Dr. Buckinghams Q&A

Question:
My rhinoplasty left me with an upturned nose. Can revision rhinoplasty fix this?

Answer:
A revision rhinoplasty can repair an upturned nose under most circumstances. In some rare instances, the skin is scarred limiting the procedures success, but usually adding cartilage grafts will bring the tip of the nose down.

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Question:

I’m in Westlake and would like to know how you fix a nose that looks turned up.

Answer:

It depends upon the cause of the nose being turned up but in general, in order to “de-rotate” the nasal tip a rhinoplasty is required. The specific maneuver would be to lengthen the dorsum of the nose and add support to the base of the nose to bring the tip angle down.

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Question:
What ethnicities do you have experience in performing rhinoplasty on?

Answer:
I have performed rhinoplasty on every major ethnic group including Caucasion, Hispanic, Asian, African and Middle Eastern. There are many subgroups of which I am sure that I had not covered them all. The number rhinoplasties performed to these ethnic groups relate directly to the location geographically of your practice. For that reason we have many more patients with Caucasian or Hispanic origins than the other ethnic groups.

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Question:
tion:I’m Chinese with a very flat nose. How do you make it protrude more?

Answer:
The usual situation with a nose with Asian genetic influence is that not only is the tip underprojected but also the dorsum. I am aware that in Asia is very common to use a one piece silicone implant to improve this. While this is a very quick operation, there is a significant risk of the implant extruding through the skin. In my opinion that risk is unacceptable and so therefore we utilize cartilage grafting to accomplish the same goals. Depending upon the patient’s age and wishes this cartilage graft is usually either the patient’s own rib or we utilize donor rib while performing a rhinoplasty. While this is a more complex and lengthy operation the results are natural and lifelong with very little risk of complication.

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Question:
How would you improve broad or wide nostrils as commonly seen in African American noses?

Answer:
Wide nostrils, commonly known as a widened alar base, is usually a result of under projection of the nasal tip as well as absolute width of that area. It is corrected by adding cartilage support to the nasal tip to elevate the tip away from the face as well as a direct excision of the excess alar width.

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Question:
How is nasal obstruction treated?

Answer:
It depends upon the cause. Nasal obstruction can be caused by a septal deviation, turbinate hypertrophy, narrowing of the dorsum of the nose or tip region, allergy or many other causes. The obstruction is treated either medically or surgically depending on the cause.

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Question:
I have a crooked nose. In what cases does this require septoplasty vs. rhinoplasty?

Answer:
If the external nose is crooked then a rhinoplasty as required. A septoplasty would also be included in the procedure. A septoplasty will only correct an internal deviation of the airway, not the external nose.

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Question:
I would like slight reduction of my nasal hump. What procedure would you suggest for this minor change, surgical or non-surgical rhinoplasty?

Answer:
In general a nasal hump would be treated using a surgical hump reduction during rhinoplasty. In certain individuals there is a depression above and below the hump that can be filled with Restylane which would be considered a nonsurgical rhinoplasty. The advantage of the surgical option is that the results are permanent. The disadvantages are that it is a surgical procedure with the associated risks and recovery.  The advantages of filler are that it is relatively easy and has low risk however the disadvantages that it needs to be repeated and only some cases our eligible.

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