Rhinoplasty surgery results
Συγγραφέας Morad Tavallali Γράφτηκε στις ,
Factors affecting your Rhinoplasty result
One of the most difficult surgeries that a cosmetic plastic surgeon will perform is a rhinoplasty or nose surgery. This cosmetic procedure is difficult for most plastic surgeons for a number of reasons;
- Not many opportunities to perform rhinoplasty in cosmetic plastic surgery training.
- Wide anatomic variations between individuals and races
- Need for the plastic surgeon to have an artistic eye
- Need for precision surgery
- Cartilage by nature will warp after surgery – degree of warping is unknown
- Healing process of the nose is special
Rhinoplasty training
Since most cosmetic surgeons find rhinoplasty surgery exacting, they typically will perform the surgery themselves and not allow a resident or Fellow in training to do the surgery. That after all is how surgeons learn how to perform surgery; by performing the surgery under the watchful eye of a teacher.
One of my professors told me that I should not charge my patients for the first 20 rhinoplasties as I would be learning along the way!
Even if the plastic surgeon has done many cases, the nose surgery requires exactness to the mm. Few cosmetic surgeons will give the knife to someone else for that level of precision.
Plastic surgeons do learn how to perform rhinoplasties through their experience with
- trauma cases where the nose is damaged and has to be repaired
- Anatomy classes and rhinoplasty teaching courses with cadavers
- Surgery on clinic patients who have rhinoplasty performed by plastic surgery Fellows at a discounted price.
Finding an experienced surgeon is even more important than usual.
Anatomic variations in Noses
We all know the wide variations that exist in noses- We talk of the Roman nose, the middle eastern nose, the African nose or the Asian nose.
The racial variations in noses are due to differences in the amount of bone and cartilage in the nose as well as the flexibility of the cartilage. The African nose for example has less rigid cartilage than the Caucasian nose.
The differences in anatomy have direct effect on the nature of healing and the cosmetic result.
Artistry in Nose surgery
There are well researched angles and relations between the different parts of the nose and the nose and surrounding structures of the face. These relations can be measured and provide a certain amount of standardization in the plastic surgeon’s approach to the nose surgery.
Despite this an “artistic eye” is essential for the plastic surgeon to have and to prevent a less than great result.
Precision in Rhinoplasty
Some of the changes that can occur with a rhinoplasty surgery are a matter of millimeters of bone or cartilage being removed or added- Even one mm makes a difference in the shape of the dorsum (top) of the nose as to whether you have a straight top or a curved nose.
In some surgeries one adds cartilage to one place and removes it from the other to achieve the wanted result. Being exact is imperative in rhinoplasty surgery as there is little room for error.
Warping of cartilage
Cartilage in the nose has a tendency to warp much in the same way a piece of wood warps.
In fact at times the very ability of cartilage to warp is used to the plastic surgeon’s advantage such as in cases of otoplasty (ear surgery).
In rhinoplasty though warping is usually a problem and unwanted. The surgeon cuts and sutures the cartilage to the shape wanted and then warping comes along and changes it all. The degree of warping, or even if it occurs in a particular cases is unknown and un-predictable.
Healing Process in Rhinoplasty
All parts of the body heal in the same way by formation of scar tissue. However, in the nose surgery where minute amounts of cartilage and bone are being removed or replaced, the very same scarring can cause a cosmetic nullification or worse of the rhinoplasty. You remove a cartilage hump and the excessive scarring adds another hump. You remove the scar and more gets formed!
Injections of steroids are at times required to slow down the scarring but nevertheless 10% of cosmetic rhinoplasties need a touch up surgery.
As with all other areas the more surgeries you have in one area the more scar tissue forms and the more difficult are subsequent surgeries and healing processes.
