Hi, I am Dr Sandeep Bhasin a Cosmetic Surgeon from Care Well Medical Centre Today I will discuss about Nose surgery called Rhinoplasty
Rhinoplasty can be defined as a surgery that is conducted to change the shape of the nose, or improve it’s ability to function.
Rhinoplasty can be categorized into two forms :
It is done to improve or change the shape of the nose.
If there are breathing problems in the nose then Functional Rhinoplasty is done. The procedure of Functional Rhinoplasty is conducted for symptoms like a blocked nose, sinusitis, or nasal polyps.
We also need to understand that there isn’t a concept of a perfect nose. These procedures can only enhance facial characteristics and improve nasal functionality if there are symptoms mentioned above.
So, I begin with Clinical and Radiological investigations of my clients planning for Rhinoplasty. I look in structure of nose and any difficulty in breathing if they are facing.
Rhinoplasty can be classified into two types, based on technique viz. Open Rhinoplasty and Closed Rhinoplasty.
In open Rhinoplasty, incision is given on the skin, so that the entire skin over the nose can be raised.
This incision is called trans-columellar incision, this gives surgeon a clear view of the nasal skeleton. All this can be achieved through an undisturbed alignment , and it also improves the result of the surgical process through trans-columellar incision.
Open Rhinoplasty is quite useful for aesthetic Rhinoplasty where significant improvements can be done for the tip, dorsum, and the shape of the nose.
As compared to open Rhinoplasty, closed Rhinoplasty is done without opening a part of the skin, and special incision is made inside the nose. This procedure is useful for functional Rhinoplasty.It is also called as endonasal Rhinoplasty, where a surgeon makes parallel concealed incision for no external scarring to occur.
This procedure limits the visibility of the surgical process, and needs to be done through a narrow opening in the nostrils.
Thus, we have defined Rhinoplasty and its types.
So, if you plan for Nose Reshaping what would you need?
If I plan to change the shape of nose I will need some material to redefine it. This material can be taken from the body itself or from the artificial source.
Autologous Graft is usually taken from 3 sources
Now cartilage is like a soft and flexible tissue,which helps to give support and shape of the nose.
If we use Artificial Material or Implant it is usually taken from:
Let us understand a common thing that is performed in Rhinoplasty, and some doctors do practice it. Grafts are used to improve the shape of the nose, to do this, surgeons use a cartilage that is taken from the Nose, Ear, or Ribs to correct nose deformity, and get the nose in a good shape.
Not all nose jobs require grafts, these are only used for structural support or create a better breathing space for the nose. Grafts are predominantly used for the specific locations like the tip of the nose, the bridge, and mid third part of the nose.
A graft is a tissue that is taken from another part of the body, in terms of nose grafts, it can be cartilage, bone, or soft tissue that is used to improve the structure and shape of the nose.
Synthetic materials like Silicon or Goretex are also used instead of Grafts & these are called Implants.
So what are these Grafts meant to do?
Well, they may help in:
Grafts are made through pieces of cartilage , and shaped as per the shape of the nose to reinforce or replace weak tissues with stronger ones. There are two types of grafts – Contour Grafts and Structural Grafts. A Contour Graft is used to smoothen the surface or appearance of a nose.
These are put on the bridge side of the nose where it looks low, there is a depression, or we need to change the shape of the tip. Structural grafts are used when there is a requirement of support for the nasal tip, or if there are breathing issues due to a very thin bridge.
So Now we can use either the Graft or an Artificial Implant for Rhinoplasty
Which one should a patient opt for?
Let me tell you advantages and disadvantages of both:
Lets begin with Implants which are made from Silicone or Gortex. Well, if you know something about Cosmetic Surgery Industry you would have heard about Silicone Implants in Breast Enhancement.
So the same Silicone is used here. Advantages of Silicone Implants are:
Lets compare this with normal Grafts, which we take from Clients own body.
So it looks that Implants as Silicone are Best Choice. Right?
But Wait !!!
I am going to reveal to you something that you should understand before you fix your Rhinoplasty if you do not wish to repent later.
So the deep Secret which is not often revealed is here:
For most of My patients I tell them not to go for Implants. I use Natural Grafts only.
Because we care for you. We have seen some patients operated somewhere else with Silicone Implants few years back ,coming to us with the pus, drooling from their nose or some complications needing another Surgery for Nose.
So My friends, be aware & avoid Implants as they are foreign body and can get infected.
I choose Grafts mostly from Nasal Septum. In some cases where we need more Structural support I prefer to look into Ear Cartilage or Rib Graft.
Well, we have moderate to great results, but I do not have to handle problems as Infection or Implant displacement.
If you need a second opinion, kindly visit me at Care Well Medical Centre. You can drop me a mail at firstname.lastname@example.org
Cosmetic surgeries can be easier than Rhinoplasty wherein the complete surgery can be done in 30-40 minutes. But, for a Rhinoplasty procedure, it could take 3- 4 hours. Results with the graft are better than Rhinoplasty, but after 3-4 years it becomes necessary for the patients to remove the grafts as there could be infection.
In our clinic, we normally recommend Autologous Rhinoplasty, wherein a cartilage can be used from the nose, ears, or from the ribcage. If a patient wants to undergo surgery with grafts, then our clinic go ahead with the procedure.
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