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The Human Nose Between Artistry and Medicine:
Interview with San Francisco Rhinoplasty Expert Dr. Kahn
San Francisco, CA, January 2008 - Building on an impressive track record of 25 years of rhinoplasty experience,
San Francisco plastic surgeon Dr. David Kahn has reached a career milestone few surgeons can take pride in - his 3,000th
rhinoplasty procedure. By combining a strong sense for aesthetics and balance in the human face with an intimate understanding
of the nasal anatomy, Dr. Kahn's rhinoplasty procedures have earned him several television appearances and numerous lectures
to other plastic surgeons. On the occasion of his 3,000th nasal surgery, Dr. Kahn is sharing some of his insights culled from
two decades of dedication to perfecting the human nose.
Reflecting on the surgical changes associated with rhinoplasty over the past 25 years, Dr. Kahn points out that the most
dramatic development was probably the introduction of the open rhinoplasty technique about two decades ago. Though he prefers
to conduct the traditional, more challenging closed rhinoplasty - mainly because of the lack of external scars - he recommends
the open technique when extra cartilage is required to enhance the patient's nasal bridge or increase projection of the nasal
tip, as is the case with Asian nose lift surgery.
According to Dr. Kahn, "the aesthetic of the ideal nose has not changed over the 25 years, but people have definitely become
more open towards rhinoplasty as well as plastic surgery in general". A look at the number of rhinoplasty surgeries performed
in 1997 versus 2005 reveals an increase of almost fifty percent. Rhinoplasty has historically been one of the most requested facial
surgery procedures (along with eyelid surgery) and is currently the second most popular cosmetic surgery procedure among male patients
(after liposuction). Interestingly, the procedure is not necessarily more affordable today than it was before. In fact, quite the
opposite is true - prices for rhinoplasty have increased substantially over the past 25 years, as rhinoplasty procedures have become
more advanced and specialized.
So how challenging is rhinoplasty compared to other plastic surgery procedures? "Rhinoplasty demands a very unique combination of
technical and artistic skills" says Dr. Kahn. "Unlike a procedure like liposuction, which is about removing fat and skin, rhinoplasty
is not just about reducing proportions, it's about modeling them by sculpting bones, skin and cartilages." Getting this process right
requires not just technical skills, but real artistry on the part of the surgeon - a very demanding combination, which makes rhinoplasty
one of the most challenging and difficult to learn cosmetic procedures.
It takes a lot of practice and training for a surgeon to develop his or her aesthetics and learn to create a natural-looking nose,
that's both beautiful, functional and in harmony with the patient's facial features. Even when following precise rules of facial symmetry,
the technical expertise and innate artistic abilities of a surgeon will greatly influence the final rhinoplasty results. Dr. Kahn cites the
example of the nasofrontal angle (the angle where the nose meets the forehead, visible from the profile), which may be too sharp in certain
patients and create a nose that starts too high and looks heavy. Since modifying this angle is highly challenging, a significant number of
surgeons shy away from making this particular change. However, a surgeon with strong technical skills and a fine artistic eye will be able to
create a subtle depression in the nasofrontal area, which results in a youthful-looking nose and a delicate profile in women.
If done right, rhinoplasty can be a highly rewarding procedure, since it enhances the attractiveness of not only the nose, but of the entire
face, which can dramatically increase a patient's self-esteem. To a doctor, the great feedback received from his or her rhinoplasty patients
can be very satisfying. Dr. Kahn recalls a particularly fulfilling experience: "I had this patient who told me he was so embarrassed with his
nose, that every time he approached an intersection or group of people, he would put his hand to his face, so that nobody could see his profile.
After his rhinoplasty surgery, his embarrassment disappeared and he said he was able to walk down the street with a confidence he never
thought possible."
Encouraged to share one of his rhinoplasty secrets, Dr. Kahn indicates that the key to a good-looking nose is the strength of the tip. "If the
nasal cartilage is not strong enough, I usually use the septum to reinforce the tip and give it a better definition", says Dr. Kahn. "This helps
achieve a refined nasal tip - characterized by the so-called "double-break appearance" - which can dramatically enhance the overall look of a nose."
At the same time, tip reshaping represents one of the most intricate and challenging parts of a rhinoplasty procedure, both technically and artistically.
"I've definitely spent a lot of time practicing and perfecting my tip refinement technique" says Dr. Kahn, "and I will continue to challenge and grow my
skills in pursuit of rhinoplasty results that bring most joy and happiness to my patients."
About Dr. Kahn: Dr. Kahn is board certified in head and neck surgery and facial plastic surgery and is licensed in the State of California. Dr.
Kahn's practice - The Kahn Center for Cosmetic Surgery - is based in San Francisco, CA, and has been devoted exclusively to plastic surgery since
1978. Dr. Kahn has developed new techniques for closed rhinoplasty and has helped introduce a revolutionary new facelift procedure known as the Weekend
Facelift. To learn more about Dr. Kahn and the Kahn Center for Cosmetic Surgery, visit www.sf-plastic-surgery.com.
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