06 April, 2023

Does jaw alignment have an affect on rhinoplasty?

I think that the position of the jaw can sometimes have a significant effect on the out come of rhinoplasty. It is always important to assess the proportions of the whole face before planning any surgery that may alter the dimensions of a nose. I believe that it is wise to make sure nasal asymmetry or apparent size is not due to disproportion elsewhere in the face. For example, the nose may appear large or protruding because of a small recessed chin or an upper jaw, which is disproportionately backward in relationship to the lower jaw. The prominence of the cheeks, or the lack of, can also influence the planning of rhinoplasty especially when determining any change in projection.

The surgeon should also check that a bend in the nose is true and not apparent. Abnormal neck positions, known as torticollis, can give the optical illusion that the nose is bent. Sometimes the nasal deviation is part of rare craniofacial conditions such as plagiocephaly, when the twist to the nose is part of a larger facial deformity. Lastly, the position of the eye sockets (orbits) can greatly influence the apparent shape and size of the nose. If the orbits are slightly positioned wider apart then noses can appear smaller therefore decreasing the width of the nose can accentuate the characteristic of the widely placed eyes.

In conclusion, part of the planning for a rhinoplasty must include an experienced assessment of the whole craniofacial skeleton in order to advise the patient about predicted outcomes.