The nose is one of the most noticeable features of the entire body. It literally stands out as it projects from the surface of the face. The nose isn’t vestigial or functionless. The size and shape of a person’s nose not only gives them a distinctive look when combined with their other facial features, but it also serves several important physical functions. By understanding the structures of the nose and their purpose, patients have the opportunity to make more informed decisions about maintaining the nose through rhinoplasty for personal and medical reasons.
Basic Structures of the Nose
A person’s nose normally has two holes, at the front of it below a rounded or grooved tip. These holes, the nostrils, are the openings of passages that extend through the interior of the nose, the nasal cavity, and then link up with the throat and roof of the mouth, the palate, above the tonsils.
The nose tip contains flexible tissues called cartilage. Several pieces of cartilage also connect from the tip to the skull under the skin with several incredibly thin bone pieces to form a structure known as the septum. The septum not only extends along the top of the nose, but also down through it creating a wall that separates the nasal passages. Tiny structures made of bone and covered by tissues and a mucous membrane, the nasal turbinates or conchae, extend outward from the sides of the nasal cavity to form four distinctive, shell-like paths through the interior.
The mucous membrane is the source of all mucus that flows out of the nose from the nostrils and down the throat. In addition to this structure, the nasal cavity also contains skin and large hairs that jut out of the interior front called the nasal vestibule, special tissues known as the olfactory epithelium and microscopic tubular structures that look like hair called cilia.
The Nose’s Physical Functions
Each of the outlined structures serve a purpose. The pieces of nasal cartilage and bone are the framework of the nose that keep it from collapsing in on itself and provide an optimal form to promote steady air flow. The most obvious function of the nose as a whole is to provide a person with a breathing mechanism. The body needs to process oxygen in the lungs. The nose allows the lungs to pull this critical element from the exterior air. It also helps with disposal of carbon dioxide that builds up in the lungs.
The structures that line the interior of the nose also protect the tissues of the respiratory system from cold and dry air damage. The conchae break up the air and help it to flow in a steady fashion. They also create more surface area inside of the nose to warm and moisten the air as it passes through the nasal cavity and down the throat.
The nose also gives a person the ability to smell and taste things. The olfactory epithelium and cilia contain millions of receptors that recognize specific chemicals and send signals to the brain to process the information into distinctive scents. These receptors also help a person distinguish between different tastes and foods.
The last most important basic physical function of the nose involves housekeeping. The large sensitive hairs of the nasal vestibule block and collect large particles that can cause allergic reactions and irritate the lungs, such as dirt, mold spores and pollen. The mucous membrane catches the finer particles, including microorganisms that cause illness. The cilia move in ways that help mucous to flow down the throat and eventually into the stomach for disposal of these particles.
Types of Functional Nasal Dysfunction
Any type of structural misalignment or nasal passage obstruction can interfere with steady airflow and make it more harder for a person to breathe. As a result, they might also breathe through their mouth more often, which can cause chronic dry mouth or halitosis. One or more obstructions can block the flow of mucus and cause a build up of unhealthy particles that cause more sinus inflammation, runny nose and congestion, smell and taste disruption, pressure and pain in the nasal cavity and facial areas, a nasally tone when speaking and sleep disturbances. A build up of harmful particles and microorganisms in the nose and inflammation can also eventually cause sinus and respiratory infections.
Some people have a natural deviated septum or turbinate enlarged by an atypical and large air cavity, also known as concha bullosa, that obstruct the flow of air on one side of the nose. Many people often also experience a deviated septum after blow to the head, such as from a car- or sports-related accident. They can lose part or all of the septum to disease or fire. Another common obstruction that forms over time is a fleshy, non-cancerous nodule that hangs from the interior of the nasal passage called a nasal polyp. A person can experience growth of more than polyp. These nodules often become inflamed and swell enough to obstruct air and mucus flow.
Cosmetic vs. Functional Rhinoplasty
It’s not uncommon for a person to believe that rhinoplasty was developed solely for cosmetic reasons. Yet, historically, rhinoplasty began as a form of nasal reconstruction designed to improve not merely the look, but also the function of the nose, especially for people born with defects or who experienced severe damage to their nose or face that required partial or total nose reconstruction. For this reason, healthcare professionals typically describe rhinoplasty in two ways:
– Cosmetic rhinoplasty focuses on altering the shape of the nose and its appearance to conform to personal taste. It is also used to help individuals enjoy a more symmetrical or balanced face that features an external structure that matches the rest of the face better than their current nose. This type of rhinoplasty can involve surgical and non-surgical intervention. A surgeon might alter or remove skin, cartilage or bone to reshape the nose. As a less invasive alternative, they might also inject fillers into soft exterior tissues to make changes. For example, they might make a bump on the ridge of the nose look less prominent or fill the seam in a grooved tip.
– Functional rhinoplasty focuses on altering the nose for medical reasons. The goal of functional rhinoplasty is to improve a patient’s total health and well-being. Functional aspects of rhinoplasty include removal of one or more airway obstructions and correction or restoration of misaligned or damaged structures. Surgical intervention can help a patient breath and sleep better. It can reduce congestion and blockage of nasal secretions. It can even improve mental health by reducing the irritation, stress and frustration caused by chronic congestion. A surgeon might also combine functional and cosmetic techniques to recreate the original appearance of the nose to help a patient experiencing mental distress after an accident or illness severely scarred their nose or forced the partial or total surgical removal of one or more structures.
No matter the type of rhinoplasty, a patient can expect inflammation and discomfort after the procedure. Complications sometimes also occur during and after surgery. Since the nose is one of the areas of the body that doesn’t heal quickly, many people don’t see or experience improvement for several weeks. Some people must wait twelve months or longer for their nose to completely heal.
A surgeon who performs nose alterations is known as a plastic surgeon. Although a lot of people believe that the word “plastic” in this context refers to the skin looking overstretched on the face and fake like the surface of a plastic doll, the term originated in ancient Greece and actually refers to the art of sculpting body structures. Intervention by the best plastic surgeons never looks fake. Instead, the goal is to make the nose look as natural as possible. A professional plastic surgeon also does more than perform physical intervention. They help each patient better understand how the nose works to make it easier for the patient to craft with them a treatment plan that includes the cosmetic or functional solutions that best fit the patient’s unique situation.