One challenge for rhinoplasty surgeons and patients alike is dealing with the overprojected nose. The overprojected nose is one which sticks out too far from the face. While it sounds relatively simple to bring the nose in closer, it requires precise planning and technical ability.
Dr. Shah typically deprojects the patient’s overprojected nose with an open approach. The weakness of a closed rhinoplasty is its inability to deproject the nose precisely. Dr. Shah is also able to control the tip so that the nose can have appropriate angle from the face, creating a harmonious appearance. One consideration for the overprojected nose is managing the nasal tip during the postoperative period. Since the nose is being made smaller, excess skin will take longer to deswell. Dr. Shah recommends several postoperative maneuvers to maximize healing.
This patient’s main goal was to have her nose look less prominent in relation to her face. An open technique was used without the use of rib or ear cartilage by using the patient’s septum. A common issue many patients have after a revision or even some primary rhinoplasty is excessive width along the middle portion of the nose. The vast majority of rhinoplasty surgeons will utilize large bulky grafts which may not help all patients functionally or even aesthetically. Dr. Shah has developed a technique to maintain a natural line without creating excessive bulk along the middle portion of the nose. Deprojection of the nose to maintain a well defined tip require is a challenge for the rhinoplasty surgeon. Dr. Shah has written several articles on rhinoplasty describing these and other various techniques.
FREQUENTLY ASKED QUESTIONS
How does Dr. Shah accurately deproject the nose?
Dr. Shah is an advocate of measuring the nose. He feels measurements make a procedure as exacting as rhinoplasty as accurate and consistent as possible.
Can you deproject the nose as far as you want?
The rate limiting step is the soft tissues of the nose. Excessive soft tissues, particularly thick soft tissues, can tend to make the nose look bulky if not addressed. One approach is to remove the extra nasal skin. Dr. Shah will balance the amount of deprojection desired with how the soft tissues overlay on the nose.
What if my soft tissues do not overlay well in surgery and I can not have as much deprojection as desired?
This is where Dr. Shah’s experience in dealing with thick skin and deprojection can be of help. Dr. Shah tends to image conservatively so if aggressive deprojection will not be possible, he will create a nose which is balanced and natural.
Do deprojected noses take longer to heal?
Yes, the soft tissues of the nose must accommodate for the now smaller nasal structure. These patients often respond to nasal taping and post procedure injections.
What ethnicities like deprojection the most?
Typically, Caucasian and Middle Eastern patients seek deprojection commonly. The amount of deprojection is dependent on the quality of the skin and thickness of skin.
Can you deproject the nose and still lift the nasal tip?
Yes, the nose can be controlled three dimensionally with the structural approach Dr. Shah uses in his rhinoplasty.
If I want a massive deprojection can I have an endonasal approach?
More than likely an open approach is a better and more likely to lead to a consistent result.
Can a plastic surgeon who does not specialize in noses accurately deproject the nose?
In our office’s experience, we have found that surgeons who do not have expertise in rhinoplasty tend to have poor results. Rhinoplasty is one of the most challenging procedures in plastic surgery (most think it is the #1 difficult procedure) and it is unlikely that the wrong technique or lack of experience in rhinoplasty will lead to a good outcome.
Dr. Shah seems kinda of young. Is he experienced in rhinoplasty?
Dr. Shah is in the top 1% in number of rhinoplasty procedures performed in the world. Dr. Shah has been performing rhinoplasty for nearly 15 years and has performed over 3000 rhinoplasty procedures. The average plastic surgeon performs around 12 rhinoplasty procedures a year. It would take them 290 years to amass the same amount of rhinoplasty experience as Dr. Shah and even then Dr. Shah still has hopefully many more years of practice. In addition, Dr. Shah is a clinical instructor at the University of Chicago and has published multiple scientific articles on rhinoplasty.
What technique or techniques does Dr. Shah use in deprojection rhinoplasty?
Dr. Shah uses a structural approach to put the nasal tip in position which may require changing the foundation of the nose.
Will I have a scar after this procedure?
If you are having an open procedure, yes patient’s will have a scar along the columella or bridge of skin between the nostrils.
If I can’t follow up with Dr. Shah can I skip my post procedure appointments?
After surgery, visits to Dr. Shah, especially in deprojection cases, to help ensure that swelling is decreasing and that scar tissue is not forming.
What exactly does projection mean?
Projection means how far does the nose stick out from the face (or project from the face).
Do most patients need deprojection?
Every nose is different and there are some patients who need more projection rather than less projection.
Does Dr. Shah perform computer imaging?
Yes, he believes this helps patient and surgeon understand each other’s aesthetic.
Where is Dr. Shah’s office located?
Dr. Shah is located on 845 North Michigan Ave., Ste. 934E, Chicago, Illinois 60611.