The size and shape of the nose are fundamental elements of facial harmony. Nasal deformities therefore represent an aesthetic concern that can sometimes cause significant insecurity. In these cases, rhinoplasty surgery is an effective solution. However, since no two noses are the same, there are multiple types of rhinoplasty depending on the deformity to be corrected, the patient’s goals, and other factors. Read on to learn more.
Rhinoplasty according to the type of surgery
Classic rhinoplasty
In classic rhinoplasty, conventional rasps are used together with osteotomes and a mallet to reshape the bone, which is the most proximal or upper part of the nose—the area closest to the eyes.
Ultrasonic rhinoplasty
In ultrasonic rhinoplasty, an ultrasonic device is used to maximize surgical precision. This technology allows the nasal bones to be filed and reshaped while preserving the soft tissues and blood vessels. As a result, bleeding and bruising are reduced, leading to less postoperative discomfort. Today, we apply this technique in almost all of the rhinoplasty procedures we perform.
Likewise, whether the rhinoplasty is classic or ultrasonic, we can also distinguish between the following approaches:
Open rhinoplasty
Open rhinoplasty is used when more direct access to all the nasal tip cartilages is required, especially when they need to be reshaped or when cartilage grafts from the patient are necessary. This approach allows changes to be made to the nasolabial angle or the shape of the nasal tip.
It is performed by making a small incision at the base of the nose, which allows the skin to be lifted and provides direct visualization of the nasal tip cartilages.
Closed rhinoplasty
When the nasal tip does not need to be modified because it already has an appropriate shape, rhinoplasty can be performed using the closed approach, without any external incision on the columella. This means there is no visible scar.
The choice between one technique or the other depends on the specific needs of each case, particularly on what needs to be done on the nasal tip. It is important to note that recovery is similar whether an open or closed rhinoplasty is performed.
Septorhinoplasty
All types of rhinoplasty can be combined with septoplasty surgery. In this way, during the same surgical procedure, we can not only improve the aesthetic appearance of the nose but also correct issues related to respiratory function.
Rhinoplasty according to technique
Preservation rhinoplasty
Preservation rhinoplasty is usually indicated in very select cases. It is characterized by maintaining the entire nasal dorsum and working on the septum to reduce the size of the nose without filing the upper part. In this way, the nasal bones and cartilages are reshaped while preserving the nose’s natural anatomy and without damaging the nasal ligaments or valves.
Structural rhinoplasty
Structural rhinoplasty is the most commonly used rhinoplasty surgical technique and involves modifying and reconstructing both the internal and external structure of the nose. This approach addresses nasal anatomy in a comprehensive way, taking into account both functional and aesthetic factors. The goal is to achieve more natural and harmonious results by improving the stability and aesthetic shape of the nose, while considering the relationship between its cartilaginous and bony components.
Non-surgical rhinoplasty
Nose reshaping (Rhinomodeling)
In certain cases where the aim is to improve the shape of the nose without reducing its size, rhinomodeling may be an option. This aesthetic treatment consists of injecting resorbable dermal fillers into the nasal dorsum to correct small imperfections and achieve a more harmonious appearance.
It is important to note that the results last approximately 18 months. After this time, the procedure must be repeated. This technique is only used in very select cases involving minor nasal imperfections.
Types of rhinoplasty according to aesthetic goals
Aquiline (hooked) nose
An aquiline nose is characterized by an excessively prominent nasal dorsum, forming a convex curve. It is often combined with a drooping nasal tip. This is corrected through reduction rhinoplasty, in which the dorsal hump is filed down and the nasal bridge is narrowed. The nasal tip is also addressed, using either an open or closed rhinoplasty approach depending on the case.
Saddle nose
This is the opposite of an aquiline nose, meaning the nasal dorsum has less projection than is aesthetically harmonious. In these cases, augmentation rhinoplasty is performed by placing grafts—usually cartilage taken from the patient’s own septum or rib—to reconstruct the depressed dorsum.
A saddle nose may be caused by trauma, unsuccessful previous surgeries, or may simply be a natural anatomical feature. Another technique that is sometimes used to elevate a depressed dorsum is the dermal regeneration sheet technique, developed by Dr. Jorge Planas.
Short nose
In this case, surgery consists of placing an L-shaped cartilage graft at the base of the nose—specifically in the columella—to lengthen the nose. A short nose is typically characterized by an overly open nasolabial angle, which excessively exposes the nostrils; this can also be corrected during the procedure.
