Rhinoplasty, or nasal reshaping is a surgical procedure designed to improve the shape and size of your nose. The degree of change may range from a subtle refinement of your nose to a dramatic change in the size and overall shape the nose. Perhaps of all the cosmetic surgical operations available to the patient, rhinoplasty demands the greatest degree of precision and technical skill of the surgeon. This is because the nasal skin and fine contour belies any small underlying imperfections.
The Dorsal Hump (the bump)
"The bump" on the nasal bridge is one of the most common concerns amongst Caucasian patients seeking rhinoplasty. The bump, which is called the dorsal hump in medical terminology and is composed of both bone and cartilage, may be a hereditary feature or a result of trauma.
The degree to which the dorsal hump is reduced may vary, and depends on the size of the dorsal hump and the patients aesthetic or cosmetic desire. The degree to which a dorsal hump needs reduction also determines the surgical technique used to reduce it. This may mean the difference between "rasping" (filing) the bump, or having to cut the bones, which tends to result in more bruising (for instance around the eyes), swelling, and therefore a slightly longer recovery period.
The width of the bridge may also need to be narrowed at the time of surgery and this may result in what appears as a disproportionatly large tip. The surgeon may, therefore, recommend refining the tip slightly to maintain the overal proportions of the nose and ensure an optimum cosmetic result.
Dorsal hump reduction and tip refinement with or without elevating the tip, is a very common combination of techniques in cosmetic rhinoplasty surgery.
The Wide Tip
Another common concern with which rhinoplasty patients present is a wide, "bulbous' or "boxy" tip. this is most often a consequence of heridity and may be partly a result of thick nasal skin. In patients with thin nasal skin, a wide tip is a consequence of large or splayed cartilages that form the tip.
Most patients seek refinement of the tip, andthis must be carried out by the surgeon in such a manner as to maintai the natural appearance of the nose. A tip that is too pointy or small, paricularly in proportion to the rest of the nose may result in an unnatural, "operated on" appearance.
In order to increase the precision of reshaping and resizing the tip, many surgeons now opt to use an "open approach' rhinoplasty technique. This method fascilitates direct visualization of the nasal cartilages, increasing the predictability of the final surgical result.
the open approach also allows for precise suturing of the nasal cartilages to reshape and refine them as well as position them more acurately.
A nose may be crooked as a result of heredity, previous surgery, or trauma. It may be crooked in certain portions (tip, bridge, nostrils...) or the entire nose may be assymetrical.
Regardless of the cause, it is important for the surgeon to determine what structural problem is causing the assymetry. It may be a cartilage problem (e.g. the septum) , a bone problem, or a combination of both. The specific procedures to address the assymetry will depend on these structural factors.
They may include osteotomies (cutting and repositioning the nasal bones), septoplasty (reshaping the nasal septum), septal extension, battten grafts and a variety of other techniques with which your surgeon should be familiar.
Often, obstructed nasal breathing accompanies assymetries of the nose, and these can be corrected using tha above mentioned techniques.
Some issues considered at the time of your consultation include:
o Your general health
Some of the more common reason patients seek consultation include:
o A hump on the bridge of the nose
These concerns can be addressed with the various techniques of rhinoplasty that an experienced and well trained Plastic Surgeon should have.
Rhinoplasty is usually performed under general anaesthesia and you may go home the same day. The details of the specific type of rhinoplasty suited to your specific aesthetic concerns and functional requirements and the placement of the incisions is determined and discussed at length during the first consultation. Depending on the desired result and the complexity of your specific problem, the surgery may take anywhere from less than an hour to more than three hours.
There are risks and complications with all surgical procedures such as bleeding and infection. These as well as complications specific to rhinoplasty will be discussed at the time of your consultation.
o 1st post-operative visit within 48 hours after surgery; to check for bleeding, level of discomfort, to answer any immediate concerns and remove gauze packing if used
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