N O S E J O B W I T H O U T S C A R S ?
By
Dr. Steven B. Hopping
Past President of American Academy of Cosmetic Surgery
Cosmetci Surgeon
Cosmetci Surgeon
American
Academy of Cosmetic Surgery Hospital
Aesthetic Rhinoplasty is the surgical procedure that aims to correct the form of
the nasal pyramid in a way that a better adequacy of facial beauty to the cosmetic
rules consensually most acceptable in each time and place can be achieved.
The goal always is to improve the
appearance and function of the nose.
Physiognomic alterations, like a nose that appears too large for the face, a hump on the nasal bridge when viewed in profile, a nose that
seems too wide
when viewed from the front, a tip that droops,
plunges, is thickened or enlarged, nostrils that are excessively flared, a nose that is off-center or crooked or even a previous injury that has left the nose asymmetrical, are some of the most frequent
problems mentioned during the consultation for Rhinoplasty.
Various techniques that can increase
or decrease the nasal bridge, reduce the size or width of the nose, narrow the nostrils,
change the angle between the nose and upper lip or reshape the tip can be
addressed dependently each case and desire. The whole shape of the nose can be
changed in a way that it will be adjusted to your face based on studies of your
profile and frontal view. Details such as the curve, the width or the
projection of your nose will be discussed.
Each patient has to understand
that the nose is a very important structure centrally located at the face. It
is a mark of human physiognomy. Every disproportion in the face is extremely
perceptive and difficult to hide.
Main goal of this surgical procedure
is to create a nose that is artistically as close as possible to each society’s
beauty concepts which are influenced every time by ethnic cultural
characteristics and fashion.
Most of all in every case the nasal
physiological function must be always maintained or even become better, the
form and symmetry must be proportional of the general facial contour and in any
way the nose should be considered as an esthetic unit isolated and independent.
Any surgical
procedure that alters the morphology of the nose will produce a permanent
change in its physiology and in patient’s psychology as well. Thus accurate
diagnosis of the particular deformity in each case is of vital importance as it
will determine the operative technique.
Thorough pre operative evaluation is fundamental for the correct
diagnosis of each deformity and local anatomical changes. No standard technique
is applicable to all deformities. Each case is different and must be treated as
so.
Most modern day rhinoplasties are
performed via intranasal incisions. The incisions are placed inside your nose
and if needed at the crease laterally in order to reshape your nostrils. Also if
your nose needs to be built up in some areas, this can be done using nasal
(septal) cartilage or perhaps bone or cartilage from another site as ears or
rib.
External Rhinoplasty, Open Roof Rhinoplasty
or Exorhinoplasty are all terms for the same procedure, the Open Rhinoplasty.
The difference from the previously mentioned Closed Rhinoplasty is that it is
performed through an extra external incision placed at the columella from which
you can unfold the whole skin nasal cover so that the internal structural
support (bony and cartilaginous) of the nose can be seen and altered.
In my opinion should not be
performed so often as we usually notice, especially in the Middle
East region, as it stigmatizes the patient with a scar. In some
cases this external scar might be less evident, but a scar is always a scar.
When something can be delivered otherwise with comparative results I cannot see
any benefit sacrificing the nose.
Furthermore the magic in Aesthetic
Plastic Surgery is to be able to perform all the procedures through small
incisions in sites that can be very well hidden, covered and camouflaged.
It still remains a valuable procedure
but for difficult cases especially for complex nasal tip problems, where a lot
of detailed work must be done molding the cartilagenous supporting system, as the
disadvantages are usually the increased post operative healing period, which
means that the nose will stay swollen for a longer period and sometimes might
end up being hard with an altered shape due to excessive fibrosis, the
increased performing surgical time and the worst of all, the uncovered outside
apparent incision.
Anesthesia for every kind of Rhinoplasty
can be local with intravenous sedation for minor cases or general, depending on
the emotional status, age, physical status, patient’s choice and the extent of
the procedure.
One night stay at the Clinic and
follow ups for two weeks when the nasal splinter and the tapes will be removed is
obligatory.
Final results will be achieved
after 6 months.
Dr. Steven Hopping, Cosmetic Surgeon
