RHINOPLASTY SEPTOPLASTY NOSE AND CHIN RESHAPING SURGERY


Rhinoplasty, nose reshaping surgery spacialist. Genioplasty chin reshaping surgery.


Dr. Philippe Chout review rhinoplasty costs, prices, advantages and disavantagse, risks, complications and results.

Rhinoplasty definition is nose reshaping cosmetic surgery. This is the well-known surgical operation that deals with either modifying the exterior shape of the nose and/or correcting a deviation of the nasal septum, which causes breathing discomfort (septoplasty or rhinoseptoplasty). Famiiar name is "nose job" . Rhinoplasty make possible to change the shape of the nose without changing the respiratory function and reciprocally. In the western people the rhinoplasty aim is to reduce the size of the nose, in the eastern and African nose it’s a reduction on the front view and sometimes and increase of the height of the nose bridge. In my website , I dr. philippe chout on internet plastic cosmetic surgeon specialist of rhinoplasty and facial beautification reviews the bad and good techniques to fix primary or revision botched rhinoplasty, some being not modern and out of fashion. Several patient gave me the authorizattion tot display the videos testimonials before after and photos. I thank them very much. >

Dr Philippe Chout website reviews rhinoplasty , nose reshpaing cosmetic surgery before after on videos. All pictures are displayed with a sign authorization from patients


Cosmetic reasons for rhinoplasty.

Most people who dislike their nose have concerns about the bridge or the tip, or nostrils or columella (below the tip). At the bridge, or dorsum, people often complain about having a hump. Meanwhile, people who want to change the tip often see this part of the nose as being too wide, round, blobby, beaked or lacking in definition. Some people also dislike the length of their nose.


Rhinoplasty nose cosmetic surgery

nose before rhinoplasty by Dr Philippe Chout plastic surgeon nose and facial beautification surgery specialist 
after rhinoplasty by dr Philippe Chout rtop hinoplasty specialist

Medical reasons for septoplasty or rhinoplasty.

Other rhinoplasty patients may opt for a rhinoplasty because of an injury to the nose, whereby the nose may be broken or bent following an accident of some kind. Others may have functional breathing problems relating to the nasal airways. In these cases, surgical interventions would be considered reconstructive, whereas for the majority of nose operations the surgery is classed as cosmetic. In Doctor Chout’s practice anyway, the operations are always done without any involvement of national insurance or any sort of private insurance, and are paid in full by the patients only.


Rhinoseptoplasty = septo-rhinoplasty

The septum is the cartilage « wall l» that separate the two sides of the nose. This « wall » may be deviated, inclined thus making the airway less permeable to the air, on one or both sides. While performing a rhinoplasty involving the anterior part of the nose and septum, the surgeon may have to perform a septoplasty as well. The sum of these two procedures done together is called a rhinoseptoplaty.The cost of this double procedure is higher than the cost of a simple rhinoplasty.


Nose operations such as rhinoseptoplasty are most commonly carried out to:

1. Alter the hump at the bridge of the nose
2. Reshape the tip of the nose, changing its shape and /or position
3. Alter the length of the nose

4. Alter the width of the nose

5. Alter the width of the nostrils, the heights of its insertion reduce the alar base
6. Restructure and reposition the nose after an injury 

7. Open up the nasal airways to help breathing, modify the septum’s position (septoplasty)


Reduction Rhinoplasty (frequent)

Doctor Philippe Chout prefers the close (scar-less technique), this technique is more difficult than the open technique and require more skills and self-confidence from the surgeon. You will have no incision and no scar on your columella. I will make cuts inside your nostrils to reach the bone and cartilage. Re-shaping the bone and the cartilage will then create the shape of your nose. The skin over your nose is left untouched an scarless and due to its elasticity, can shrink down to the new shape. Making the nose smaller and narrower may mean it is also necessary to make your nostrils smaller. This is done by making further cuts in the skin of the nostrils located at its threshold, which leave fine scars on each side. Your surgeon will advise you whether you may need this procedure.

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Rhinoplasty and septoplaty nose plastic surgery to correct a birds like deformity

deviated nose and septum bfore rhinoplasty septoplasty by Dr Philippe Chout
 photos before after deviated nose surgery rhinoplasty by dr Philippe Chout  photos  after deviated nose surgery rhinoplasty by dr Philippe Chout
photos before after deviated nose surgery rhinoplasty by dr Philippe Chout facial beautification surgery specialist photos before after deviated nose surgery rhinoplasty by dr Philippe Chout best rhinoplasty specialist

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Video before after a rhinoplasty revision, nose reshaping surgery.


This young Lady, despite a previous rhinplasty done by another surgeon had a severe deformity, a deviation, a bump and a broad tip. She benefited from a revision rhinoplasty. The natural appearance, the gaze and personality were preserved and enhanced.


Video before and after rhinoplasty,nose reshaping surgery, and lips augmentation.

This young Lady did not like the bump on her nose , the dropping tip and the thin lips... She benefited from a rhinoplasty, nose reshaping surgery, bump removal and nose shortening and a subbtle lips augmentation according to her wish.


Information about Rhinoplasty the nose reshaping surgery . Cost range 4900- 8900 euros


Aesthetic surgery of the nose, Nose reshaping surgery by Dr Philippe Chout , rhinoplasty specialist in Paris.


I prefer to perform the rhinoplasty through a close , internal , scarless approach. The inicision is hidden inside the nose


Rhinoplasty is the surgical operation that deals with either modifying the exterior shape of the nose and/or correcting a deviation of the nasal septum, which causes breathing discomfort. It is possible to change the shape of the nose without changing the respiratory function and reciprocally. In the western people the rhinoplasty aim is to reduce the size of the nose, in the eastern and African nose it’s a reduction on the front view and sometimes and increase of the height of the nose bridge.


Reduction Rhinoplasty (frequent).

Your surgeon will make cuts inside your nostrils to reach and shave the bone and cartilage. The incision therefore the scars are hidden inside and note visible.Partially removing and re- shaping the bone and the cartilage will then create the shape of your nose. The skin over your nose is left untouched and due to its elasticity, can shrink down to the new shape. Making the nose smaller and narrower may mean it is also necessary to make your nostrils smaller. This is done by making further cuts in the skin of the nostrils, which leave fine scars on each side. Your surgeon will advise you whether you may need this procedure.

Augmentation Rhinoplasty (rare)

Your surgeon will make a cut inside or between your nostrils and re-shape the bone. Additional bone or cartilage may be needed to build up the nose. Bone may be taken from: your hip ,a rib ; this is called a bone graft. If cartilage is used it may be taken from: your ears, spare cartilage inside your nose sometimes artificial implants are used. The skin over your nose will probably not need to be cut as it stretches over the new shape. After reduction or augmentation rhinoplasty, the cuts inside or between your nostrils will be closed up with dissolvable stitches. Your nose may be filled with surgical packing to help control any bleeding. You may also have small pieces of soft plastic inside your nose to prevent scar tissue from forming. Ethnic rhinoplasty or revison rhinoplasty are often augmentation rhinoplasty techniques . Dr Philippe Chout has an outstanding knowledge and experience of this type of surgery .

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The principle is to re-shape the nose partially or totally. It will modify the bone and cartilage skeleton of the nose, which determines the shape, and the replacement of the skin. The modifications could concern part of all the elements of the infrastructure: the point of the nose, the nostrils, and the bridge of the nose, the nasal septum.
The modification of one of these elements often automatically lead to the modification of another even untouched, or change its visual perception. The final modification sometimes of large magnitude is however limited by the quality of the skin and the cartilage of the patient, by the scaring reactions rarely predictable as well as the anatomical and functional realism. The final result is not exactly predictable therefore the patient will have to limit his wishes of improvement to realistic expectations. You will never get the nose seen on someone else’s pictures. The goal of the operation is to improve the overall shape not to give “the perfect nose”.


THE COST OF A RHINOPLASTY. The price for a rhinoplasty range from 4900 to 8900 euros



Before the Operation

Some photographs will be taken before and after the intervention, on these photos the surgeon will outline the plan of operation. The preoperative drawings, the computer study or diverse plastic shapes are not contract but only means of study.
The intervention will take place for the most part under a general anesthetic; a consultation with an anesthesiologist, before the operation, is, therefore necessary. You won’t breathe spontaneously during the operation but through a machine. Do not take aspirin or any medication containing aspirin within the eight days that precede the operation and that follow the hospitalization, due to the fact that this form of medication increases the risks of hemorrhaging. The intervention takes one to two hours in regard to the extensiveness of the operation. The hospitalization lasts between 24 hours. The intervention is performed by passing essentially through the interior of the nostril and is therefore totally hidden. Rarely when a reduction of the size of the nostrils is sometimes carried out. The incision is then placed on the threshold of the nostril, which leaves a scar that is barely invisible. The modified pictures done on on the computer before the operation (usually during the second consultatinon) are just studies, not contract pictures.


After the Surgery

The intervention is generally painless but uncomfortable because of the plaster to wear on the nose and difficulty to breathe through it. The operation brings about, during the first week, a feeling of discomfort from the edema to the haetatoma (bruising and swelling) and to the ecchymosed of the eyelids, all of which is customary resulting in nasal fosse as well as the need to wear a nasal plaster for the duration of one week. Under no condition should you remove the plaster yourself, any manipulation is excessive due to the fact that the nose is extremely fragile during the first week and might possibly risk deformity .You may have a runny nose during the first two weeks, and relative obstruction during the first six month .You should wipe your nose and avoid blowing it. You should put drops into the nasal fosse each day for two weeks and clean the nasal openings with an antiseptic and Q-tip.


Rhinoplasty recovery

After eight days the plaster is removed, the nose does not yet appear shapely as the post-operative oedema (swelling) masks the details, and gives to the eyes a strange look. This will disappear within a few weeks. The remaining edema of the tip will decrease in six to nine months. Professional activities may be continued, normally eight days after the intervention. There is no need to remove the stiches as they are dissolvable; Exposure to the sun is possible after one-month minimum. Sports that expose the nose to any form of trauma should be avoided for two months until the nose become solid. Post-operative intermittent nasal obstruction during a few months is related to the swelling of the mucosa (mucus membranes).


Usual evolution after a rhinoplasty

After the removal of a bump, the aesthetic result is not perceivable when the plaster is initially removed, as the process is not finished until at least six months later. Actually, the post-operative oedema (swelling) which initially gives a ‘ski slope’ look (round, high and large appearance of the nose tip and a wider space between the eyes) disappears in two weeks to three months approximately. The scarring of the internal tissue is indeed not predictable and could alter the cosmetic result and therefore a touch up under local anaesthetic 6 months post-operatively could be necessary. Often, small injections are made in the tip during consultation after the first month (hyaluronic acid). Sometimes when an augmentation rhinoplasty is performed, a cartilage graft will be taken from the posterior part of the ears. The rhinoplasty can be surgically associated, at the same time, with the modification of the shape of the chin; the combination of these two procedures is called a profiloplasty. An enlargement or reduction of the lips, the correction of excess skin or fat of the eyelids can equally be performed at the same time.


Possible complications after a rhinoplasty.

Some complications that are possible but rare they could delay or alter the final result: Hemorrhaging, haematoma and infection that can require a surgical intervention are some rare complications. Secondary shifting of osteocartilaginious structures after the removal of the plaster, in cases of traumatism. Obstruction of the nasal valve, septal perforation or deviation, the retractile scaring fibrosis, corbin deformity Skin necrosis, poor scaring, unwanted scar the belated gradual resorbption of a cartilage graft, Hiposmia, anosmia, and nasal hydrorrhoea, Psychological disorders (depression, psychosis) For the record, vomiting, respiratory complications, neurological cardiovascular or allergic complications, sometimes lethal or invalidating due to anesthesia. They can evolve unto themselves.


Revision rhinopplasty.

The rhinoplasty is a very difficult plastic surgery procedure and many patients who are not fully satisfied with a rhinoplasty performed by another surgeon (sometimes in other countries) are then referred to Dr. Philippe Chout for a rhinoplasty revision. This procedure is even more difficult than the first hand rhinoplasty because of th eifbrous tissue and unpredictable healing. This does require either further shaving/ shaping the bone and cartilage, making the nose more harmonious. Because it is far more difficult , revision rhinoplasty is far more expensive as well



Genioplasty and profiloplasty: Cosmetic Modification of the Chin /Jaw


The chin is a very important component of the facial appearance and Beauty. A lack of chin projection can give the impression that the nose is too big. The combination of a chin surgical improvement genioplasty and a nose surgery is called profiloplasty.


Cosmetic alteration of the chin can be:
• A Reduction of chin : either by intraoral incision (in the mucosa) or external cutaneous incision, reduction of the osseous mass or projection and/or of the soft tissues anterior to the bone.The principle is to shave the bone with a rotative macine. Results are visible after a minimum of three months. The risk in this type of surgery is represented by the chin and lips permanent loss of sensation or modified sensations, due to stretching of the mental nerve. Other risks are those of surgery (hemorrhagic, infections, scar problems) or anaesthesia (allergy, choc, immunologic complications of medications, cardio respiratory complications of anaesthetics, which can be lethal or invalidating).

• A chin Augmentation: through an incision in the mouth or external approach, either osteotomy + metal osteosynthesis (cutting the bone and putting metal plates) , or silicone implant. The Silicone implant is often the best option with a faster and lighter recovery time of one or two weeks. It is natural looking and permanent. The implant can be placed either through an incision located inside or outside the mouth. I prefer the approach inside the mouth as being invisible. The later option is even lighter. Sometimes if the chin is not only short, but some fat is visible as well, a liposculpture through an incision hidden below the chin and two incisions hidden behind the ear lobe, will be done at the same time of the chin augmentation. It will be charged additionally.

• An augmentation and smoothing the chin countour with a fat transfer (see liposculpture and fat transfer): this smart technique can be done alone or combined with an implant. If done alone it can be done under local anaesthetic plus a light sedation as a day case.
• The risk in this type of surgery is represented by chin or lips permanent loss of sensitivity anaesthesia, due to stretching of the mental nerve. Other risks are those of surgery (haemorrhaging, infections, implant rejection scarring problems) or of anaesthesia (immunologic complications allergy to medications, cardio respiratory complications of anaesthesia, which can be lethal or invalidating). Normally, prostheses are very well tolerated and become part of the profile, which means that the patient in most cases forgets about it completely. • In both augmentation and reduction, the relationship between lips and teeth and the motility and mimics are modified due to scarring and volume modifications. • It is not possible to modify the lips without modifying these relationships. The scarring process is not totally predictable; therefore the patient will have to limit their wishes to realistic expectations.

The association of a rhinoplasty and genioplasty chin improvement is called profiloplasty. The cosmetic effects of these operation combined is often spectacular


Video before and after Beauty Design Surgery: rhinoplasty, chin augmentation, temporal lift.

Beauty Design Surgery. This 30 years old Lady, had a severe facial dysharmony, severe lack of chin projection, descending eyes slants, dropping cheeks and jowls, nose bump too big. She benefited from a Beauty Design Surgery by Dr. Philippe Chout. A rhinoplasty, nose reduction surgery, a chin augmentation with an implant, temporal model lift, eyes corner lift by canthopexy, fat transfer to the cheekbones. An attractive, very natural and youthful facial appearance is obtained.

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Video before after rhinoplasty, temporal lift of cheeks and eyes, fat transfer.

This 30 years old Lady had a long and protruding nose, a gaunt facial appearance related to a lack of fat volume under the eyes, and cheekbones. She benefited from a reduction rhinoplasty, a fat transfer to the under eyes tear through and cheekbones area, a temporal lift with an incision only in the hair above the eyebrows. A natural and youthful appearance of the midface, the nose and the gaze were obtained.

This 39 years old Lady, had un-natural looking lips, and a gaunt facial appearance with heavy features, premature ageing, several descending lines and a lack of harmony in the mouth-lips-nose-cheeks-complex. She benefited from a Beauty Design surgery, I combined in one single operation a lips reduction, a facelift, a rhinoplasty, a fat transfer. An attractive and youthfull facial appearance and the gaze and personality revelation were obtained. Dr Philippe Chout facial beautification surgery specialist


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(©) copyright- All Rights Reserved - Dr Philippe Chout- tous les droits sont réservés- Article L335-2 et 335-3 modifié par loi française n°2016-731 du 03/06/ 2016 - art. 44 , et Article L215-1 - LPD