We can draw an analogy between the nasal surgery and repairing a car engine. When you want to repair a car Firstly, you have to open up the hood to take a look under it and then begin to repair.

Doing a rhinoplasty also requires lifting the nasal skin up and then the underside consisting of the bones and cartilages is repaired to achieve a favorable outcome. The nasal skin will be again draped over its original place and then sewn with stitches.   

The surgeon will make a few alterations to nasal skin and it is only the skin of the nostrils that will be changed at the end of rhinoplasty if nostrils are going to be reduced. So as it was described, the surgeon is able to repair bone and cartilage and the form and the type of nasal skin cannot be changed by the surgeon. It is the type and thickness of the nasal skin which is determining factor in surgical outcome and the pace of recovery following rhinoplasty. Nasal skin of Iranians is thicker than western races. A nose with a thick skin is mistakenly referred to as a fleshy nose.

Of course, the nasal skin can become slightly thinner during a rhinoplasty. In fact, the surgeon can remove underlying adipose tissue. Nevertheless the surgeon must be cautious lest damage the blood vessels of the skin.   

The alterations made to cartilage tissue especially at nasal tip are intended to be perceived despite the thick nasal skin. And of course, a tiny nasal tip cannot be expected along with a thick nasal skin.

All of the patients must have in mind what type of nose they have.  Bearing this point in mind helps the patients give up unrealistic expectations and be somehow aware of surgical outcome. A lot of dissatisfaction with the surgical results comes from unreasonable expectations prior to rhinoplasty and one of the surgeon’s tasks in the consultation session previous to rhinoplasty is clarifying this issue for the patients. Dr. Gharooni honestly tells his patients the truth in the consultation sessions so that the patient acquires needed information and wisely makes up his/her mind whether undergo or doesn’t undergo the surgery.


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