The nose has an important place in the face. For people who consider it as a handicap, rhinoplasty allows them to change their own ideas about their appearance, and to find that they have a natural nose and not a caricature.
It is not necessarily necessary to resort to surgery to correct a defect of the nose. Medical rhinoplasty, by injection of hyaluronic acid, allows in many cases to meet the expectations of patients.
ANALYSIS OF NOSE
The nose in the face
-The nose should represent about 1/5 of the total width and 1/3 of the total length of the face.
- The intercanthal distance (width of the eye) must be equal to the width of the palpebral fissure, and the width of the base of the nose must be equal to this distance.
- The distance between the nasal spine and the lip sup must be 1.8-2.8 cm.
- The line passing through the point of mid-nasal height and the most prominent point of the upper lip must pass 3 mm in front of the chin.
Nasal profil
Naso-facial angle
Between 30° -40°.
This gives the nasal projection.
Nasal-chin angle
It should be between120°-130°.
Dorsal angle
Flat, thus 180°. it should be convex for men and concave for women.
Chin-neck angle
It should be between 80°-95°.
Naso-labial angle
This measures the incline of the columella (lower part of the nose) in relation to the upper lip. It should be between 90°-100° for men, and 95°-110° for women. The tip plunges downwards if the angle is small, and is curled up when it’s more open.
Naso-frontal angle
It should be between 115°-135° for men, and 120°-125° for women.
This is the most important angle for the beauty of the nose/ aesthetics of the nose. If the angle is too open (Grecian nose), the nose seems longer, and if it is too closed, the nose seems shorter.
Study the base of the nose
- The base of the nasal pyramid is a triangle whose base is equal to the height.
- The nostrils have an elongated shape whose posterior part is larger and whose axis is oblique forwards and inwards which forms with the sagittal plane an angle of 15 ° laterally open.
- The upper edge of the nostrils is midway between the points of definition of the tip and the lobulocolumellar angle.
Study of nasal tip
The shape and orientation of the tip are given by the alar cartilages. Its dynamics is influenced by the depressant muscle of the nasal septum, the common elevator of the upper lip and nose.
– Projection of the tip, depth of the radix, length of the nose
Several rules can be used to calculate the correct projection of the tip:
1) The ratio 1: 2: 3
The projection of the point (2 in the image), defined by the distance between the alogenian groove and the cartilaginous domes,must represent two thirds of the length of the nose (3 in the image) and must be twice the distance nasion (the most recessed point of the naso-frontal depression) and the internal canthus (1 in the image).
2) The projection is adequate when 50-60% of the tip is in front of the vertical which passes through the upper lip and if it is equal to 60-65% of the length of the nose.
3) Rule of the Crumley triangle: the ideal projection is that which makes it possible to draw a right triangle whose sides respect the ratio 3: 4: 5 (on the image) of the triangle of Crumley.
-The rotation
The rotation is defined by the opening of the nasolabial angle which must be between 90 ° -100 ° for the man and 95 ° -110 ° for the woman.
For the rotation-projection of the point, it is necessary to discuss the part of the visual illusion: the convexity of the dorsum gives a feeling of falling peak even though the naso-labial angle can be normal; an exaggeratedly concave dorsum will give a visual impression of excessive rotation.
- The Definition is based on characteristics that are not always met.
1) Visualization of the cartilaginous reliefs when a skin too thick does not mask them.
2) Subtle depression of the supra-tip, automation of the tip when its projection slightly exceeds that of the dorsum.
3) Double break lobulo-columellaire which makes apical lobule a separate element of the columella.
POSSIBLE TREATMENTS
Hyaluronic Acid
The hyaluronic acid used is highly crosslinked type Restylane Perlane or medium-cure type Restylane. Depending on the indication, the injection will be deep or superficial.
The indications are as follows:
- Correction of the fall of the tip of the nose.
- Correction of anomalies at the nasal angles.
- Correction of the dorsum of the nose.
- Correction of post-traumatic or genetic bony or cartilaginous depressions and bumps.
- Improved symmetry.
- Narrowing of the nostrils.
- Erase furrows of the wings of the nose.
- Improved definition of the tip of the nose.
- Correction of changes due to aging: thinning of the skin tissues of the nasal margin, closure of the nasolabial angle.
- Narrowing of the nostrils by laying son tensors.
- Correction of functional defects of the nasal valve during inspiration, that is to say the collapse of triangular cartilages on the cartilaginous septum during inspiration.
Threads
The interest of the threads is to lift the tip of the nose and straighten the dorsum.
They are used mainly on Asian noses.
BEFORE AND AFTER PICTURES
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