The face is the most visible part of the body but the nose is its most prominent feature. It is not surprising therefore that nasal surgery is one of the most common procedures in North America. Rhinoplasty is the term used for nasal surgery.

The first rhinoplasties were performed to reduce large noses. Today, similar procedures are followed to reduce excess amounts of bone, cartilage, and fat in the nose in order to make it more esthetically pleasing. Making the nose larger (augmentation rhinoplasty) to achieve a desired esthetic result has also gained in popularity This may involve adding cartilage from the nasal septum or from the ear to the bridge and tip of the nose. Silastic (silicone) implants are also frequently used. An augmentation rhinoplasty can help those who are unhappy with an unsuccessful reduction rhinoplasty.

The surgeon is frequently asked to create the same nose as a model's in a glossy magazine. It is not possible to surgically duplicate a nose. This is because anatomic characteristics differ from one person's nose to another's.

Before surgery the physician will ask the patient about any difficulty with nasal obstruction. Intranasal examination may reveal some obstruction to the nasal airway which could be corrected simultaneously.

In addition, the surgeon assesses facial balance, including the neck, chin, upper lip, forehead, cheek bone areas, and glabella (the area between the eyebrows). A surgical plan based on the esthetic goals is then established and thoroughly discussed with the patient.

If the patient is over 50, and wishes to undergo a reduction rhinoplasty, he or she should be aware that there may be an excess amount of nasal skin after the surgery. Due to the loss of elasticity and resiliency experienced with age, the skin does not shrink to the new shape of the nose. Usually this problem is anticipated by the surgeon and is corrected by removing the excess skin or, in some cases, by lifting the brow.