Understanding Nose Anatomy for patients thinking of nose surgery

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Getting a Nose job or Nose Surgery? Learn more about your Nose anatomy for a better result

When talking about facial aesthetics and beauty how your nose looks is a crucial part. Every person’s nose is different and unique in its own way. Unfortunately, a lot of people don’t like their nose and how it looks, luckily nose surgery can help. However, there are many variables when it comes to nose surgery, so, we have put this together to help you understand your nose anatomy, common nose shapes and problems, and a glossary, with important terms that you should know. All of this will help you not only understand the procedure better but also give you the vocabulary you need to explain what you want to your surgeon. It will also help you to better understand what can and cannot be done.

Your nose sits in pride of place on your face, it is a defining feature. It is also a delicate, complicated one. As a result, a Nose job requires a highly skilled surgeon to achieve the perfect result. Your ENT or plastic surgeon needs to take a lot of factors into consideration when operating. Our Australian based surgeons are highly proficient in nose surgeries. You can see the results on our nose patient photo page.

Nose Anatomy Guide for Nose Aesthetics and Beauty Surface Nose Anatomy

Understanding Basic Nose Anatomy

Surface Anatomy

Surface anatomy refers to the visible parts of the nose without the structures that form it on the inside. The visible anatomy of the nose includes:

  • The Radix: This is the highest point of the nose, directly in between your eyes also known as Glabella.
  • The Dorsum: Also known as the bridge. this is the part of the nose that runs from the radix to the tip of your nose.
  • The Columella: The straight column between your two nostrils
  • The Alae: These are the side boundaries of the nostrils. When referring to one side you use the term “Ala” but when referring to both the plural is “Alae”.

Below the surface.

Underneath the surface anatomy, there’s bone and cartilage that gives the nose its shape. The nose can be divided into 3 parts vertically;

  1. The upper third is formed by the nasal bones,
  2. The middle third by the upper lateral cartilages,
  3. And the lower third from the alar cartilages or lower lateral cartilages
  • Nasal bones: These bones are not very hard, and are usually cut during rhinoplasty to form a new look. The nasal bones also give the bridge of the nose its shape and projection.
  • Upper lateral cartilages: Cartilage is a type of firm tissue that’s much softer than bone. It starts right below your nasal bone, in the middle third of your nose. You can try to feel it yourself (it’s the soft compressible part). These cartilages keep the nostrils widely open, and if they’re weak, your nose can have a “pinched” appearance
  • Alar cartilages: These are very important as they give your nose tip its appearance. These cartilages underlie the tip of the nose, the columella, and the alae. Furthermore, they are usually manipulated during rhinoplasty.
  • Nasal septum: Refers to the wall that runs inside your nose, right in the middle. It separates the right and left nasal cavities from each other. You’ve probably heard the term “deviated septum”, which refers to a problem in the nasal septum.

specialist-surgeon

Who needs a nose job?

Rhinoplasty can be done for a variety of cosmetic and medical reasons. Below is a list of possible problems that might lead to you getting a nose job:

Dorsum problems

The dorsum (or bridge) of the nose is the region extending from the radix to the tip. The ideal dorsum should be a straight line with no or minimal curvature. Here are some common dorsum problems that can be treated by rhinoplasty:

  • Large dorsal hump: This is when the dorsum projects excessively and is curved to the outside, causing a hump. It’s a common problem that can be the result of enlarged nasal bones and cartilages.
  • Wide nose: This can mean that the nose is wide at any part: the upper dorsum (dorsal bridge), middle dorsum (dorsal base), the tip, or the nostrils. You might feel that your nose is wide at any of these locations in a way that’s not proportional to the rest of your face.
  • Under-projected dorsum: Usually associated with an under-projected nasal tip (explained below). An under-projected dorsum is one that is short and does not protrude enough outside the face.
  • Saddle deformity: This usually happens after over-correction of a large dorsal hump, when too much tissue is shaved off. The dorsum appears like a “ski-slope”, with an inside curvature.

Tip problems

The tip is made of the alar cartilages, which support the nostrils at their sides and give the tip projection in the middle. Some nose tip problems include:

  • Droopy tip: This is when the tip is has a downward tilt. This is commonly the result of a large nasal septum that pushes the alar cartilage down and causes a droopy tip. Or, the connective tissue that holds the upper and lower cartilages together is weak.
  • Over-projecting tip: Also called “Pinocchio Nose”. This is when the tip projects too much outside the face, usually as a result of large alar cartilages.
  • Under-projecting tip: This is when the nasal tip does not project enough away from the nose. It can be associated with an over-projecting dorsum (hump), or an under-projected dorsum.
  • Bulbous tip: When the nose tip is too large or wide.
  • Boxy tip: When you look at the nose from below, it should resemble a triangle with the tip of the nose as the top corner, and the alae as the sides. A boxy tip refers to a nose tip that appears rectangular, not triangular in shape.

Alar problems

The alae are the sides of the nostrils. Below are some of the problems with the alae that a nose job can help correct:

  • Wide alae: This is when the alae project sideways too much, making the nostrils look wide sideways.
  • Notched alae (nasal flaring): This is when the alae notch above their normal position so that the columella appears from the sides, giving a “snarl” appearance.
  • Asymmetric alae: An asymmetrical alae means that the sides of your nostrils are visibly different.

Other nose problems

  • Deviated nose: This is when the nose deviates to one side of your face. This happens if you have a deviated septum, deviated nasal bones, deviated tip, or deviated upper lateral cartilage. These problems all require a different surgical approach.
  • Airway obstruction: If you have trouble breathing through your nose, something might be blocking the way. This can include;
    • A deviated septum
    • Enlarged turbinates
    • Or, another problem that can be diagnosed by a specialist surgeon.

different rhinoplasty

What are the different types of Rhinoplasty?

There are two different techniques that can be used to perform a nose job; open rhinoplasty and closed rhinoplasty. Our surgeons have experience using both these techniques to deliver excellent aesthetic results. Furthermore, a combination of the two can help give you the look you desire. Each technique is applicable in specific situations and can provide certain advantages over the other.

  1. The open technique is mainly utilized when the problem is in the tip or alae. A small incision is made in the skin of the columella (between your nostrils) and excess tissue is removed, the remaining tissue is then is redesigned to create the desired shape, after this, the skin is closed. Usually, no visible scarring is left after healing.
  2. The closed technique is performed when the problem is mainly in the dorsum (bridge) of the nose. A small incision is made inside the nose to perform the surgery. In other words, the visible skin is left untouched, meaning there is no external scar visible.

What can I expect after a nose job?

Our surgeons are some of the top plastic and ENT surgeons in Australia, they offer rhinoplasty with excellent results. Your surgeon will discuss your concerns with you and try to learn what it is that you don’t like about your nose. they will then explain to you how they can help, and how they can make your nose more aesthetically pleasing and proportional to the rest of your face.

After surgery, you can expect some discomfort, swelling, pain, congestion, and bleeding for the first week. This will get better as the days pass, and should not last more than 1 to 2 weeks. However, you should know that a full recovery will take longer. Your nose will not settle into its final shape until a few months post-surgery.

You should have realistic expectations about the shape of your new nose. Hopefully, your surgeon will do his/her best to give you the beautiful nose you’ve always wanted and you’ll be happy with the overall improvement in your facial aesthetics.

Coco Ruby Blog - Nose Anatomy Guide for Nose Aesthetics and Beauty Bone and Cartilage Nose Anatomy for Nose Jobs

Nose Anatomy Important Words

A-L

  • Bony vault: The bony part of your nose (includes the nasal bones and bony septum)
  • Bulbous tip: A nose tip that’s too large and too round
  • Cartilage: It’s a type of tissue that is softer than bone and it’s responsible for maintaining the nose structure
  • Cartilage graft: Cartilage tissue is taken from another part of your body (like your ear) and grafted into the nose to treat certain conditions.
  • Columella: The narrow strip of tissue that separates the nostrils (also called the columella)
  • Columellar Show: The height of the columella showing from the sides
  • Hanging Columella: An above-average columellar show, where the columella is over-protruding downward and a big part of it is showing from the sides
  • Caudal Excess Deformity: A cosmetic deformity of the nose where the septum is too long and the upper lip is too short.
  • Cocaine Nose: This is when the nasal dorsum collapses and the septum is perforated and is a deformity that’s often seen in cocaine abusers.
  • Deviated septum: Cartilage that separates the nostrils is misaligned which may cause partial nasal airway obstruction.
  • Dorsum: The nasal bridge
  • Edema: Tissue swelling
  • General anaesthesia: These can be injectable drugs and gases taken through inhalation, ensuring you remain ‘asleep’ during surgery and feel no pain.
  • Hematoma: Blood collection beneath the wound.
  • Seroma: Fluid collection beneath the wound
  • Intravenous sedation: Sedatives administered by injection into a vein to help you relax, however, you won’t be completely asleep.
  • Local anaesthesia: A drug injected directly at the site of surgery to numb it so that you won’t feel any pain

M – Z

  • Mucosal lining: The thin layer of tissue that covers the surface of the septum and the inside of the nose
  • Nasolabial angle: The angle between your columella and your upper lip
  • Nasofrontal angle: The angle between your radix and your forehead
  • Necrosis: Tissue death
  • Radix: The highest part of your nose, almost directly between your eyes
  • Rhinoplasty: Surgery to reshape the nose (nose job).
  • Septoplasty: Surgery to correct and straighten the septum.
  • Nasal septum: A wall of bone and cartilage located in the middle of your nose to separate the two nasal cavities
  • Open rhinoplasty: A surgical technique where a skin incision needs to be done
  • Closed rhinoplasty: A surgical incision without an external skin incision.
  • Projection: How much your nose protrudes in front of your face
  • Osteotomy: Removal of part of the nasal bone
  • Open Roof Deformity: Formation of a gap between the nasal bones due to overcorrection of a large dorsal hump.
  • Turbinates: This refers to large bony bumps in your nasal cavity. They are covered by a mucosal lining that serves different physiological functions. Turbinate overgrowth can lead to breathing difficulty.

Further Reading – Medical Sources:

Last updated: 24/02/2021
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Dr Stephen Kleid
Dr Stephen Kleid is an experienced Ear, Nose and Throat ENT Surgeon (Otolaryngologist) based in Melbourne with a passion for aesthetic nose surgery. rhinoplasty and a strong interest in Rhinoplasty Revision.