Example of large nose overwhelming facial harmony. (Click picture to enlarge).

The nose is the most central part of the face. Ideally, it should not attract attention. A large, deviated, or disproportionate nose will dominate the face and attract unfavorable attention. An attractive nose is aesthetically pleasing and allows the observer to pay more attention to other structures such as the eyes and lips. There is no set way that a nose should look, but one thing is certain, it should be unobtrusive and in harmony with the rest of the face.

The medical term for surgically altering the nose for cosmetic reasons is rhinoplasty. Rhino means nose and plasty means to shape.

Patients seek rhinoplasty for various reasons. Sometimes, it is traumatic nasal injury that has altered the nose. More often, it is because someone is simply unhappy with its appearance. Common reasons include: a hump, a deviated nose, a wide nose, a crooked nose, a long or short nose, a pug nose, a ski nose, a beaked nose, flaring nostrils, a bulbous tip, and many others. All of these can be corrected or at least markedly improved with rhinoplasty.

Commonly, there are two ways to perform rhinoplasty. The first way is called a closed rhinoplasty and the second way is an open rhinoplasty. Dr. Cruise likes to think of a third way which is a combination of the two otherwise known as a delivery technique. Many plastic surgeons favor one particular way. Dr. Cruise utilizes all three techniques depending on the situation. He has developed skills with all three techniques because he feels that each technique has a particular advantage depending on what he wants to obtain. There is no right or wrong way. The only important thing is that whoever does the rhinoplasty must be comfortable with that particular technique and the bottom line is, obviously, the final result.

Dr. Cruise utilizes the closed technique when the majority of the nasal work is performed on the top and the bridge of the nose, or if only small modifications are being made to the nasal tip. This technique is performed through incisions inside the nose which are not visible from the outside. The complete lack of any visible scar is an advantage but the downside of this technique is lack of exposure of the nasal tip.

He uses the open technique when there is a significant amount of work that needs to be done on the nasal tip. This technique requires that a very small incision is made along the thinnest part of the skin between the two nostrils. This normally heals without a visible scar. This provides excellent exposure of the nasal tip and allows for a more accurate rhinoplasty.

Finally, Dr. Cruise performs the delivery technique when there is a moderate amount of work necessary to be done on the tip. This technique does not require any visible scars yet it still allows significant exposure of the nasal tip.

Another reason for nasal surgery includes airway problems. Airway problems may lead to difficulty in breathing at certain times or, perhaps, all the time. This may be due to a deviated nose or an enlarged turbinate among other reasons. Determining the exact cause requires consultation with Dr. Cruise or a competent plastic surgeon. Airway problems can usually be resolved by correcting the underlying problem.

Rhinoplasty is the quintessential plastic surgery operation. It incorporates all the skills as well as the artistic prowess that a plastic surgeon develops over the course of his/her training. The techniques used are quite predictable, however, the way each individual patient heals is different.

Changes in the appearance of the nose have a profound effect on the facial aesthetics. Removing a large dorsal hump or making the nose somewhat thinner and smaller can dramatically improve one's appearance.