What Is Rhinoplasty?
A plastic surgical approach to correct the deformities of the nose is known as rhinoplasty, also commonly known as a nose job. A plastic surgical approach can be a reconstructive one to restore the function by construction of damaged nasal parts, or a cosmetic one which is done in order to enhance the overall appearance of the nose and thus of the face.
Causes of Nose Disorders:
- Congenital defects: In cases such as cleft lip and palate, Treacher Collin’s syndrome, Cleidocranial dysplasia, hemifacial microsomia, alcohol baby syndrome, Crouzon’s disease, the nose may be severely deformed. This not only impairs the breathing pattern but also gives an unaesthetic appearance to the individual.
- Nasal septum may also be deviated to either side since birth causing difficulty in breathing
- Nasal polyps develop anywhere along the septum or the conchae. Polyps are masses of epithelia which eventually may cause bleeding and obstruction of air passage
- Trauma: Nose may be damaged, fractured, bruised in cases of fights, road traffic accidents
Signs and Symptoms of Nose Disorders:
- A clear deformity in the shape, size and proportion of nose
- Compressed nasal root and bridge
- Difficulty in breathing
- Bleeding from the nose, pus discharge
- Asymmetry in the nostrils
- Blood clots in the nasal passage
Diagnosis of Nose Disorders:
- Physical examination: The cosmetic surgeon visually examines the nose closely in terms of its size, structure, studies the various ratios and proportions between the length, width and breadth of nose. Any obvious deformity is also looked for. Nostrils are checked for asymmetry which would give an insight into the nasal septum deviation.
- Assessment of photographs: Preoperative photographs of the face are taken in the frontal and lateral views along with the same angles for close up views of the nose. Measurements can be done on the photographs and a rough assessment on how to go about the surgical procedure can be done.
- Endoscopy: A long tubular structure fitted with a small camera at one end called as an endoscope can be inserted inside the nostril to check for the location of the pathology along the course of the nose.
- Radiological examination: These include PA views, cone beam computed tomography CBCT, computed tomography CT to detect the level and extent of nasal fractures. It also gives idea about the pathology with the conchae, nasal root and the nasal cartilage.
Types of Nose Diseases Requiring Rhinoplasty:
Treatment Procedures for Rhinoplasty:
Once a thorough diagnosis has been made, the next step is to enquire about the expectations of the patient. Depending upon the requirements of the patient, any of the four types of rhinoplasties can be chosen
- Open Rhinoplasty
- Close Rhinoplasty
- Filler Rhinoplasty
- Revision Rhinoplasty
The procedure is done as an outpatient department procedure and thus no long hospital stays are required. As an adjunct to Lefort I, II and III surgeries, rhinoplasty can be done on the surgical table also in order to avoid a second surgical intervention.
- Open Rhinoplasty: It is the choice of intervention when extensive work needs to done on the nose and its associated structures. An incision is made in the skin between the nostrils from beneath the nose, the area known as columella.as soon as the skin is lifted, the inside nasal structures can be seen and the actual procedure of cutting, recontouring, reshaping can be begun. An open approach may also be done secondary to placement of bone grafts or after the revision type of rhinoplasty has been done. Conditions such as genetic deformities of the nose, damage due to trauma and collapsed valves from previous hump removal can be corrected with an open rhinoplasty approach. After the procedure is done, the columella is sutured and the nose is taped for recovery. A customized splint is then placed over the tape which helps to protect the delicate tissues of the new nasal structure during the healing process.
- Close Rhinoplasty: It is the most common type of procedure chosen by the surgeon for either a reconstructive or a cosmetic correction this method, all the incisions are hidden inside the nose. As a result, no external scars can be seen post operatively. This approach is more esthetic and less invasive as compared to the open method. It causes reduced nasal irritation since the incision at the columella is avoided. Post operative edema is also seen less. It shows excellent post operative recovery.
- Filler Rhinoplasty: It is the least preferred method, non surgical approach and can be done by dermatologists as well as assistants to plastic and cosmetic surgeons. There is no requirement for an incision to be made, instead an injectable filler is used to correct the minor imperfections of the nose. The most common types of fillers are Juvederm and Restylane. The greatest disadvantage of the procedure being that the changes are not permament, a relapse does occur. However, the scarring that results from this method is permanent and obstruction of vessels can result leading to necrosis of the skin over the nose. Eventually, the fillers are absorbed into the skin and an additional procedure may be needed.
- Revision Rhinoplasty: It is an approach required subsequent to an open or a close rhinoplasty. In case the patient is not satisfied with the primary type of surgery, he may opt for a revision one. It may be considered as a final touch up procedure also. If after the primary surgery, breathing becomes difficult or a hump develops in the nasal bridge, a revision approach is needed to be done to correct it.
Complications and risk Factors Associated With Rhinoplasty:
- Difficulty in breathing
- Scarring of the nasal and para nasal areas
- Infections, bleeding post operatively
- Formation of hematoma, edema and swelling in the nose and para nasal areas
Am I A Good Candidate For Rhinoplasty?
There is no one particular criteria to opt for a cosmetic approach, unless the systemic diseases do not permit you to do so. If you feel your nose doesn’t look good, it doesn’t. However, if the deformity is congenital or due to trauma, you ideally are a good candidate for the rhinoplasty procedure.
- Improves the function of breathing
- Enhances the esthetic appearance
Why Choose India?
India is a leading country in the field of plastic and cosmetic surgery with a diversified range of highly ardent skilled practitioners. Team MedcureIndia being one of the finest medical tourism platforms in our country assure the safety of clients along with assuring top class satisfactory treatment outcomes both for the reconstruction as well as esthetic enhancement of nose.