As the focal point of the face, nasal structure plays an important role in creating an overall attractive facial appearance. Natural defects, trauma to the nose or disproportionately sized and oddly shaped nasal structures can significantly alter facial aesthetics, and unfortunately often have a negative impact on how people view themselves.
‘Rhinoplasty’ is a surgical procedure that can sculpt a new nasal structure to restore balance and facial beauty. Most patients seeking this treatment wish to improve the size or shape of their nose to achieve a more proportionate and attractive facial appearance.
During this procedure, cartilage may be removed, repositioned, or added to custom-shaped new nasal structures - with attention being paid to achieving natural looking results. Adjusting the nostril size also plays an important role in this process, along side modifying the angle of the nose’s bridge so it has a subtle slope which helps create a more natural nasal shape.
The techniques that can be used to achieve nasal correction are referred to as either open rhinoplasty or closed rhinoplasty.
Open and closed rhinoplasty
As the name suggests, an ‘open’ incision is made during this procedure to allow the surgeon to have more visibility of the nasal structure and make extensive adjustments such as adding, repositioning, or removing cartilage to custom-shape the nose. A small scar may develop at the base of the nose following open rhinoplasty, which fades over time and can easily be covered using makeup.
During a closed rhinoplasty procedure, all incisions are created inside of the nasal cavity, which prevents the development of visible scarring. Skin is released from the cartilage, and the structures of the nose are shaped. This is typically a shorter procedure than open rhinoplasty and requires a less extensive recovery period.
Nasal casts and splints are used to support the nasal structures during the healing process when patients will experience bruising and swelling (which can be alleviated with ice packs). Most can return to work one week after their procedure and can expect to resume their regular activities four weeks after surgery.
Mr Ivo Gwanmesia is a Consultant Craniofacial Plastic Surgeon with several central London clinics, including 10 Harley Street. He provides all aspects of plastic, aesthetic and reconstructive surgery, however most of his work concentrates on the face and craniofacial procedures. During his extensive career he has completed 12 months as a fellow within the Craniofacial Unit at Great Ormond Street Hospital, and another 12 months as a Craniofacial Surgery Fellow at the Cleveland Clinic in the United States. He is also on the specialist register of the General Medical Council for Plastic Surgery.
In this article Mr Gwanmesia provides his expert insight on common surgical methods that are used for correction of the nose and chin.
Genioplasty (also known as chin surgery) is a surgical procedure that can improve facial harmony by correcting the size and prominence of the chin. Those choosing to have the treatment may consider their chin to be small and weak, receded, prominent, or overly projected, making it appear to be out of balance with their other facial features.
The most common and frequently performed genioplasty procedure is known as ‘Sliding (Osseous) Genioplasty Chin Augmentation’. This involves the relocation of a portion of the chin bone to correct and enhance a small or recessed chin. As surgical incisions are made from inside the mouth, there is no visible scarring following the surgery, which also utilises absorbable sutures (stitches).
In the instance of reducing chin size, a similar process is used where a portion of the chin is removed instead of relocated (Sliding (Osseous) Genioplasty Chin Reduction).
Synthetic implants can also be utilised to enhance chin size and prominence, which are again inserted from within the mouth meaning no visible scarring is present.
About Mr Gwanmesia
Mr Gwanmesia trained within the London Deanery, working in most of London’s Teaching Hospitals and obtained his Certificate of Completion of Training in Plastic Surgery in November 2010. He spent all of 2011 working as a fellow within the Craniofacial Unit at Great Ormond Street Hospital, and in August 2013 left the UK for the United States where he undertook a 12 month fellowship in Craniomaxillofacial surgery at the world renowned Cleveland Clinic Foundation, Ohio.
During his time at the Cleveland Clinic, Ivo spent time further sub-specialising in adult and paediatric craniofacial surgery. He also undertook pioneering research which led to the development of a new technique for the reconstruction of the middle vault of the nose, known as the ‘Fulcrum Spreader Graft’. This method is now published in the scientific literature. He is the author of several papers and is co-author of several chapters in the newly published Plastic Surgery textbook ‘Plastic Surgery – A problem based approach’, as well as being the author of a couple of chapters in the new 'Atlas for Craniofacial Surgery'.
Mr Gwanmesia regularly performs successful rhinoplasty and genioplasty procedures from his surgical bases at the Highgate Private Hospital in North London and the Welbeck Hospital in Central London. He consults with patients at his Harley Street base:
10 Harley Street
For further information on the above and other procedures offered by Mr Gwanmesia, visit www.ivogwanmesia.com.