Rhinoplasty remains as one of the most challenging of plastic surgery operations to master. You may wonder how can such a small structure on the face can pose such difficulties. It comes down to the complex anatomy of the nose. Hidden under the skin of the nose are numerous bones and cartilages that come together in various ways to give everyone their unique nasal shape. Five separate pieces of cartilage (septum, paired upper and lower alar cartilages) and four pieces of bone (maxilla, vomer, paired nasal bones) make up the supporting framework of the nose. Unlike the bones, the cartilages are not rigidly fixed but rather suspended to each other making them flexible. (this is why the tip of your nose moves) One piece of the framework, like a stacked deck of cards, can affect the shape of the others if it is moved or adjusted in size. Learning how making one structural change affects the rest of the nasal anatomy and its external appearance is both science and art.
Dr. Barry Eppley
Indianapolis, Indiana