The functional and/or aesthetic problem must first be identified. Only then can the necessary corrective treatment be proposed, discussed with the patient, planned and performed when convenient for the patient.

Complete evaluation of the nose is done by clinical history, clinical examination, allergy evaluation, formal endoscopic digital photography plus external nose photography with modulation.

Nose Examination

Hereby nasal valve and intranasal structural problems are identified (deviated septum, polyps, enlarged nasal shelves, etc.). These findings are objectively shown to the patient on a computer screen.

There are four nasal valve areas that are very important for the normal functioning of the nose.

  • Inferior Turbinates Lining Membranes - bottom nose shelves;
  • Septum Lining Membrane - partition of nose;
  • Upper Nasal Valve - where upper lateral cartilage joins septum cartilage                                                                                                                                                                                      Known as  Internal Nasal Valve                                                                                                                                                         
  • Lower Nasal Valve - where lower and upper lateral cartilages meet.                                                                                                                                                                                                 Known as External Nasal Valve - -Formed by Lateral Nasal Wall                                                                                                                                                                                                                              and Anterior edge of  Inferior Turbinate                                                                                                                                                                                                              and Nasal Septum.

Clinical Photography

Dr. Van der Merwe uses digital endoscopic photography plus external photography of the nose showing his patient what the actual functional problem inside the nose is and how shape of the nose can relate to the functional problem.

Clinical Photography 1Clinical Photography 2

He directs these photographic findings into his specialised computer programme as an objective diagnostic finding; hereby he can show you exactly what the nasal function and dysfunction is, and how it can be related to different causes, such as loss of elasticity of cartilage secondary to trauma or advancing age.

He is at present the only doctor in Africa using this photographic explanatory technique.

Clinical photography is used to identify internal and external nasal problems.

International and local patients are welcome to email digital photos of the face and nose to or post the photos to us.

Please use the following as a guideline and use the highest resolution.

Clinical Photography Guideline


Modulation of the nose is done with a specialised computer programme enabling surgeon to identify external structural problems.

The correctional needs - both functional and aesthetic - of the nose are established. Together the surgeon and patient decide what the patient would like re the shape of her/his nose (simulation), whilst preserving, restoring or improving the function of the nose. You, the patient, have a definite input into the type and shape of nose you would like. There is no anxiety about the outcome.

The possibility of chin augmentation implants can also be discussed if needed.

ModulationModulation Example