Plastic surgery encompasses a wide gamut of surgical procedures from complex microvascular reconstructions to delicate cosmetic eyelid surgeries. As with all surgeries, plastic surgery requires a mastery of the anatomy and a profound understanding of the form and function of its component parts, but one distinct aspect that is somewhat unique to cosmetic plastic surgery is the way in which artistry and a keen aesthetic eye must accompany technical prowess for a surgery to be truly successful. Even in a highly complex and demanding surgery such as using tissue from a patient’s forearm to reconstruct a portion of a patient’s tongue that has been resected, there are certainly some judgements that have to be made with regard to appearance, but very much secondary to function. In this way the surgery becomes almost algorithmic, with success predicated more on the completion of each requisite step rather than a more holistic assessment of the outcome that places utmost emphasis on the beauty of the result.
For this reason, many plastic surgeons consider rhinoplasty to be the most challenging plastic surgery procedure. The nose has multiple core functions that must be preserved, and sometimes enhanced, during surgery including breathing, smelling, and contributing to the tonality of your voice. In addition to the critical functions the nose represents the central facial feature and must be cohesive and balanced with the rest of the face to optimize facial harmony. Perhaps the most challenging aspect, however, is to create a shape that is aesthetically pleasing not only when judged by “textbook” measures and standards of beauty, but to create a shape to the nose that blends and enhances the face when you as the patient look at it. As everyone has their own standard of beauty, influenced by personal bias, rhinoplasty surgeons have the task of understanding and incorporating their patients aesthetic ideals and biases to create the closest shape surgically possible with their unique anatomy, and the limitations this presents.
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