Anatomy Of Nose

Today I will attempt to explain using simple language that the unintelligent masses can understand of the basics of that which we do to parts of nose to make more aesthetic.

Nasal bones - these compose the top third of the nose, and will usually need to be significantly hacked away during surgery to sculpt lovely "scoop" in profile. In addition, they should always be broken - whether patient ask for this of not - and pushed together to make bridge of nose as narrow as possible (the thickness of a piece of cardboard as a good ideal to aim for). Always make sure one side is pushed in more than another, this creates impression of nose being even thinner and also creates harmonious asymmetry which will look wonderful on patient. Sometimes patient will complain of asymmetry or supposed "open roof deformity" (which is NOT a deformity! is lovely aesthetic feature of beautiful nose), this just means you have not made it narrow enough. Try to coerce patient into getting second surgery with you, then break nasal bones and shift in so nose is even thinner! At this point you should not be getting any further complaints from patient; as they will either become accustomed to their aesthetic new look, or go and commit suicide. Either scenario is fine for surgeon.

Upper Lateral Cartilages - These are them what form the middle section of the nose. Always should have outside edge cut off along with bone and septum to make nose smaller and more aesthetic. During surgery, they should be detached from the nasal bone and be allowed to collapse, thus producing a pleasing narrowness of nose. This may present the patient with some breathing difficulties, but this should not bother them as they should be grateful for beautiful aesthetic of new nose.

Lower lateral cartilages - These comprise lower part of nose and what give shape to the tip. These can often present problem as being bulbous and wide; and having unattractive "normal" level of columellar show. The best way to deal with these is to cut out as much as possible. This allows for slender, sculpted pointy tip and attractive, aesthetic alar retration.




Left we see unattractive "normal" nose. Right, we can see that with almost entire removal of lower lateral cartilage will create aesthetically pleasing alar retration, which will allow another to see up one's nose. Many say that eyes are the window to a person's soul, but I truly believe nostrils are the windows to the soul. With creating alar retraction, we allow people to gave upon a patient's soul by giving other people a look at the interior of their nose.



Septum - this if the middle part of the nose, and all that is really necessary for a beautiful nose (look at LaToya Jackson). Is truly beautiful this to witness nose comprised entirely of septum, unencumbered by unsightly, unaesthetic bone and cartilage.
Generally, should have outside edges resected when trimming entire nose to make smaller and more aesthetic. Sometimes this can be crooked, in this case, we should never attempt to straighten it, but attempt to create an asymmetrical look for entire nose to match.

By following these steps above one will always create aestheticness of beautiful nose! Remember, that what we do will not only change a persons looks, but also change their life!

Key principals of aesthetically pleasing rhinoplasty!

For benefit of those surgeons what I mention before, who have yet not garnered much experience such as I to be expert of rhinoplasty, here are key principals which remain constant no matter the situation!;

1. Always smaller is better. Noone ever request larger nose for surgery; always better to over-resect nose than have complaint from patient that nose too big. Always you must aim for the smallest size nose possible!

2. No-one likes round, bulbous ugly nose. Always you must endeavour for most sculpted, pointed tip. This shows quality of craftmanship of nose, thin nose and sharp tip are indicators of great surgeron!

3. If patient request "conservative" rhinoplasty, then better it is to preserve some inherent traits than aim for perfection! For example, if patient nose is crooked, aim to have nose just as crooked after surgery, or even more crooked, this make sure others will have disbelief at nose being result of "nose job". Or if naturally then hanging columella exist then make sure columella still hang after surgery, to preserve patient unique "look".

4. If irregularities (dent or pinch) appear on surface of nose after surgery, is not the fault of surgeon! Never accept responsibility for poor healing of patient! Whenever collapse or irregularity appear is always fault of patient for inability of body to heal nose properly after surgery. Never it is fault of surgeon; can even happen to expert of surgery! I should know! Happen with me all the time!

5. Never tell patient before surgery of that what is to be done to them. It is no business of patient what you shall do to them during procedure! There is not even any need for surgeon to have prepared that which he will do for surgery before operation, if surgeon have any experience !

Follow this steps and you shall have always glorious practice of making aesthetic nose!

"Natural" vs. Unnatural

Sometimes patients come to me and complain of result to be not what they like. Always they complain of not looking "natural"; I tell them, "nature ugly, why you come to me for perform rhinoplasty then?". Surgery can only improve unsightly nose, the more surgery performed on nose the more aesthetic the nose will look.

I have very troublesome patient come to me and tell me nose not look good. I very shocked and surprised; new nose is finely sculpted with tip so pointy could open envelope. Who could be dissatisfied with such a thing? Also complaining he was about irregularity of nose, I tell him "irregularity of nose wonderful thing! do you not want nose multi-faceted like diamond?". He not like asymmetry of nose, but his face is asymmetric so I made nose more asymmetric to fit with face. Is not to have matching face and nose splendid and aesthetic thing?


He get very threatening and agressive, when leave he slam door causing damage to door, even damage to building (he even slam door so hard he create cracks in walls of dirty old house I consult from that were already there!).

Later he complain to medical board, but I use persuasion to other plastic surgeon to not testify against me. Are we not all genius? Should one who has risen to godlike status of plastic surgeon be dropped to masses of great unwashed?

Eventually, medical board agree with me that "open roof deformity" not a deformity! Of course this is known to those with wisdom. Lots of money westerners pay for cars with open roofs, yet they not want open roof on nose? Ridiculous is such a thing.

Here in instruction on protection against patient:

1. Simply tell medical board you have done actions all complying with "standard practice". While some may say it is an unethical thing to lie to medical board, this is only said by those not imparted with higher wisdom of plastic surgeon.

2. Never admit you wrong. Because you not wrong! Even wrong you are, then you are right because you are plastic surgeon! Every nose will look better after operation, and this should be known.

3. Never, ever give refund to patient. Even if patient die. If you lose money, you lose power; and it is well known that women are attracted to money and power. How you expect prostitute to show any interest then?


Follow these steps, and then you will be able to create stupendous deformed nose they rest of life.

Defending of wondrous fellow surgeon against LIES!

Here, I must take opportunity to defend highly well regarded surgeon Ellenbogen - some claim he evil, but look! Here: http://richardellenbogenruinedmynose.blogspot.com/2008_11_01_archive.html . Make lovely aesthetic nose for patient! Ungrateful is patient for spreading such impertinent lies. Now, when you see wondrous results of Ellenbogen and lies of malice spread by ungrateful patient, you know why all lies spread by patients of Dam are FALSE!
Even medical board agree Barrell Dam wondrous surgeon - though did have to lie to board in investigations, was only to protect wonderful godlike surgery of great Dam. If medical board stop me from operating on patient, who would give them aesthetic mangled nose? I know of not any!

Come to Barrell Dam and you get good result just like ones seen in vexing blog above!