One thing I’ve learned throughout my career as a plastic surgeon here in Toronto is that the most powerful facial trait combination has to be the nose-chin relationship. The beautiful proportions in both the frontal and profile views are critical to beauty, for both men and women.
Noses should be straight, no doubt about this. Refined and upturned, narrow bridge and fine tipped for ladies; straight but broader in males, with a 90-degree angle with the upper lip. As far as dorsal hump is concerned, there are accepted “rules” in North America. However, I do listen to my patients, as some patients want to keep some cultural traits in their noses. Still others want a more classic European nose. Personally, I do lean with keeping some of one’s ethnic characteristics. I don’t feel the Parisian “ski jump” nose look good on non-Parisian people, whereas a gentle “ski slope” is often what’s needed. That being said, a slight dorsal hump may give character to a woman of Middle Eastern or South Asian descent. But again, I listen and work with my patients.
One somewhat novel nasal technique (I have been using this technique for more than 15 years now) is the use of dermal fillers – the so-called non-surgical rhinoplasty – to correct a mild asymmetry, a slight curve in the dorsum, a concavity on the nose, a low nasal bridge, raised nostrils, and more. It is a great in-office technique that often avoids a more complex and less predictable rhinoplasty. I like to use components of the Misko technique, and I always use the cannula technique. The cannula is a blunt, hollow, needle-like tool that allows to deliver the dermal fillers without the risk of puncture to a blood vessels, avoiding serious complications and excessive bruising. I always use topical anesthetic creams and I only purchase and offer fillers containing local anesthetics in the vial, for my patients’ utmost comfort.
Chins are also paramount is giving a strong (or weak) “first impression” to an interlocutor. A lady’s chin should be at least round, but best oval. The projection should be harmonious with the face and with the nose; not too small, not too big. A man’s chin should be strong, more projected and more square, yet still harmonious with the nose.
Harmony is therefore the keyword in nose-chin relationship. This is a key concept in profiloplasty.
Therefore, it is very common for plastic surgeon to perform both a chin augmentation and a rhinoplasty – or the non-surgical nose job – at the same time.
The chin is commonly augmented with fillers or with a chin implant. We, plastic surgeons, have a vast selection of models and sizes of chin implants that can match all faces and all desires. Chin implants are commonly inserted via a small incision under the chin, tucked underneath the mandible, and very hard to see once healed. I use the same incision for neck lift when performing a facelift.
In conclusion, it is a very wise idea to find a plastic surgeon who does both noses and chins so you get the best aesthetic recommendations and outcomes.
Dr. Marc DuPéré
