in place.

Pain will range from moderate to severe for two to ten days, but prescribed medication will help you feel better. While the entire nose will slowly regain normal sensation, the tip may be numb for several weeks. Any swelling or bruising will diminish over one to six weeks if you the closed rhinoplasty technique was performed. If you were treated with the open technique, these issues may linger for one to six months. Dr. Brown will tell you if any nasal bones were broken during the surgery. If this is the case, then the degree of bruising and swelling you experience will be more severe and take longer to subside.

Everyone heals differently, but, as a general rule, the optimal results of surgery may become apparent in as little as three months, while in some cases it may take up to two years. Despite this, most people return to their normal schedule after only three to four days. After a few weeks makeup can be used to conceal any lingering bruising.

Guidelines for a Safe Recovery

If you require glasses you should plan to wear contact lenses during recovery. If this isn’t possible, your glasses must be propped onto the cheeks or taped to the forehead in order to avoid damaging the delicate bones of the nose. This will be necessary until the nose is completely healed after six to seven weeks.

During this period of time it’s extremely important to avoid doing any activity that causes the nose to move. This includes not only touching and blowing your nose, but exercise as well. You should plan to wait ten to fourteen days before working out and at least six weeks before swimming. Direct sun exposure must also be minimized for at least two weeks. Sun block should be worn through the first three to four months. Report excessive bleeding or increased pain to Dr. Brown immediately if either occurs during the first days of recovery.

Tips for Speeding Up Recovery

There are a number of ways that you can help speed up your recovery process. It’s a good idea to apply either cold or warm compresses (usually cold for the first day and warm afterward), use a humidifier and saline nasal spray for two weeks, and keep your head elevated while sleeping. Elevating the head at night—and avoiding bending over during the day—helps minimize swelling.

You should allow your stomach to fully settle after the surgery by eating only broth, thin soup, juice, and water. These foods should be eaten around the time your medication is taken in order to avoid upsetting your stomach. Vomiting hurts the nose while it’s healing, so it’s important to take care during the healing process and only return to a normal diet once your stomach has completely settled.

Revision Rhinoplasty Specialist

Rhinoplasty is one of the most difficult cosmetic surgery procedures to perform since just milimetres can make a huge difference in the appearance of the patient. It can also be difficult to determine the exact results patients want, although Dr. Brown prevents a dissatisfactory outcome by speaking to every patient at length before the surgery to pinpoint the particular changes that are desired. He also examines each patient to ensure expectations can be met.

According to the industry average, it is true that many patients seek a secondary nose job procedure to correct undesirable results that occurred from their first procedure. The following are some of the more common problems that patients seek to correct in a revision rhinoplasty:

  • A pinched tip, one of the telltale signs of over correction.
  • A nose that projects too far from the rest of the face.
  • A drooping tip, indicating lack of support from insufficient cartilage.
  • A nose that looks “too small”, which causes disharmony of facial proportions.
  • A nasal bridge that is indented or “scooped out”, which means too much bone or tissue was removed. If too little tissue has been removed, then the opposite may result so that a bump on the bridge remains.
  • A crooked nose, where it appears twisted in the upper of lower portion.
  • Breathing problems, caused by airway blockage.

These issues may all be corrected with a revision rhinoplasty, a procedure that tends to be more complex to perform than a primary one because of damaged, scarred or inadequate tissues. The surgery usually takes longer and is more involved, requiring advanced surgical expertise that Dr. Brown has cultivated over the 25 years he has been a plastic surgeon.

Before Your Second Rhinoplasty, Wait At Least a Year

It is best to wait at least a year before scheduling a secondary nose contouring procedure for several reasons. This allows your body to heal completely so that swelling has subsided and the tissues in the nose are more resilient. It allows scar tissue to soften so that it is more pliable and easier to surgically modify. It also allows your nose to “settle”, which is important. Sometimes, concerns following the first procedure resolve themselves once full recovery is completed. There have been many situations where a patient has come in for a consultation for revision rhinoplasty about a problem that gradually corrected itself as their nose healed, making a second procedure unnecessary.

Rhinoplasty and Septoplasty Surgery

Septoplasty is a form of rhinoplasty that targets the nasal septum, the wall that separates the two nostrils (nasal passages).

The Septum

The septum provides structural support to the nose so that it can project from the face. Constructed from cartilage and bone with a mucus membrane cover, it also serves to direct airflow in and out of the body.

The primary goal of septoplasty is to correct a septum that is displaced to one side. Known as a deviated septum, this condition causes one nasal passage to be smaller than the other. In some cases, this can be so prominent that it inhibits the passage of air through the smaller, compressed nostril, making it difficult to breathe. A deviated septum may be present at birth, develop naturally, or be caused by trauma to the nose.

While a perfectly straight septum is rare, for some individuals any deviation can cause both functional and aesthetic concern. Breathing difficulty and an undesirable nose contour may be reasons why septoplasty is performed.

Septoplasty is performed on an outpatient basis at Briarwood Cosmetic Surgical Centre and takes about one to two hours to perform, depending on the extent of correction requested. Your surgery typically involves an incision placed inside the nose. For this reason, the resulting scar is located discreetly inside the nose.

Following your surgery, you’ll recover for a few hours in our recovery room under the watchful eye of Dr. Brown, our anesthetist and nurses. Once discharged, you’ll be able to continue your recovery in the comfort of your own home. Medications may be prescribed to help ease discomfort, and the tenderness and swelling you’ll experience as common side effects of surgery will gradually subside within two weeks or so. Dr. Brown will provide you with post-care instructions that you should follow to facilitate your recovery.