Mr Rowe-Jones prefers to carry out surgery with the patient asleep (under general anaesthesia). It may be possible to perform surgery with local anaesthetic and sedation.
Figures 1a shows the normal anatomy of the nose under the skin.
Figure 1b shows the lower lateral (tip) cartilages from below.
Cuts for closed approach rhinoplasty are placed inside the nostrils, where they cannot be seen and the skin is lifted off underlying bone and cartilage. Changes made to the bone and cartilage of the nose under the skin are performed by looking and feeling.
Figure 2 shows the position of the cuts.
Figure 3 shows the position of the cuts used in open approach rhinoplasty. Most are placed inside the nostrils except for one small cut on the skin between the nostrils.
Figures 4 & 5 show a reduction rhinoplasty to remove a bump from the nose and make the tip smaller.
Figures 6 & 7 - When the bump has been removed the roof of the nose is seen to be open just as if ridge tiles had been removed from the roof of a house. Small breaks must be made in the bone of the nose to close the "open roof". These same breaks can be used to narrow a wide nose or straighten a twisted nose.
