Center For Cosmetic Surgery: Todd Gerlach MD
Center For Cosmetic Surgery: Todd Gerlach MD
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Nose / Rhinoplasty

The following information has been prepared to familiarize you with facts about the surgical procedure known as rhinoplasty. You are requested to read this information thoroughly and to discuss any questions which might arise with your surgeon before you proceed with the nasal operation.

Such an operation may be designed to: X Improve the general cosmetic appearance of the patient by reducing, recontouring or reshaping the external nose; X Straighten a previously injured nose, and/or; X Improve the patient's ability to breathe.


It is important that you understand that no nose is perfectly symmetrical. Every attempt will be made during surgery to minimize your side to side dissimilarities, but such differences always persist to some degree even after the most successful operation.

There are many irregularities beneath the skin of a nose before and after surgery, but these frequently become more noticeable after surgery. It is unnatural for a nose to be exactly in the center of the face, before or after an operation. The two nostrils are never exactly the same shape or size. These irregularities and asymmetries will persist after a corrective operation. These facts are being stressed as many patients are not aware of pre-operative nasal irregularities and may be more critical of their appearance following surgery than pre-operatively.

Many patients have a fear that the nasal change will be so great as to create a subject of discussion among family members and friends. Actually, following a well done rhinoplasty, neither the patient nor the patient's friends and relatives usually remember the shape of the patient's original nose a few weeks following surgery. The patient is also warned that there may be individuals who will not wish to acknowledge that the patient's appearance has improved and may disappoint the patient by making an unrestrained comment such as, "I liked your nose better the way it was before", or, "I didn't see anything wrong with your nose".

The cosmetic procedure of recontouring the nose is one of the most popular operations performed by plastic surgeons today. The patient's input is always sought regarding the desired nasal change, but the patient must accept the judgement of the plastic surgeon as to the type, shape and contour of the nose as he is more acquainted with limitations imposed by the patient's tissues and facial features.

Since no two people are alike, a patient should not expect to "select a nose" by studying other people's noses or photographs, but such input is helpful to the surgeon as it gives some idea of the patient's general desires.

A surgeon must consider the patient's entire facial profile when planning nasal surgery. Patients with moderate sized noses, but very weak chins will appear to have much larger noses than they actually have. In such cases, it is impossible to reduce the nose sufficiently to provide a satisfactory profile, but facial balance may be restored by simultaneously performing a chin augmentation. Additional ancillary procedures such as a liposuction of the neck or a face lift may enhance the result of the rhinoplasty even further by restoring facial balance.

Occasionally, if in addition to a weak chin, severe malpositioning of the jaws and teeth is present, an evaluation of the dental abnormalities by an oral surgeon will be recommended before making a final decision about the nose. Conversely, it may occasionally be necessary to reduce the size of an excessively large chin in conjunction with the nasal surgery if the ideal profile is to be obtained for the patient.

Call Dr. Gerlach's office at 310-540-0144 for a complimentary consultation.



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