Egyptian Solon Who Had Nose Job Loses Parliamentary Immunity

In Egypt, it is hard to be a politician and fan of plastic surgery.  Anwar El-Balkimy, who is a member of a conservative Islamist party, learned this lesson the hard way when he got a nose job and was forced to make up stories just to prevent any suspicion among his colleagues who think that all cosmetic procedures “meddle with God’s work.”

On February 29, the parliamentary member went to a hospital and claimed that he was beaten and robbed by unidentified men.  However, his colleagues found that the story was just an attempt to cover up his nose job and prevent any suspicion on why his face was covered with heavy bandages that only his mouth, chin, and eyes could be seen.

After initial investigation revealed that El-Balkimy was just making up stories, he was immediately expelled from the conservative Islamist party.  And in an attempt to mend his reputation, he requested other lawmakers to lift his parliamentary immunity so he can face the lawsuit against him.

Meanwhile, state prosecutor is considering filing the estranged solon with lawsuits based on “creating anxiety among the public” and “worrying public officials” with his lies.  At first, many people were hooked on his “robbery story” and it even lead to criticism over the government’s failure to address street crimes which have erupted after authoritarian leader Hosni Mubarak was overthrown. 

Rumors of El-Balkimy’s nose job started when local media showed pictures of him with his face covered with bandages, citing suspicion that it may be the result of plastic surgery.  For this reason, his colleagues brought him to a hospital and was examined and interviewed by doctors.

Perhaps El-Balkimy could have avoided the blunder if he admitted having nose surgery in the first place and just made some white lies that he needed it to correct breathing problems or nasal injuries.  Unfortunately, he chose a more action-packed, harder-to-believe story. 

Teens, Parents Must Consider Factors Affecting Rhinoplasty Result

About 244,000 rhinoplasty or nose surgeries were performed in 2011, making this the second most popular plasticsurgery in the US.  Meanwhile, the procedure is particularly appealing to teenagers who want to improve their appearance or those who are not happy with their nose.

If performed for cosmetic reasons, it is best to wait until the face has completely developed before conducting rhinoplasty.  This means girls should be at least 15 years at the time of surgery, and for boys, the minimum age requirement is 17 years old since their nose takes longer time to mature.

By waiting until the nose has fully developed, patients will more likely enjoy permanent or at least longer results.  However, reconstructive rhinoplasty, which is used to treat nasal injuries or improve breathing function, does not involve age limits.

Aside from physical maturity, teenage patients and their parents should consider the aspect of emotional and psychological maturity.  As with any cosmetic surgery, rhinoplasty is not advisable to individuals with unrealistic goals and expectations and those who see this as a way to please other people.

Another thing to consider is the result largely depends on facial features and nasal structure.  This simply means that it is extremely hard, or even impossible, to recreate the nose of celebrities; any plastic surgeon who is claiming that he can perform such procedure is creating unrealistic expectations.

As mentioned earlier, emotional and psychological maturity is very important as it allows patients to understand the limits of rhinoplasty and its potential complications.  With this consideration, plastic surgeons and parents should carefully guide teenagers when making decisions.

Ideally, parents should also accompany their teenage daughter or son during consultation with a plastic surgeon.

While the result of rhinoplasty is supposed to last a lifetime, the revision rate is about 7 percent due to unexpected changes in the nose, certain complications, and other factors.  Fortunately, newer techniques have led to a more structurally sound nose after surgery; this usually means a conservative approach.

Previous nose surgery techniques involved too much removal of cartilage (flexible tissue inside the nose), resulting to a higher risk of drooping tip because of the “weakened structure.”  By contrast, modern methods only manipulate or reshape the cartilage and bone; and if there is a need to remove some tissue, doctors use a conservative approach.

Another improvement is that many rhinoplasty implants today are made of a porous material that allows tissue to grow inside them, thereby lowering the risk of rejection and unnatural result.

Details on Asian Rhinoplasty

A successful rhinoplasty or nose job is determined by a result that looks harmonious with the overall face.  And for ethnic patients, this means their nose should complement their unique racial traits.

With more understanding and respect with racial traits, plastic surgeons have started using ethnic rhinoplasty when treating the Asian nose.  With this technique, the result will be compatible and harmonious with the Asian face.

Unlike in Caucasian nose surgery in which the usual aim is to make it smaller, Asian rhinoplasty often involves making it larger or at least “more defined.”

Most Asians asking for rhinoplasty want to achieve a more defined nasal bridge as they typically lack this feature.  To correct this aesthetic problem, doctors will likely use synthetic implants such as the silicone plastic which can provide great results as long as the patients have a thick skin that prevents implant visibility.

Aside from silicone plastic, surgeons may also use Gore-Tex which was first used for Caucasian patients.  But because of its lower risk of rejection and ability to provide a very natural result, manufacturers have decided to make a thicker version of this implant to accommodate the Asian nose.

However, some doctors advocate using a patient’s own tissue to build a nose bridge.  But unlike Caucasians, most Asians lack enough amount of septal tissue (the one that separates the left and right nostrils), making this technique impossible.  Fortunately, the ear can serve as a donor site.

Grafting tissue behind the ear does not result to visible scar and does not affect the hearing of patients.

Other potential donor sites include the hips, ribs, and skull.  However, many patients are not willing to undergo another surgery just to graft tissue from their body that is why most prefer synthetic nasal implants like the silicone plastic and Gore-Tex.

Compared to other ethnic groups, Asians have a nose that tolerates slightly less projection and definition, although a small alteration is often enough to create a dramatic improvement.

When treating the tip of the Asian nose, most doctors prefer using a patient’s own tissue because introducing synthetic implants in this area can result to implant rejection, visibility, protrusion, and other related complications.  However, this is not the case when treating the nasal bridge because it has enough coverage (because of the thicker skin).

To avoid destroying the ethnic features, plastic surgeons rarely narrow the nostrils.  This is because increasing the projection of the nose is often enough to create a narrowing effect.

Rhinoplasty to Treat the Saddle Nose

The term saddle nose describes the loss of height of the nasal bridge; this is also called “boxer’s nose” because it is often caused by trauma that leads to deformity, although some people have this due to inborn abnormalities, cancer surgery, botched cosmetic rhinoplasty, infection, and destructive diseases. 

Rhinoplasty, or more commonly called nose job, can correct the saddle nose.  Take note that if the condition leads to severe deformities and breathing difficulties, insurance reimbursement is possible.  By contrast, a surgery that is purely done for cosmetic reasons is not covered by health insurance.

In mild cases of saddle nose, many patients only have aesthetic problems and not breathing difficulty.  In order to treat them, augmentation rhinoplasty is often the most preferred choice; in this technique, plastic surgeons raise the nasal bridge and sometimes also the tip to create the most natural-looking result.

During augmentation rhinoplasty, plastic surgeons use different materials to correct the aesthetic problem or breathing difficulty.  For some patients, their own nasal cartilage and bone can be simply manipulated, or grafted from other body areas including the ear (behind it) and rib.

For slight defects, collecting cartilage behind the ear will usually suffice.  This is a relatively simple and safe procedure that does not impair the patient’s hearing and affect the ear’s appearance because the scar is hidden from plain sight.   But for large defects, rib cartilage is often a better choice.

Aside from natural grafts, plastic surgeons also use artificial implants such as Gore-Tex, Medpore, and Silastic when correcting the saddle nose.  But with this technique, there is always a concern of implant extrusion, infection, and implant shifting.

When there is a need to use artificial implants, many doctors in the US prefer Gore-Tex which has the lowest rejection rate among synthetic materials used in rhinoplasty.  Its notable characteristic can be attributed to its porous structure that allows nasal tissue to grow and develop inside until the implant becomes part of the nose.

The good thing about using Gore-Tex to treat the saddle nose is that it can be easily molded into the desired shape and various thickness, leading to a more natural-looking result after rhinoplasty.

However, patients should remember that severe saddle nose deformities are challenging problems because more often than not, the septum (tissue separating the left and right airways) has large perforation or in extreme cases even absent.  For this reason, perfect results are quite rare, though improvements are still possible.

Rhinoplasty Surgery for Nasal Tip Refinement

Rhinoplasty or “nose job” involves improving the nose’s appearance.  This is one of the most challenging in facial cosmetic surgery because it combines science, because the result should be “structurally sound,” and art, since the outcome should be pleasing to the eyes.

Nasal tip refinement is probably the most challenging part of rhinoplasty surgery.  First and foremost, the result is not only dictated by the plastic surgeon’s skill but also by the underlying features of the nose. 

In fact, about 95 percent of the nasal tip refinement result is achieved by changing the tip cartilages which are the flexible tissue, while the remaining is dependent on how the plastic surgeons will manipulate the skin and other tissues.

There are many available techniques to change the tip of the nose because each person has a unique nasal structure in addition to different goals and expectations of every patient.

But regardless of what technique is used, most plastic surgeons remove only a small amount of cartilage so the nasal tip will not collapse as the patients grow older; this method is also ideal because it can give a long-lasting result and structurally sound changes in the nose.  This is quite different from the approach used 20 years ago in which doctors removed more cartilage to refine the tip.

For patients with a wide or bulbous nasal tip, the problem is generally caused by the widely splayed cartilages.  To treat this aesthetic problem, some doctors recommend suturing technique which often leads to lasting result if properly conducted, although patients should remember that there is always the probability of future revisions due to unexpected changes in the nose cause by aging and other factors.

As mentioned earlier, the result of rhinoplasty is largely affected by the nasal structure, particularly the skin thickness.  Doctors have found out that African-Americans have thick skin but weak underlying cartilages—ethnic features which must be respected to create the most natural result possible. 

On the other hand, Caucasian nose typically has thin skin and strong cartilages.  With this consideration, certain synthetic implants such as silicone plastic is not ideal for patients with this nose because of the higher risk of visibility.

When treating the Caucasian nose to reduce the nasal tip’s projection, it has almost been a sacrosanct among plastic surgeons to simply rearrange or remove a small amount of cartilage instead of introducing synthetic implants (although there is some exception to the rule).