Nose Anatomy

 

 

Nose Anatomy

 

Rhinoplasty is perhaps the most technically challenging procedure in plastic surgery for a variety of reasons. There are many variables that must be taken into consideration. Each nose is dramatically different and, hence, requires different techniques to obtain the desired result. For these reasons it is critical that you make sure your rhinoplasty surgeon has a clear understanding of what you want to accomplish.

 

The purpose of this overview is to educate so that you have a working knowledge of what defines an attractive nose. Furthermore, it describes in easy to understand terms what are the most common problems seen with nose surgery and how they are normally treated. It includes many pictures to clarify and, hopefully, make it fun to read.

My recommendation is to read along and identify what your concerns are with your nose. It is important to understand the basic anatomy and be able to clearly point out to your surgeon what you would like to achieve.

 

The treatment plans that I have laid out are how I normally address the area of concern. They are one way to treat the problem but each surgeon may have a different approach. Please, do not try to tell the surgeon which techniques to use. It is important for him to use the ones he has experience with.

 

Rhinoplasty is a learned art and science. Experience is paramount. Choose your surgeon wisely.

 

“Re-operating on a nose is considerably more difficult than getting it right the first time.”

 

This overview is divided into six major sections.

 

• Basic Anatomy
• Dorsum
• Deviated Nose
• Tip
• Alae
• Airway Obstruction

 

Basic Anatomy

 

As you start your rhinoplasty journey it is important to have a basic understanding of the anatomy of the nose. Knowing this will allow you to more accurately describe what you want to change to your rhinoplasty surgeon.

 

Important visible anatomy

 

 

• Radix

 

The radix is the deepest part of the nose. It separates the nose from the forehead. Typically, it is at the level of the pupil.

 

• Dorsum

 

The dorsum runs from the radix to the tip; it is often called the “bridge” of the nose.

 

 

The most important anatomy for you to know when looking from below (worm’s eye view) is the columella and the alae.

• Columella

 

Columella in Latin means “small column”. This is exactly what it looks like. It is a column between the two nostrils. Underneath the skin of the columella is the medial crura of the alar cartilages (See below).

 

• Alae

 

Alae in Latin means “wings”. While the columella provides the inside support to the nostril, the alae provide the outside support. Underneath the skin of the alae is the lateral crura of the alar cartilages (See below).

 

Important internal anatomy

 

Below is the anatomy with the skin and soft tissues removed revealing the bones and the cartilages.

 

 

The length of the nose can be divided into thirds. The upper third is composed of the nasal bones. The middle third is composed of the upper lateral cartilages; and the lower third is the tip, which is composed of the alar cartilages.

 

• Nasal bones

 

The nasal bones are a pair of relatively weak bones that make up the “bridge” of the nose. These bones are often repositioned during a rhinoplasty.

 

• Upper Lateral Cartilages (ULC)

 

The ULC make up the middle third of the nose. You can feel it on your own nose when the nasal bones end and the ULC begin. It goes from a hard bony feel to a soft, spongy feel.

 

The ULC are primarily responsible for keeping the airway open. Weak ULC will create a “pinched” look in addition to causing airway problems.

 

• Alar Cartilages

The alar cartilages give support to the tip. This tip support is critical and has a tremendous impact on the look and shape of the tip. Rhinoplasty often involves adjusting their shape and size.

 

• Septum

 

The septum is much like a wall that separates the right and left side of the nose. It is the primary support structure of the nose.

 

 

Now let’s go through the most common concerns rhinoplasty patients have. As we do, try to relate it to your nose. Hopefully, this will make it easier for you to express to your surgeon what you want to accomplish.

 

In addition, having this knowledge will make your entire rhinoplasty experience more enjoyable.

 

‹‹ Dr. Cruise’s Philosophy

Nose Anatomy – Dorsum ››