Objectives: Highlighting certain convictions, techniques
and tactics that can be crucial to surgical outcome of rhinoplasty,
as an attempt to define clearer indications for what's
termed "aesthetic" rhinoplasty.
Methods: A 20-year single-surgeon review of 1000+
diverse rhinoplasties.
Results: Surgical outcome was satisfactory in 90-97% of
post-traumatic rhinoplasties, and in 82-90% of aesthetic
rhinoplasties. Complications were minimal. Differences of
satisfactory results between post-traumatic and aesthetic cases
were found to be statistically significant, and there was
disparity in assessment of results between the author and the
other surgeons' panel.
Conclusions: Like fingerprints and iris pattern, each
human being has a unique shape of nose, related to (and
inseparable from) the other facial features, and any attempt
to impose geometric dimensions or mathematical beauty
measures in such case is like squaring the circle; simply
impossible. Each nose has a limit for change, and successful
rhinoplasty is not only in imagining this particular limit; let
alone achieving it, but successful rhinoplasty is when our
imagination meets the patient's expectations, which is not
more than a mere probability. The dilemma in figuring out a
suitable “new look" for the nose, whether it is driven by an
exact science or by the passion of plastic surgeons, can blur
the thin red line between a justifiable rhinoplasty and a medical
malpractice. Therefore, the most critical choice in rhinoplasty
is the decision to do a rhinoplasty in the first place. The nose
is undoubtedly the most significant facial feature. It characterizes
shape and shapes character of the human being. So
rhinoplasty is a Psychosurgery and the worst pitfall in practice
of rhinoplasty is failing to realize that success and failure will
always have equal chances.