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The following images are some examples of patients who have had rhinoplasty, whether primary or secondary, under the care of Prof. Palma. Please remember that rhinoplasty is never the same operation twice. Each case is unique. Therefore, each patient’s result is also unique and cannot be replicated exactly for another patient. The are many complex reasons why there cannot be a cookie-cutter approach to rhinoplasty. However, if you consider the absolute unique qualities of each human being, it becomes apparent that there are equally specific anatomical limitations that place boundaries on what can be achieved. This situation is made more complex by the presence of past trauma, previous rhinoplasty or septorhinoplasty surgeries, underlying skin disorders, and a myriad of other vital factors such as the patient’s ethnicity, individual desires, understanding of surgical limitations, and unique anatomy.
In summary, the human nose cannot simply be molded into any shape with impunity. The limitations placed on the surgeon by anatomical features can be difficult to grasp. However, if you consider the fact that the nose is covered by multiple layers of fat and muscle which are usually not operable, then the limitation of only operating on cartilage and bone become apparent. I always advise my patients on what is achievable in their unique circumstances. Although many cases can be improved with surgery, you may have to accept that in certain circumstances, adjunctive treatments for dermatological conditions might become necessary. Similarly, some patients cannot be helped by surgery, and must accept that any further operations would carry too many risks and should therefore be avoided. At all times, I will convey my message to you with utmost sensitivity and truthfulness. The complexities of rhinoplasty are difficult for experts to grasp and convey to patients. Please give yourself adequate time to fully digest a rhinoplasty expert’s advice: he/she has your best interest at heart.