Know your nose – Nose anatomy and nose surgery

Your nose is the beginning of the external respiratory system that plays a crucial role in filtering the air that we breathe. The nose is also recognised as an important aesthetic feature on a face. When asked what is the first feature you notice on someone’s face, the most common answer was the nose. Given the importance of the nose, it is self-explanatory as to why you should know the anatomy of your nose. Not just because you want to alter the appearance of the nose with no surgery but also to further understand your nose. 

The nose is divided into two parts, both of which are important for the aesthetic and physiological aspects of the nose. Both parts are targeted by nasal surgery, depending on the cause of the procedure. The two parts of the nose are the external nose and the internal nose, and the anatomy of both is discussed below. 

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Anatomy of the External Nose

The external nose is the part of the nose that is visible on the face. Most of the aesthetic flaws of the nose affect the external nose and because of its protrusion from the face, even the slightest flaw can be exaggerated enough to be a cause of concern for you. If you are unsatisfied with the appearance of the nose and choose to undergo nasal surgery to rectify the flaw, the procedure would most likely involve surgical manipulation of certain components of the external nose and the internal nose. 

The different parts of the external nose are as follows: 

Radix

The radix is the part of the nasal root which marks the origin of the nose from the glabella. Simply put, the radix is the part of the base of the nose that is between the eyes. It is the bony part of the nose that is responsible for the bump in the nose. This is also the part of the nose that is often targeted in ethnic rhinoplasty or nose augmentation. For these procedures, a cartilage graft is used to combat the flatness of the radix. 

Nasal bridge or dorsum

The nasal bridge or dorsum is the part of the nose in between the radix and the nasal tip. It is the largest part of the external nose which is why flaws of the nasal bridge are so exaggerated on the face. The common problems with the nasal bridge are a deviated nasal septum which can give the bridge a crooked appearance or a skewed appearance. The nasal bridge can also be affected by a bump which is one of the common reasons for people to choose to undergo a rhinoplasty. 

Nasal Tip

The nasal tip is the part of the nose that protrudes outwards and usually, a petite, round, and upturned nasal tip is preferred. However, there is a wide range of nasal tips that can occur, for which a nose surgery can be performed. The least liked nasal tip belongs to the hawk or bulbous nose shape and the most desired one belongs to the Roman nose shape for men and the upturned and Duchess nose shape for women. 

The hawk nose shape is named such because the shape of the nose resembles a beak with its slanted tip and a small bend in the middle of the nose. This nose type is not flattering in either of the genders. The features of this nose type are not considered attractive by anyone and most people with these nose types prefer to change them. 

The bulbous nose shape is associated with a widened nasal tip, as apparent from the name. This widening results in the nose structure being completely out of proportion when compared to the rest of the face. The bulbous tip can also be asymmetric or lop-sided, along with being hard to contour

Columella

The columella is the column between the nostrils that runs between the nasal tip and the base of the nose where the nose meets the philtrum. This part of the nose is quite important but not for the same reasons as the rest of the external nose features. Instead, the columella is the part of the nose through which rhinoplasty is often performed. The purpose of using columella is that it is the least visible part of the external nose. Any incision made here will be easily hidden and there will be no visible scarring. You could undergo shape-altering surgery and no one would be able to tell. 

Anatomy of the Internal Nose

The internal nose has more to do with the nose’s functionality and less to do with the nose’s aesthetics. However, it does not mean that the parts of the internal nose do not affect how the external nose looks. As mentioned below, the external and internal features of the nose are connected to one another and the deformity of one will definitely affect the other. This is why it is so important to know the anatomy of the nose thoroughly.

It is also important to understand thoroughly the internal and external nose before deciding to undergo any nose surgery. Because this allows you to understand the risks and complications of the surgery better and make an informed decision regarding the procedure. 

Nasal Septum

The nasal septum is the cartilage wall between the two nostrils that are responsible for keeping both the nasal cavities open and unobstructed. A direct injury to the nose often injures the nasal septum and either fracture the nasal septal cartilage or deviates it. The deviated nasal septum, also known as DNS, is a cosmetic and physical deformity. The nasal septum is what gives the nasal bridge its shape so any deviation of the nasal septum equates to the deviation of the bridge. Moreover, the deviation often obstructs the nasal cavity on the side of the obstruction, making it difficult for you to breathe.

In such cases, nose surgery is definitely helpful. Depending on the extent of the injury, the surgery of choice might be either a septoplasty or rhinoplasty. In extreme cases, a septorhinoplasty may be performed. 

Nasal Wings or Alars

The sides of the nose which exaggerate the size of the nostrils when you flare them are known as nasal wings or alar. This part of the nose is absolutely crucial for the overall aesthetics of the external nose. Widening of the nostrils as seen in the piggy nose shape is unflattering and one of the common reasons why people opt to undergo nose reduction rhinoplasties. 

The nasal wings are not only important for the appearance of the nostrils but also for the appearance of the nasal tip. The wings are the extension of the nasal tip on the sides and they are responsible for supporting the nasal tip. Weak nasal alar cartilage means a lack of support for the tip, which is why such noses often appear wide and flat at the tip.

Nasal Bones

The nasal bones for the framework for both internal and external nose shape. They are important for the shape and projection of the nose, but unlike other bones in the body, the nasal bones are not as hard. They are very easy to manipulate and shave during a rhinoplasty procedure when it is being performed for enhanced nasal projection or improved appearance of the nose. 

Upper Nasal Cartilages

The upper nasal cartilages are the cartilages apart from the alar cartilages and the septal cartilage, that is found over the nasal bones in the upper and lateral parts of the nose. This cartilage is important for determining the appearance of the nasal root as weak cartilage in that region gives the nasal root a pinched appearance. Moreover, it cannot support the nasal dorsum which can be devastating for the aesthetics of the rest of the nose. 

Features of an Attractive Nose

There are different features of an attractive nose, depending on the overall face shape and size and the ethnicity of the person. However, there are traditionally attractive noses which are believed to have the most attractive features. Although there are different technical aspects to be considered in determining the attractiveness of these features, it all boils down to symmetry and compatibility with the rest of the facial features. 

Starting from the root of the nose and the nasal bridge, the presence or absence of this bridge, along with the extent of the prominence of the nose has the potential to describe your ethnicity and shape your entire face. The ideal nasal bridge should be between 45 mm to 50 mm, a bit shorter than the average Caucasian nasal bridge. 

The nasal root starts from nasion, or the space between the eyes, and extends downward to the nasal bridge, and the angle between these two is known as the Nasofrontal angle. Generally, the nasofrontal angle should be between 115 degrees to 130 degrees, to give the required lift to the bridge, without making the bridge too prominent. Moreover, this angle determines the height and profile of the nasal bridge as it projects onto the nasal bridge. 

The nasal bridge extends into the nasal tip which ideally is supposed to be lifted slightly, to give the appearance of a button nose, which is highly sought after. Also, a bulbous nasal tip or a pointed nasal tip may alter the appearance of the entire face. It also determines the size and projection of the nasal bridge with a small, rounded nasal tip giving the nasal bridge a thinner appearance, and the nose a contoured, sleek look. 

The nasolabial angle is the angle between the base of the nose or the columella, and the philtrum. Columella refers to the skin between the nostrils and the philtrum is the raised skin between the nose and lips. The ideal nasolabial angle is supposed to be anywhere between 95 degrees to 100 degrees, with columella positioned such that at least 4 mm of the nostril is visible. This slightly raised angle is crucial for the appearance of the highly sought-after nose type which is a small button nose. 

The features mentioned above give the nose its slender and feminine appearance when viewed from the front. However, the external nose also has other nasal features on the side that play a huge role in determining the size and projection of the entire nose. Nasal alar or nasal wing refers to the nasal skin projections on the lateral side of each nostril, closing off the nostril on the side not covered by the septum. Excess flaring and slightly bigger nasal wings are characteristic male nasal features that are not suitable for a slender, feminine look. Altering them is also possible through plastic surgery or cosmetic surgery procedures. 

The use of mathematical formulas to determine the beauty and aesthetics of the face is a common practice in the cosmetic field, and it has been recently found that a mathematically average nose is what is considered to be attractive by the masses. For a nose to be considered attractive and feminine, there are certain characteristics it should have, with the ideal nose sizes being determined mathematically. An ideal masculine nose does not need to have these features, instead, it is often preferred for men to have larger and rougher noses when compared to small and sleek feminine noses. A nasal bump, to an extent, is not a big concern for a masculine nose. 

Moreover, masculine noses are rougher in appearance to match the overall aesthetic of the face. A small feminine nose on a traditionally masculine nose can be a major confidence issue for men, requiring rhinoplasty to correct the error at hand. The general features of the male and female noses are quite different and the aesthetic ideals are equally different. 


Why Choose Dr Kleid for Rhinoplasty?

Dr Stephen Kleid
Cosmetic Rhinoplasty
Melbourne

Dr Stephen Kleid is an experienced ENT Surgeon (Otolaryngologist) based in Melbourne with a passion for Septo-rhinoplasty, Septoplasty and a strong interest in Rhinoplasty Revision.

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