The Evolution of the Button Nose

If you were to ask what the most popular aesthetic operation in this region is, the answer would no doubt be the rhinoplasty. The countries that rhinoplasty is performed the most are Turkey, my paternal homeland and Iran, my maternal homeland. So, why do we come across so many problematic rhinoplasty results if this operation is performed so commonly in these regions? Why are streets filled with ‘’ski slope’’ noses that seem to shout: ‘’I’m a nose that was operated on’’? The answer is actually very simple: rhinoplasty is a very complex surgical procedure. The proportion of the facial features, expectations, regional varieties, and the concept of beauty should be evaluated all together. And, rhinoplasty should be planned specifically for each individual.

 

The Ideal Nose

So, what’s the ‘’ideal nose’’? This is the most common question that I ask myself during each patient’s examination. But, with a slight difference, ‘’What’s the ideal nose for this face?’’ Okay, the hump should be removed, the tip of those nose should be reshaped and lifted, etc. I call these standardized noses: monotypic, with a slightly sloped dorsum and an upturned, button tip, ‘’perfect’’ noses. So, how can you tell that it was operated on? Because it does not suite that face.

There have been many descriptions for aesthetic ratios and the concept of beauty when it comes to evaluating a face in plastic and aesthetic surgery. The golden ratio (pi number), the rule of 3, the rule of 5, symmetries, asymmetries and many other rules. Contrary to what many people think, ‘’beauty’’ is found in hidden asymmetry, not symmetry. A completely symmetric face is not necessarily beautiful. Visually pleasing, attractive, beautiful objects contain slight asymmetries and patterns. The same applies for facial aesthetics. What about our nose? The one, single organ that stands in the middle of the face? It’s all about being able to include the nose in this war of symmetry. So, then we can speak of a beautiful face instead of just a beautiful nose.

 

Remove the Hump but Don’t Change the Tip!

“Let’s remove the hump without changing the tip”; “Let’s lift the tip a little but not too much’’; ‘’I want my nose to change, but not my face.’’ These are some of the most common requests I hear during my rhinoplasty consultations. Some complain about the hump, some about the droopiness of the tip. Some are not aware of their nasal deviations, others don’t know that they have a thick skin. When you’re planning a rhinoplasty procedure, the whole face and its features must be evaluated together, and the resulting changes made to the anatomy of the nose need to be foreseen. The length and the angle of the dorsum, its relation to the forehead, the curvature, the width, its proportion to the tip, the width of the tip, the amount of elevation, and its relation to the upper lip, should all be well proportioned for beautiful and natural results.

 

Dynamic Rhinoplasty

For many people, the nose is a static, motionless organ. For this reason, in many classic rhinoplasty surgeries the cartilage and the bone tissue are reshaped and stitched together based on this concept. This oftentimes results in stiff and motionless noses. In fact, the nose is not a motionless organ. On the contrary, it is quite dynamic. The nose moves with laughing, crying, speaking, breathing, and all other facial gestures. When we look at its anatomy, the nose does not just consist of bone and cartilage, but also an intense network of muscles, nerves and vessels throughout the skeletal structure. This soft tissue holds together all the bone and the cartilage and makes the nose dynamic and “alive”. In the approach that I refer to as a “Dynamic Rhinoplasty,” once these soft tissues are preserved, while shaping the bone and the cartilage during the surgery, the result will be a beautiful structure that preserves the anatomy and dynamics of the original nose rather than a nose “attached” to the face with a surgery like an object.

 

You Have a Button Nose!

Our first goal is often to create a more feminine nose for women and a more masculine nose for men. And when doing this, our priority should be to avoid creating a nose that stays like a statue forever. This single organ in the middle of the whole face can be a button nose, but it should not look ‘’operated on.’’ In short, your face should be ‘’displayable’’.

Even though rhinoplasty consists of some standard procedures, each person has different facial anatomy, ratios, concepts of beauty, and expectations. Therefore, a rhinoplasty procedure should be planned considering the whole face of the person, their nose, mouth, eyes, forehead, jaw, smile, the look in their eyes, desires, thoughts, psychology, their view of life and self, and their understanding of beauty. At the end of the day, we should aim to make you get used to hearing ‘’What a beautiful, button like nose!’’ without being exposed to the question ‘’Did you get a nose job?’’