Anatomy of the Nose
For a rhinoplasty to be successful it is essential that the surgeon have a complete understanding of the nasal anatomy. For patients, a basic knowledge of the nasal anatomy can help them to understand what gives the nose its distinct appearance and why certain changes are made in order to achieve their desired rhinoplasty result.
The nose is made up of the following: skin which covers the nose; cartilage and bone which support the nose; and mucosa which lines the inside of the nose. The upper portion of the nose is mainly comprised of bone, with two bones near the eye sockets which join together to form the nasal bridge or bony dorsum. The lower two-thirds of the nose is comprised of cartilage: the middle third corresponds to the cartilaginous dorsum and is known as the upper lateral cartilage; and the lower third corresponds to the nasal tip and is known as the lower lateral cartilage.
The nasal septum, which is comprised of cartilage and bone surrounded by mucous membrane, divides the inside of the nose into two nasal cavities. These cavities are lined with nasal mucous membrane. On the underside of the nose the column of skin that separates the nostrils is called the columella, while the side of each nostril that attaches to the cheek is called the ala.
During rhinoplasty, the shape of the nose is modified by altering or reducing the nasal cartilages and bones. In some cases, particularly when improving the shape of the nasal tip, cartilage may be taken from the nasal septum, the ear or the rib to replace missing cartilage or build up certain areas. Some patients seeking rhinoplasty also have a crooked or deviated nasal septum which may be congenital or may result from nasal injury. A deviated septum may restrict breathing and also cause a crooked appearance to the outside of the nose. Surgeons can correct this crooked appearance to improve the look of the nose as well as the breathing function.