The nose is the central, dominant feature of an individual’s face. Changes in the aesthetics of the nose will have a dramatic effect on any individual’s look. Even the slightest change to the nose, can greatly affect one’s overall facial appearance, improve their look and boost their self-confidence.
The analysis of the patient’s nose, their goals, and expert surgical technique are of the highest importance. That is why it is important to find a qualified plastic surgeon who has extensive experience in performing rhinoplasty. During your consultation with Dr. Brenner, a comprehensive review of your aesthetic goals will be reviewed. Additionally, evaluation of your nasal airway will be performed to help determine any functional problems that you may have with your septum (i.e. septal deviation) or turbinates (i.e. turbinate hypertrophy). Rhinoplasty, Septoplasty and Septorhinoplasty can either be performed by the “closed technique” or by the “open technique.” Since no two noses are the same on the outside or on the inside, candidacy for either “open” or “closed” rhinoplasty will depend greatly on each individuals internal nasal anatomy, degree of deformity and desires. Following your evaluation, Dr. Brenner will review your surgical options with you and also determine if additional graft material (ear cartilage, rib cartilage, fascia) may be required.
Nose Surgery Common Terminology:
Primary Rhinoplasty: When nasal corrective surgery is performed on someone’s nose for the first time, it is called Primary Rhinoplasty. This may include patients who simply wish to have a prettier, more aesthetically appealing nose. It may also include patients who have had significant traumatic injury to their nose in the past, but never sought treatment.
Secondary Rhinoplasty: Also known as “Revision Rhinoplasty,” Secondary Rhinoplasty is the term used for nasal corrective surgery performed on someone who has already undergone a first (or second or third…) nasal operation in the past. The reasons that patients seek a secondary operation are multiple, and include: a persistent defect that was never corrected during the first operation, a new defect that has occurred as a result of unfavorable healing from the prior operation or simply ongoing aging or scarring changes that have occurred to the nose over time.
Septoplasty: Septal deviation is a common reason for nasal airway obstruction. Traumatic injury to the nose is the most common reason for a deviated septum, although some patients will develop septal deviation over time even without any previous injury. Septal deviation can be problematic to many patients, interfering with their nasal breathing. Patients typically complain that their breathing is more difficult during exercise or sleep, and that they therefore must breathe through their mouths. Snoring is also a related symptom.
Turbinate Hypertrophy: The turbinates are the structures on the inside of your airway that moisten and warm up the environmental air as you breathe in through your nose. They are comprised of a piece of bone encased with a mucosal lining. The turbinates can become enlarged and/or irritated in people who have environmental allergies (Allergic rhinitis). They also can become deformed alone or in conjunction with deviation of the nasal septum. Although nasal sprays can control many peoples nasal symptoms, some patient will require either reduction or partial removal of their nasal turbinates. This procedure can frequently improve nasal airway obstruction.
Ear Cartilage Graft: There are some nasal deformities that require correction with autogenous (i.e. a patient’s own) cartilage tissue. If additional tissue is needed during your operation, the ear is a common source of graft tissue for these purposes. A small incision either behind the ear or within one of the curvatures on the front of the ear can be used to easily obtain this additional tissue.
Rib Cartilage Graft: Rib cartilage can be harvested for use in a rhinoplasty when a large amount of strong cartilage tissue will be required to rebuild or augment the inside of your nose. Patients whom require this procedure commonly have had one or more previous rhinoplasty operation, resulting in either nasal deformity or instability. Common deformities that require rib grafting include over-resection(removal) of tissue during a previous rhinoplasty, severe nasal trauma with septal fractures, cocaine abuse with loss of septal tissue or even congenital nasal deformities(i.e. the patient was born with a nasal abnormality).
Deep Temporal Fascia Graft: The thin connective tissue lining the temporalis muscle in the temple area is an excellent source of tissue that can be used to re-line the inside of the nose. The tissue is easily harvested through a small incision in the hair-bearing portion of your scalp in the temple area.
“The nose is a very special part of the face. It dramatically affects the way a person looks and feels. Operations that alter the nose must be delicately performed with deep respect for the individual’s facial features and his or her desires. There is no substitute for superior technical ability coupled with a keen aesthetic eye.”