By Dr. Jesse E. Smith, MD, FACS
Facial Plastic Surgeon

Also known as mentoplasty or chin surgery, genioplasty is a form of cosmetic surgery that is used to alter the shape of a person’s chin. Other techniques may also be used, such as introducing an implant that makes the chin larger or reducing the size of the jawbone so the chin is smaller.

This procedure is more common among men than women. Based on a report by the American Society of Plastic Surgeons in 2019, 57% of these procedures are done on men.

What Genioplasty Entails

Most people who choose genioplasty do so to improve their appearance. There are two methods of reshaping the chin. The bone that supports the chin can be repositioned, or chin implants can be placed. Various implants are available in different materials, including silicone and others.

Osseous genioplasty is the most common technique; it involves modification of the skeletal structure of a person’s chin. However, there are other ways to reshape the chin, such as:

• Jumping genioplasty
• Reduction genioplasty
• Sliding genioplasty
• Widening genioplasty

A plastic surgeon performs genioplasty, often under general anesthesia. It is a popular procedure for people of all ages and genders.

Jumping Genioplasty

With this form of genioplasty, the chin bone is moved in two directions: upward and forward. A cut is made on the lower part of the jaw before that section is brought forward and upward. This results in the lower edge of the chin resting on the upper part of the lower jaw. The way the cut area moves from the lower jaw and upwards is why it is known as the jumping genioplasty.

Reduction Genioplasty

Reduction genioplasty is a procedure that removes or reduces the amount of bone at the chin. It can also be used to make the chin smaller for those who feel it is a bit too prominent. Two cuts are made parallel to each other, each the width of the chin itself. The chin can be made narrower, smaller, or moved backward. Sometimes, two or more of these things are done at once.

Sliding Genioplasty

For a misaligned chin or a retrusive chin, sliding genioplasty tends to be the best procedure. An inverted V-shaped cut is made from one canine all the way to the other side of your teeth. A saw will then be used to pull the chin bone away from the remaining parts of the jaw. This corrects the defect and creates better jaw alignment.

Widening Genioplasty

If you have a narrow chin, widening genioplasty is designed to make it wider. Horizontal and vertical cuts are made to divide the bottom of the chin into two parts. Once cut, a bone graft is used as a midline divider to widen the chin to your preferences.

Is Genioplasty Right for You?

Genioplasty tends to offer great results with soft tissue and bone stability. If you are interested in genioplasty, make sure to speak with an experienced facial plastic surgeon to learn about your options.

Rhinoplasty, also known as a nose job, is a complex and challenging surgical procedure. Revision rhinoplasty refers to a surgery that corrects or revises a nose surgery that was done in the past.

Each person’s skin, cartilage, and bone determine the shape of their nose. When having rhinoplasty, the healing stage also has an impact on appearance. Poor healing can lead someone to have results that they are not satisfied with.

Proportion and attention to detail from the surgeon are essential to creating the best results with rhinoplasty. Close monitoring and adequate intervention are both critical during the healing process.

The Basics of Revision Rhinoplasty

A revision rhinoplasty, or a secondary rhinoplasty, is a complicated plastic surgery procedure that corrects the results of a first nose job. Revision rhinoplasty is typically done when a patient is not happy with the results of the original procedure, whether based on aesthetics or continued difficulty breathing.

The Various Benefits of Revision Rhinoplasty

There are several benefits to revision rhinoplasty. These tend to be similar to the benefits provided by an initial rhinoplasty. Some of them include:

• Increased confidence – This procedure may change the shape and appearance of the nose. It often provides confidence to patients who may be self-conscious about the appearance of their faces.
• Rejuvenated appearance – Revision rhinoplasty is made to reshape the nose. This can lead to a more balanced and youthful facial appearance.
• Better breathing – Some forms of rhinoplasty are combined with septoplasty or nasal obstruction surgery. These procedures can correct obstruction in the nasal passages that may have been present before surgery.
• Improved facial symmetry – Crooked noses, bulbous nose tips, and other facial issues can be repaired through revision rhinoplasty. This creates a better degree of facial symmetry.

If your original rhinoplasty gave you less than perfect results, you may have many emotions. It could make you upset, or frustrated, that your expectations were not met. When this is the case, a revision rhinoplasty can help. As you consider your options, make sure to choose a trustworthy surgeon who understands the results you desire.

Preparing for Revision Rhinoplasty Surgery

Your plastic surgeon will provide you with specific instructions before the revision rhinoplasty procedure. You’ll be given information on what to do the week before and after the surgery. In addition, you’ll be provided with care instructions for after the rhinoplasty.

Some medications are known to cause excessive bleeding during surgery. If you are taking these medications, you may be asked to stop taking them for a few weeks before the procedure is done.

What Happens During Recovery?

The recovery from revision rhinoplasty lasts about one to two weeks. You may need to stay home for a week or longer from work, depending on how intense the swelling and bruising are. A splint will be on, and inside, the nose for the first week, but nasal packing is uncommon for revision rhinoplasty.

When you choose the right surgeon, you can expect routine follow-ups to ensure the best results. The full results will not be present until a year or two after surgery, when all internal swelling is gone. Consults will ensure you stay on track throughout the process.

The nose is one of many parts of the human respiratory system. Air enters the body through the nose; the air is then then warmed and moistened. Air is also filtered from debris as it passes through the upper airway. Because it is the most prominent fixture on the human face, the nose has an effect on your appearance.

Many people experience issues with their noses. These can be as small as a stuffy nose, a minor nosebleed, or as extensive as serious breathing issues. Different solutions are available to help with these issues. However, before choosing one, it’s important to know the parts of the nose.

The Anatomy of the Human Nose

Looking at your nose, it might seem as if it is made up of only a few parts. However, there is far more to this structure of the body than it initially appears. The following are all parts of the human nose:

• Bone – The upper 1/3 to ½ of your nose is a hard bridge that is made up of two bones, one on each side and fused in the midline. The bony portion of the nose is what surgeons modify when reducing a dorsal hump in rhinoplasty.
• Outer walls – The lower ½ to 2/3 of the nose are composed of lateral walls. These parts of the nose are made up of cartilage and covered in skin in the outside, and mucous membranes on the inside. These walls are the beginning of the nasal cavities, the nostrils, and the nasal tip. Small contour irregularities in the cartilage portion of the nose can sometimes be addressed without surgery using liquid rhinoplasty.
• Nostrils – Also known as nares, these are the openings that lead to your nasal cavities. The nostrils are visible on the face.
• Nasal cavities – Two nasal cavities are found in the nose. These are the hollow areas on both sides of the nose where the air comes in and out. Each nasal cavity is lined with mucous membranes. They are divided by the septum.
• Cilia and hair – Cilia (small structures similar to microscopic hair) and hair are located inside the nose. These are used to trap particles like dirt. These items are then moved toward the nostrils so they can be wiped away or sneezed out, or the back of the throat so they can be cleared.
• Nerve cells – The cells in the nose are used to communicate with the brain. The nerve cells are what provide you with a sense of smell.
• Septum – The septum is made of both firm cartilage and bone. It goes down the center of the nose. A septum is used to separate the two nasal cavities and allow breathing through each nostril. A deviated septum is a common cause of breathing difficulty and is often corrected during functional rhinoplasty or septoplasty.
• Sinuses – Four pairs of sinuses are found in humans. These are little pockets filled with air that connect to the nasal cavities. The main purpose of the sinuses is to create mucus that keeps the nose moist inside.
• Turbinates – Also called conchae, three pairs of turbinates are found on the sides of each nasal cavity. These are folds that ensure the nose stays warm, while filtering debris as well. They also help moisten the air when you breathe it in and help with nasal drainage. These can swell tremendously with allergies.

As part of the respiratory system, the nose has many jobs. If you are experiencing issues with it, it is important to speak to a physician. There are many solutions to problems, whether related to the structure or aesthetics of the nose.

Not smoking, drinking lots of water, and keeping your living space clean can prevent many nasal issues. Using saline on a regular basis within the nostrils can also be useful for many people.

When the Anatomy of Your Nose Bothers You

If you are unhappy with how your nose looks or how it functions, the structures described above are exactly what a facial plastic surgeon evaluates at a rhinoplasty consultation. Dr. Jesse Smith is dual board certified in facial plastic and reconstructive surgery and head and neck surgery, and operates exclusively on the face. Patients from Fort Worth, Colleyville, and the broader Dallas–Fort Worth area can request a rhinoplasty consultation to discuss their specific concerns.

While traditional rhinoplasty might be what most people think of when considering modifying the appearance of the nose, it isn’t the only option.

Preservation rhinoplasty is a new technique that offers many of the same benefits as traditional rhinoplasty. It is a technique where Dr. Smith works to retain as much cartilage and bone as possible while improving the aesthetics of the nose.

One of the largest benefits of preservation rhinoplasty is that it creates a fully natural-looking nose. In a world where people want to avoid looking as if they have had surgery, this solution fits the bill where other procedures might not.

What Preservation Rhinoplasty Is

The main idea behind a preservation rhinoplasty is to modify the nose while preserving as much of the tissue as possible.

This procedure demands the use of advanced surgical techniques. The surgeon will change the shape of the nose by removing small bits of cartilage and bone found under the bridge of the nose. Experienced facial plastic surgeons, like Dr. Smith, can reduce the height of the nose bridge without making changes elsewhere.

The Difference Between Preservation and Traditional Rhinoplasty

Many people choose rhinoplasty as a way to lower the height of the bridge of the nose. Those with an arch or a hump on the bridge may wish to have it removed.

During traditional rhinoplasty, patients get a changed nose and reduced dorsal or bridge size. However, some believe the results do not look natural based on the change to the nose’s dorsal or bridge lines.

Since traditional rhinoplasty removes cartilage and bone from the top of the bridge, the bone structure of the nose is altered in the process. So, it can correct an issue like a bump on the nose bridge, but it also changes the lines of the nose.

On the other hand, preservation rhinoplasty retains a natural appearance while changing the height of the nose bridge. Instead of removing bone and cartilage on top, it’s taken from underneath the nose instead.

Because of this, the result from a preservation rhinoplasty may provide a more natural appearance. This makes it less likely that a revision rhinoplasty will be needed.

What to Expect During Preservation Rhinoplasty

Before your preservation rhinoplasty, you should eat a healthy diet and get lots of rest. If you smoke, you should stop six weeks before the procedure, as smoking can make recovery harder. Nicotine decreases circulation and blood flow to the skin, which makes it harder to heal. Someone should drive you to and from the surgery as you will be under general anesthesia.

On the day of the surgery, you’ll speak with Dr. Smith to ensure everything is going well and to answer any questions you might have. At the time of the procedure, an anesthesiologist will give you general anesthesia. The whole procedure generally lasts an two to three hours.

Once the surgery is complete, a small cast will be placed on your nose to protect the area. You will be monitored until you wake up. When it is safe for you to leave, the person driving you can take you home to begin recovery.

Most people think of rhinoplasty or a nose job as a method to change the appearance and shape of the nose. Hundreds of thousands of patients have rhinoplasty procedures each year. Patients vary, but tend to be between the ages of 20 and 50, with a slight predominance in women over men.

Rhinoplasty can be used for aesthetics as a way to balance facial features. However, it also acts as a way to address structural issues which cause breathing abnormalities. There are numerous uses for rhinoplasty, but we will address five of the most common below.

1. Large Nasal Tip

A bulbous (or rounded, enlarged) nasal tip can make the middle third of the face seem unbalanced compared to the rest. Rhinoplasty surgery involves removing or rearranging some of the bone and cartilage to create a more natural and harmonious facial appearance. One of the most popular methods to alter the nose tip is by accessing the cartilage from inside the nose. This has the benefit of minimal to no visible scar.

2. Deviated Septum

The septum is the part of the nose between the two nostrils; however, it also continues to the very back of the nose, and all the way to the bridge of the nose. In most cases, it is in a central location and air moves through each passage evenly. However, genetics or injuries can cause the septum to be pushed to one side or the other.

Active individuals may want to correct the deviated septum to create better airflow and cardiovascular performance. With rhinoplasty, the internal structures of the nose can be rebuilt, which results in a septum that is centered. This can improve breathing, so that it is equal through each of your nostrils.

3. Nasal Bridge Humps

Another use of rhinoplasty is for a bump or hump on the bridge of the nose. When this bump is large, it can make look as if your nose has been broken or can give the perception that your nose is larger than it really is. If the nose has been broken, this can also create a hump or a bump in this part of the nose. Even if you have not had a broken nose, excess bone and cartilage can create the same look. Rhinoplasty can remove excess bone and cartilage to eliminate the bump and reshape the nose.

See our article on preservation rhinoplasty.

4. Nostril Shape and Size

Some people dislike the appearance of their nostrils. They might find them to be too wide, too narrow, or unsatisfying in some other way. Rhinoplasty can be used to change nostril shape, but this is a more invasive procedure since the entirety of the nose is taken into account. Breathing is the primary function of the nose, so the changes that are made for nostril shape surgery can be limited by this factor.

5. Broken Nose

One of the most common reasons for a rhinoplasty that is not only aesthetic, but functional, is repairing damage from a broken nose. This may involve resetting the bones inside the nose, reshaping the cartilage, or both. In most cases, rhinoplasty for a broken nose focuses on breathing function, but can also address aesthetic concerns at the same time if desired.

Final Thoughts

Due to the many uses for rhinoplasty surgery, and the extreme technical skills needed to perform rhinoplasty, it essential to work with an experienced surgeon dedicated to rhinoplasty procedures like Dr. Smith. Dr. Smith has performed thousands of rhinoplasty procedures, and routinely recreates and rebuilds new noses for cancer patients. He is well-versed in all aspects of the nose, from aesthetics, to structure and function. Schedule a consultation today to create a more aesthetically pleasing nose or improve your breathing function.

Recovery from Rhinoplasty can be a process, especially if you are not accustomed to taking downtime. But with a few simple tips, your recovery process can go as smooth as possible.

Take Care of Your Nose

Taking care of your nose may seem like an obvious suggestion for rhinoplasty recovery. However, if you are not careful about nasal care, you can cause issues and lengthen your recovery. One tip for caring for your nose is to avoid rubbing it; even if it is difficult to do so.

You will want to avoid blowing your nose for the first two weeks (check with your doctor). You can use a tissue to gently wipe your nose if you need to do so. Be careful about sneezing as well. You’ll want to do that with an open mouth.

Get Plenty of Rest

Rhinoplasty is surgery, so you will require extra rest as you recover. If you feel tired, even during the day, rest. Get plenty of sleep at night. Sleep is highly beneficial to a proper recovery and healing.

Part of resting is refraining from strenuous activity. That includes hobbies and fitness activities. You’ll want to stay away from work for a minimum 3-7 days. Your surgeon will let you know if you need additional time away from work or activities.

Keeping your head elevated will help reduce swelling. You should keep your head above your heart even when sleeping. You can do this by using extra pillows behind your head when you go to sleep, or by sleeping in a chair that reclines.

Be Patient

Swelling can last months after having nasal surgery. Some patients experience mild swelling for as long as a year. Most people will not notice the swelling after a couple of months, but you may notice the swelling yourself for a while.

While swelling is present, you may be unable to tell what the final shape of your nose will be. As you recover, and the swelling reduces, you will begin to recognize what your new nasal shape is. Be patient during this process and remember that the swelling is temporary.

Conclusion

Rhinoplasty is surgery. As with any surgery, you will require adequate time to recover. Sometimes, recovery can seem extremely hard. There are things you can do to make that recovery go more easily.

The first thing you need to do is realize that your nose, and possibly around your eyes, will remain swollen for a while. To help with the swelling, you can sleep in a more upright position, and use ice around the nose. Get plenty of rest including limiting some routine activities. Follow your surgeon’s instructions carefully. Take care of your nose for the easiest possible recovery from rhinoplasty.