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Have you performed rhinoplasty on someone with mild facial scoliosis?

Your questions answered by our surgeon, Lucian Ion, FRCS(Plast)

Question

I wondered if you had previously performed rhinoplasty procedures on someone with mild facial scoliosis?

My daughter who is an otherwise healthy, 26 year old has suffered from low self esteem for the last 10 years since she noticed her nose began to twist to the left.

She has recently found the courage to enquire into a rhinoplasty procedure and was further saddened to hear that although certain refinements could be made the 'twist' could not be corrected as this would then look at odds with the rest of the facial line. She was told that she had mild facial scoliosis and that her forehead nose and chin were all curving in line to the left.

She was advised that her right forehead and eyebrow were more prominent and could be reduced. This was somewhat of a shock and has left her in more distress.

I feel it would be wise to seek a second opinion. Would you feel this was something you could help with?

I am also wondering if this 'scoliosis' may progress as there were no signs of these problems before my daughters 16th year. It has only been since then that she has noticed the change in her nose. The lump on her forehead has more recently been noticed. She has suffered from severe headaches during this time and has 'Amblyopia' in her left eye.

Answer

Every rhinoplasty I perform is in a patient with facial scoliosis, because facial scoliosis is universal and can be traced in each and every person. As far as my observation goes this is related to the fact that one half of the face develop more than the other. I would be delighted to demonstrate this in the photographs of any person you choose. The reasons behind this remain however obscure.

The degree of the scoliosis is the only element that is variable, and to some extent interventions for facial sculpting produce a masking effect or reduce the asymmetry between right and left sides. In some instances, the characteristics of development in the upper and lower jaw, contribute to the impression of scoliosis, in combination with the orbit and forehead, and can be influenced also with surgery.

It is possible that some aspects of the asymmetry have become more noticeable as facial development progressed, and an evaluation of the occlusion would also be important, in particular regarding possible progression of the asymmetry in the future.

Because of this, there is no such thing as a true midline of the face, and the alignment of the nose follows primarily the principal of a “best fit" rather than a geometric alignment.

I suggest that the best approach to evaluating the degree of asymmetry and the characteristics of the possible changes is to use a 3-D photograph and an assessment in the combined facial sculpting clinic that I carry out together with my maxillofacial colleague, Mr Henri Thuau.

In general terms though, I tend to carry out rhinoplasty interventions after the age of 18, when the facial development is more advanced.

Lucian Ion Cosmetic Surgeon Mr Lucian Ion FRCS(Plast)
129 Harley Street
London
W1G 6BA

Get in touch. Talk to our helpful team or book a consultation with Mr Lucian Ion. Call 0207 486 7757

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