I’m the type of person who, when I’m about to step into something, adds caution on top of caution throughout the process. The information I’ve gathered about the nose surgery I’d wanted since my senior year of high school is like this. First, I’m a writer with a short bulbous nose and thick skin. Doctors really had different opinions about my nose. So I went to 12 places for consultations, studied a lot on YouTube, and this is the information I got. Also, before reading, don’t trust BabiTalk. It’s broker-talk, so just use it as a reference.
1. Septal extension and columellar strut I thought the material would be the most important thing in rhinoplasty. Naturally, I thought using costal cartilage would fix it more firmly, so I tried to use costal cartilage from the first surgery. But what matters is not the material, but the method.
Septal extension is based on the septum and costal cartilage, a method where the septum is extended long while leaving only the pillar. Pros: easy for the doctor to freely decide the nasal tip, a high nose is possible (a flashy nose) Cons: the nose becomes hard, foreign-body sensation, nasal deviation due to fixation of the nose (high chance of nasal obstruction) By my standards, for my nose, septal extension seems possible from silicone 3 mm and above.
A columellar strut is based on ear cartilage and septal cartilage, a method where a strut is inserted into the alar cartilage and sutured, then cartilage is placed on top of it. Pros: free movement of the nasal tip (piggy nose possible), fewer nasal obstruction symptoms Cons: a flashy nose is impossible; what people commonly call a natural nose A method where only 1-3 mm of silicone can be placed.
Regarding nasal-tip drooping, I thought the columellar strut would be severe, but they say there is no big difference in nasal-tip drooping between septal extension and a columellar strut. But personally, since the materials being put in are different from the start, I personally wonder if a columellar strut might droop more..
2. The controversial donated costal cartilage The really big merit is that it can replace autologous cartilage. At first, I really did consider putting it in. People say it’s someone else’s, but its rigidity is firm. But as I kept watching YouTube, my thoughts changed. The biggest reasons my thoughts changed were unpredictability of long-term results (loss of strength in donated costal cartilage), different absorption rates, breaks easily when external force is applied!! (if its strength is depleted) nasal obstruction increases (due to capsule formation), and there are reports that it is mostly absorbed after 3-4 years. I don’t think there’s any need to use a material that is unpredictable..
3. Lowering the nostrils / raising the nostrils They say this really isn’t something to do carelessly. If someone recommends this, I think it would be good to ask them to explain the surgical process. Usually they say the surgery is done by adding cartilage (ear cartilage), but they say it wears down and ends up going back to the original anyway. (This part doesn’t apply to me, so I didn’t look into it in detail.)
4. Alar reduction / alar incision There are external and internal approaches for alar incision. They say my alae are the type that would be ruined if done externally. They say I’d scar a lot and definitely regret it. They also say oily skin types scar more easily. (So I’m looking into the internal approach.) When you look at before-and-after photos of alar reduction, the nostrils really get smaller, and from the front, there are people who look stuffy-looking.. I hope people really look into alar reduction carefully before doing it, and I also recommend doing rhinoplasty first and later proceeding with only alar reduction separately.
5. Lastly, bulbous nose
This is the reason I’m writing this post. I’m a man with a short, thick-skinned bulbous nose. I received a lot of opinions about my bulbous nose, and broadly, there were two things recommended to me: 1. Improve the bulbous nose by giving definition to the nasal tip through septal extension (using costal cartilage) 2. Improve the bulbous nose by building a support with a columellar strut and doing cartilage repositioning (using septal cartilage and ear cartilage) These two in total were recommended to me. But here is what I’m worried about.
Improving a bulbous nose through septal extension seems like it would cause a severe foreign-body sensation. And since there is nasal flesh inside, even though I don’t have rhinitis, I thought that if my nose deviated even a little, it would feel stuffy when breathing.
And cartilage repositioning through a columellar strut. This is a more difficult surgery than septal extension, and in terms of stability, I think this might be better..
But what I want is improvement of my bulbous nose, and I’m suspicious of the surgical method. I wonder, can a bulbous nose be improved through cartilage repositioning?
So I’m still thinking about it, and I thought, ah, if I post the knowledge I have as a written post, I might be able to meet someone similar to me! With that in mind, I’m writing this.
For people who know nothing about rhinoplasty, I wanted to let them know that these kinds of nose-related terms exist,
and I wrote this because I wanted to know what people who are still considering nose surgery or have had nose surgery think.
I really want to talk with people who have a bulbous nose similar to mine!
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