Planning For Success

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Dr. Steve Byrd is a Dallas nose surgery (rhinoplasty) specialist and board-certified plastic surgeon. Below he reviews his published methods of rhinoplasty analysis.

It has been said that if you don’t know where you are going, every road will take you there. Nothing could be more true than in rhinoplasty where I believe it is absolutely essential to have a detailed preoperative plan that describes the ideal nasal dimensions based on facial proportions as well as the identification of all problematic anatomy.

For each rhinoplasty procedure, I begin by determining the ideal nasal length for the face, a measurement known as “RTi.” Ideal nasal length is equal to two thirds of the mid facial height (MFH), measured from the glabella (area between the eybrows) to the alar base (by the nostrils). RTi not only serves as a reference for whether the nose needs to be shortened or lengthened, but also serves as the key proportion for determining the ideal projection of the nose.

Ideal nasal tip projection is two thirds the ideal nasal length. Ideal projection of the nose at the radix (the top of the nose by the eyes) is 9 to 12 mm in front of the cornea. The ideal dorsum (bridge) extends between these two points.

Ideal chin projection is determined by a line drawn from a point on the nasal dorsum at 1/2 RTi and passing across the upper lip. The ideal chin in the female will project 3mm back from this line while in the male it will touch the line.

At this point we have a basis for knowing which dimensional changes will produce the best-looking nose by creating both intrinsic and extrinsic nasal proportion. An important point to remember, however, is that while nasal proportion is based on chin vertical, a small or underdeveloped chin gives the illusion of an overly large nose. Care must be taken not to over-operate on the nose and to consider enlarging the chin in these situations (see chin augmentation).

A good analysis not only determines the ideal dimensions for the nose, but also identifies problem noses that are at risk for secondary deformity following rhinoplasty. Examples include noses with dorsal and caudal septal deviation (crooked nose), noses with weak lower lateral cartilages and inadequate tip projection, alar malposition, weak midvault, cleft deformities, thick skin, and ultra thin skin. Special techniques that enhance the structure are often necessary to avoid secondary deformity in these noses.

To learn more about my methods of rhinoplasty analysis and other details about a "nose job" procedure at my Dallas practice, I encourage people to request a consultation online or call my office at (214) 821-9662. Our compassionate care begins from your first phone call and follows you throughout your post-operative care and beyond.

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    Dr. Steve Byrd

    Board-Certified Plastic Surgeon

    To visit our office use address:
    9101 N Central Expy #560
    Dallas, TX 75231

    For mailing purposes use address:
    9101 N Central Expy #600
    Dallas, TX 75231
    Tel (214) 821-9662
    Fax (214) 828-2609

    The American Society for Aesthetic Plastic SurgeryAmerican Society of Plastic Surgeons