How Should the Nose Aesthetics be Planned in Facial Asymmetry?

Among facial cosmetic surgeries, rhinoplasty is the most commonly performed one both in Turkey and abroad. Leaving aside the fact that the need for both functional and cosmetic revision is 5% in every rhinoplasty operation, your patient may not be very happy even if you have made a nice nose.

Are we making a mistake in terms of surgical technique or do other factors that we cannot take into account affect success?

As a rhinoplasty surgeon who has operated on many patients for many years and tries to follow scientific norms in the world, I can easily say that it is not the right approach to plan rhinoplasty without evaluating and analyzing the nose together with the forehead, lip, chin tip and under the chin and to complete the operation without ensuring the harmony between these structures at the end of the surgery. In such cases, surgery is actually like to be ended incomplete.

The first thing I do is to evaluate their nose and face profile when patients, who had undergone rhinoplasty but were still unhappy, applied to me. I mostly observe that they have asymmetrical facial contours and their profile problems are not fixed.

The most important point in today’s modern rhinoplasty is the necessity of ensuring the proportion and harmony between all the structures of the face. This view supports the argument that we should evaluate nose aesthetics in combination with facial cosmetic surgery. Therefore, profile and facial analysis are essential for all patients applying for rhinoplasty.

Proportional adjustment of the nose, lip, forehead, chin tip and under the chin – the quinary complex structure – is also important for the patient’s happiness after surgery. In order to obtain a more beautiful profile, the nasal tip and upper lip should be at the same distance.

Can you understand the facial asymmetry before surgery?

Yes, you can easily understand. Go before the mirror and look at your face carefully. If the right and left sides of your face are the same, we can say that you have a symmetrical face but if one side is ahead or your eyes and eyebrows are not aligned, it means that you have symmetry problems. This is a common situation in Turkey.

We sometimes encounter with extremely serious symmetry problems and may have to do skeletal restorations to ensure the harmony between the jaw, cheekbones, and forehead. In less problematic situations, fat injections and tissue augmentations are sufficient.

In every patient for whom routine profile analysis is performed, curvature of the forehead, forehead-nose joint, distance between nose and lip, and chin tip should be evaluated repeatedly.

If the forehead is flat, this can be fixed by using fillers or fat injection. Lips can be plumped. If the chin is small and located at the back compared to the nose, the implant can be placed on the tip or if the jaw is located in the front compared to the nose, it can be shaved with a shaver.

If your chin is small and located at the back compared to the nose, even if you have successful rhinoplasty, you will not have a beautiful profile because your nose will always look big as long as there is no harmony between chin and nose. The biggest mistake in surgery is to reduce the nose size to ensure the harmony between the nose and chin. In fact, our ultimate goal in all these processes is to ensure a balanced and harmonious profile and to achieve the golden ratio between all the structures on your face.

What is this golden ratio?

The Golden Ratio, which is believed to exist in nature, art, and architecture, is also used in facial aesthetics. According to this, the Golden Ratio in the human face is the ratio of the width of the nose to the distance between the nostrils; the ratio of the distance between the pupils to the distance between the eyebrows; the ratio of mouth width to nose width; the ratio of lower lip width to upper lip width; and the ratio of the length of the face to the width of the face to be 1.618.

Beauty has attracted the attention of many artists and scientists for centuries. Researches have revealed measurements and ratios that have universal validity for the ideal face. The golden ratio that we encounter everywhere in nature is the reflection of the beauty on harmony and proportion.These ratios exist even in the arrangement of leaves in the tree branch.