Rhinoplasty, corrects the morphological and functional defects of the nasal pyramid. If the patient preoperatively reveals the surgeon a respiratory difficulty caused by an obstruction of the nostrils, probably even the nasal septum can be deviated and the intervention is called rhinoseptoplasty.
A manipulation of the septum with cartilage levy it is almost always necessary in the case in which, even in the absence of deviation, it is necessary to have the material to be used as a graft to modify the architecture of the nose.
architecture speak because in modern rhinological surgery are considered the anatomical features of the nose as they were viewed very differently from in the past:
- You tend to avoid distorting the more the profile of people with an important nose.
- The tip must have its normal symmetry with supratip and infratip (typ = tip) regularly positioned.
- The columella must have a good support capability to be able to support the tip.
- The patient after surgery “must” breathe better since, surgical site, you have an opportunity, with minor surgical procedures, to intervene in the septum and turbinates place, preoperatively, the proper diagnosis is made.
- Any “humps” are to be reduced or removed according to the demand of patients trying to leave no surface irregularities on the nasal dorsum.
For its front and central location in the face, the nose is the first point that is illuminated by light rays and the slightest irregularity or disharmony is perceived by the patient and then by the people who surround it therefore must be meticulous in the execution of the intervention, in the dressing and the patient’s postoperative follow-up.
The multiplicity of races that make up the demographic reality of our society, is changing the aesthetic characteristics of the nose “European” today.
As we all know the Asian nose is different from Caucasian nose, Negroid or Mediterranean and in each race the structural characteristics (bone and cartilage) of the surface (thickness, color, level of hydration and sebaceità skin) can vary widely.
This is the concept of ethnic rhinoplasty that today’s surgeon must know what the patient’s physical examination suffering from nasal dimorphism must be complete and accurate to be able to adapt the surgery.
The approach to nose surgery stands out in the open (internal and external incisions-visible transcolumellare) or closed (internal incision type marginale- intracartilaginea and intercartilaginea). There is no better than the approach being employees results skill of the surgeon. A good surgeon will have good results with any technique. Note that the patient preparation work must be done before the operation during the preoperative talks which assess the expectations, driving on the stages of the postoperative period, and s’ illustrate the strengths and potential complications of the post.
The help of a professional photography and analog or digital simulations are today a tool that allows you to see a good approximation of what will be the end result.
I can only add that my approach varies depending on the patient and the type of work to be done. In cases of secondary rhinoplasty, that is when the person has already been made, it may be convenient to have a full view of the nasal cartilage structures achievable only with the open technique, which allows us to practice delicate surgical procedures necessary to restore the form, harmony, function and symmetry.
In front of the frequent request of a minimum of retouching an almost perfect nose you can use a closed approach to minimally invasive, but do not underestimate the difficulty of meeting a patient who could have definitely higher expectations. The surgery takes place under general anesthesia and usually lasts for 90 minutes.