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Nose Reshaping (Rhinoplasty)

Rhinoplasty or Nose Reshaping can take the form of reconstructive surgery, aesthetic surgery or a combination of both. The cosmetic aspect of rhinoplasty surgery usually involves the appearance of the nose, including changing the tip and/or dorsum and their relative proportions.

If you are considering surgery to change the shape of your nose, the current options are much greater than ever before. Rhinoplasty surgery has advanced in recent years, giving both surgeons and patients many more options. The surgeon can better diagnose the needs. Computer imaging has greatly enhanced the ability to customize nasal surgery. Dr. Delgado can give you a realistic “before and after” image of the proposed outcome. This is an excellent communication technique. Through an analysis of facial proportions and angles, one can better fit one’s nose to the facial anatomy. Today, the emphasis is on individual customization. All noses should not look the same.

The advancement of the “open approach” to nasal surgery has greatly improved the outcome of nasal surgery. With this technique, one is able to see the anatomy that needs to be changed as opposed to operating with the skin sleeve attached and distorting the anatomy. However, closed rhinoplasty continues to be a popular technique for more simple and straightforward procedures.

INDICATIONS

Rhinoplasty, or nasal surgery, can be performed in men and women at almost any age. It is usually recommended that young people wait until their facial growth is complete, usually about 15 years old.

You may be a candidate for rhinoplasty if you have any of the following conditions:

  • Your nose is out of proportion to your face, either being too large or too small
  • There is a hump or depression on the nasal bridge seen on profile
  • The nose seems too wide in front view
  • The nasal tip droops, or is thick and enlarged
  • The nostrils flare outward excessively
  • Your nose is crooked
  • A previous injury has caused asymmetry of your nose
  • You have an obstructive airway and difficulty breathing

If you have had past rhinoplasty surgery and are not happy, you may be a candidate for secondary nasal surgery. The issues related to a primary (rhinoplasty) can be under- or over-resection of tissue. Many techniques exist today to reconstruct the nasal anatomy, both for function and aesthetic reasons.

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OPERATIVE PROCEDURE

The operative procedure for rhinoplasty is probably the most challenging aesthetic surgery. All cases are customized. The surgeon must foresee many steps to achieve the desired outcome. The operative procedure I describe is the most general to help your understanding.

The most common technique is the “open approach.” This technique provides greater exposure and more accuracy in the reconstructive process. An incision is made at the root of the nose. This gains access to all of the nasal anatomy. Once the skin is elevated from the cartilage and bone, the nasal tip cartilage is trimmed. The nasal bone is reduced, enhanced and/or narrowed. The nasal passage, at this time, will be addressed, if necessary. The nasal tip is further refined with suture techniques and cartilage-sparing procedures. The incisions are closed and an external cast is molded into place. The procedure is complete and the patient is taken to the recovery room.

INSURANCE OPTIONS

Insurance companies do cover reconstructive nasal surgery. This usually involves post traumatic nasal injury or a deviated septum causing breathing problems.

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Before Rhinoplasty

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