Does the Shape of the Nose Change with Chin Surgery?

Orthognathic surgery, i.e. jaw surgeries, are surgical procedures that provide significant improvements in both functional and aesthetic terms. These surgeries, which aim to regulate the position of the jaw and facial skeleton, can significantly affect facial proportions and profile as well as regulating the chewing functions of the patients. At this point, one of the most frequently asked questions is whether jaw surgery changes the shape of the nose.

In this article, we will examine the effects of orthognathic surgery on rhinoplasty with its scientific foundations and provide patients with a better understanding of their expectations after this surgery.

Anatomical Connections in the Face: Jaw and Nose Interaction

The facial skeleton consists of compatible and connected bones. The upper jaw (maxilla) and lower jaw (mandible) are directly related to the structure of the nose. Especially the position of the maxilla can affect the appearance of the nasal base, nasal tip and nostrils.

Any forward or backward movement of the maxilla can directly affect the nasal tip position and nasal base width. The main reason for this is the anatomical connection of the maxillary bone with the nasal base and nasal spina (nasal tip support).

Which Jaw Surgeries Change the Shape of the Nose?

The effect of orthognathic surgery on the nose may vary according to the type and amplitude of the surgery.

1. Maxillary (Upper Jaw) Surgeries

Osteotomy of the maxilla (Le Fort I osteotomy) can affect the base of the nose and the tip of the nose.

• Anteriorisation of the maxilla: Bringing the upper jaw forward may cause the base of the nose to be slightly wider and the tip of the nose to lift. The nostrils may become more prominent and the angle of the nasal tip may change.
• Retraction of the maxilla: Moving the upper jaw back may cause the tip of the nose to fall down and reduce the nasal tip support. This may create an aesthetically undesirable situation in some patients.
• Elevation of the maxilla : Raising the upper jaw (vertical impaction) can lead to lifting of the tip of the nose and widening of the base of the nose.
• Lowering of the maxilla: It can widen the base of the nose and cause the tip of the nose to fall downwards.

2. Mandibular (Lower Jaw) Surgeries

Lower jaw surgeries usually do not directly change the nasal structure. However, when the lower jaw is retracted or brought forward, the perception of the nose may also change as the general proportions on the face change.

For example:

• When the lower jaw is brought forward, the nose may appear more balanced and proportional.
• When the lower jaw is taken back, the nose may appear larger.

3. Le Fort Osteotomies and Nasal Structure

Le Fort osteotomies can affect the structure of the nose, especially as they provide movement of the maxilla. When the upper jaw is moved, the nostrils may enlarge or the shape of the nasal tip may change as the nasal septum and nasal soft tissues are also affected.

Is it possible to control the shape of the nose?

Orthognathic surgeons can predict possible changes on the nose by making a detailed preoperative planning. Nasal base narrowing sutures can be used to prevent excessive enlargement of the nostrils during surgery.

In some cases, patients may wish to complete their facial aesthetics by planning rhinoplasty after orthognathic surgery. If there are undesirable changes in the structure of the nose after surgery, correction can be made with such additional surgeries.

Possible negative effects of large movements

When large movements are made in the maxillary bone, some undesirable results may occur in the nasal structure:

• The tip of the nose may be excessively raised and an unnatural appearance may occur.
• The base of the nose may be over-expandedwhich can be aesthetically disturbing.
• Curvature of the nasal septum may occurwhich can lead to breathing problems.
• Nasal tip support may decreasewhich can cause the nose to fall over time.

In order to prevent such risks, a comprehensive evaluation should be made before surgery and patient expectations should be discussed in detail with the surgeon.

Conclusion

Jaw surgeries can significantly affect the perception of the nose by changing facial proportions. Especially upper jaw surgeries can create direct changes on the base of the nose, tip of the nose and nostrils. When large movements are made, some unwanted aesthetic changes may occur.

For this reason, how the shape of the nose may change should be analysed in detail when planning orthognathic surgery. If necessary, a more balanced facial profile can be obtained by planning an additional rhinoplasty after surgery.

 

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