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The Tug of War Between Form and Function

Recently, I have been seeing a number patients regarding revision rhinoplasty. And a common theme has come up in each of these consults: how to balance the aesthetic goals (form) with maintenance, or in most cases, improvement in nasal breathing (function). In most of these cases, patients have had overly aggressive reduction rhinoplasty. And even when the aesthetic result has been adequate, the functional result has been a source of continual frustration for the patient.

When I meet with a patient who is interested in rhinoplasty, we have two important and inter-related conversations. The first is about the aesthetic issues that have led the patient to seek nose reshaping. The goal in this conversation is to examine the nose in the context of the face, and to identify ways of improving symmetry and overall harmony. The second conversation is about breathing and nasal function, including issues with obstruction (e.g., from a deviated septum or previous fracture) and allergies (including enlarged turbinates), as well as the patient’s common activities (e.g., long-distance running). THEN, we put the two conversations together in order to determine the best plan for maximizing the outcome – this allows me to choose an approach that is individualized to each unique patient.

There is a Latin saying that comes to mind here: Vita brevis, ars longa (or,roughly, “Life is short, art is forever”). But just because you want a beautiful nose, no matter how short life may be, you shouldn’t have to sacrifice your breathing or be limited in any way. With an appropriate selection of techniques, as well as conscientious execution, there’s no reason that either form or function has to take precedence.

 

Evan R. Ransom M.D.
Rhinoplasty Specialist in San Francisco
San Francisco Center for Facial Plastic, Reconstructive & Laser Surgery

5.0

Based on 19 reviews

Christina G.
I had several nasal/sinus issues including a severely deviated septum and a dorsal hump, which I wasn't crazy about. Dr Ransom did both the medical and aesthetic parts of my surgery and he did a wonderful job! While I did have some swelling, I didn't experience much bruising at all. I loved that he left the natural look of my nose just making small corrections. My breathing has GREATLY improved. His office staff was super helpful in scheduling and making sure payment and everything was very clear. I am very, very, very pleased with my results!!
Tk I.
I had a terrible surf accident in Bali and needed to get 50 stitches to repair what the reef did to my face. I had emergency cosmetic surgery in Bali the day of the accident. Immediately when i got back to the states i was introduced to Dr Ransom through some mutual friends. I was searching for the best cosmetic surgeon in San Francisco to help in my recovery. He and his team have been amazing! he helped establish a plan for my post-op wound care/treatment and administered some initial laser treatments. Dr Ransom and his team are extremely knowledgeable and very patient / helpful. I am very grateful for their help and support. I am finally looking normal again!
Joey B.
I had three issues with my nose - which inhibited my breathing: 1- broken nose, 2 - narrow nostrils that collapsed when I inhaled through my nose, 3 - deviated septum. When I was living in New York, I went to see a doctor about my breathing issues, and he said my skin was too thin and there was likely nothing he could do to rectify the problem. Dr. Ransom was recommended by an ENT I saw through One Medical. As soon as he saw him, he said he could easily fix my nose, and remove the bump that had formed from the trauma. His confidence and strong sense of self immediately put me at ease, and I had little doubt that he could accomplish exactly what he promised. He showed me a modified picture of my nose , and really liked what he proposed. The end result very closely matched what he promised. Not only can I now breath much more easily through my nose, it looks much better. He managed to make it look like an improved version of itself, however I still look like me, and unless I tell anyone I had it done, it's not overly noticeable, which I prefer. I'm pretty vain and very critical, and I can say that Dr. Ransom is great, and comes highly recommended.
Edward T.
Doctor Evan Ransom took my surgery on relatively short order and did a wonderful job. He is very talented and has a nice friendly professional support staff. I can not thank him enough, he was calm, caring, professional and interested in the follow results of his work . He seemed to bring a certain artistry to the profession.
Lisa C.
Dr. Ransom is a talented physician. He is knowledgeable, professional and goes the extra mile to make you feel comfortable during your treatments. He has been blessed with an artistic eye which brings wonderful results. I highly recommend Dr. Ransom and would refer all of my friends and family members to choose him as their physician.
Cheryl H.
Dr Ransom is very kind, honest, and conscience doctor. I was referred by my best friend, she is also Doctor Ransom patient. She has so much good things said about Doctor Ransom. So I had a face lift done by Doctor Ransom on July 2015. He did a wonderful job on my face and I have a lot of compliments on my face. So if anyone want to get their face done. I would highly recommended Doctor Ransom to you. I give Doctor Ransom a five stars.
Jill P.
I have currently been getting botox regularly with Dr. Ransom and he does a fantastic job. My previous doctor's office moved to another location where it was no longer convenient. I didn't realize what I was missing until I went to Dr. Ransom. I felt really comfortable, but most important he did a terrific job blowing my previous doctor out of the park. (Sometimes it's good switch it up a bit to make sure you are getting the best treatment.) On top of that, Dee the office manager is an incredible asset to the office. She personalizes your visit and relationship with the office to an extent I have never experienced before. I even get follow up calls to see how I am doing after a treatment. I highly recommend Dr. Ransom for his great work, and his team's impeccable customer service.
Arielle C.
Dr. Ransom and Dee are the BEST! Whether it's aesthetic or reconstructive, I'd trust him over and over again with my face.

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