Less invasive techniques in rhinoplasty

Rhinoplasty (popularly called a nose job) is a cranio-facial plastic surgical procedure which reshapes the nose. It is a tricky procedure, as the nose is vital for respiration, so any errors or complications can restrict breathing ability. In this article, accomplished oral and maxillofacial surgeon Mr Moorthy Hasland goes over the less invasive techniques for rhinoplasty.

What is rhinoplasty?

Using hammers, chisels, and blades, surgeons manipulate the nose’s structure to the patient’s wishes to correct asymmetry, deformities, injury, or undesired size and width. With rhinoplasty, the nose can be altered at its profile, hump, tip, or septum. People may get rhinoplasties due to personal aesthetic preference, but they can also be necessary for breathing function and as a reconstruction for injury or defect.

Rhinoplasties are often performed as an open procedure, where incisions are made in the nostrils and along the bottom of the nose so that a flap of skin can be flipped back, exposing bone and cartilage which is what the surgeons will manipulate to reshape the nose. Open rhinoplasty is a long procedure, at least four hours long, and it can result in visible scarring, heavy bruising and extensive swelling for several weeks as it heals. However, there have been developments in the techniques that are available for rhinoplasty.

What are less invasive techniques in rhinplasty?

1. Closed rhinoplasty, which is a similar technique to open rhinoplasty, but it is through the incisions in the nostril that the procedure is conducted, using fine tools. The benefits of closed rhinoplasty are reduced swelling and bruising, non-visible scarring, and shorter recovery time. However, this surgery is best suited to patients who require less drastic nose reshaping, and this surgery is a little trickier for surgeons due to the small, awkward anatomy, and the limited visibility of the structure of the nose.
2. Septorhinoplasty, a technique used to correct a deviated septum, which can obstruct breathing. During this procedure, incisions are made in the internal lining of the nose, exposing cartilage and bone of the septum, which can then be adjusted. This same technique can be employed to correct other structure problems in the nose.
3. Tip surgery, to change or correct the end of the nose, for patients who perceive a disproportion to their nose and face. This technique is used to address nose tips that are too broad, narrow, bulbous, or asymmetrical by shaving down and reshaping the cartilage. If volume needs to be added, cartilage can be donated from other parts of the body, such as the hips and ears. This kind of procedure cannot address the nose bridge height or profile, but there can still be a dramatic change to the visual of the nose with just an alteration to the tip.
4. Nonsurgical rhinoplasty uses dermal fillers to modify the nose. This technique can be less costly for the patient, and recovery time is shorter, without less swelling and bruising than surgical techniques. This technique is also reversible if the patient should change their mind in the future. The fillers are expertly placed around the contours of the nose to alter the shape and make it appear more symmetrical, straighter, or fuller. It cannot take away volume as it is an addition, not a subtraction in the nose, but a skilled surgeon will know how to make the nose best fit in with the rest of the face for visual harmony. Those who want to get rid of dorsal bumps or significant rotation of the tip of their nose will not be able to achieve the results they want with nonsurgical rhinoplasty.
5. Ultrasonic rhinoplasty, which uses concentrated ultrasound waves to sculpt bone and cartilage with precision through narrow incisions made inside the nostril. The tissues are then moulded accurately without damage and trauma. This is an advanced technique but with many benefits, such as no visible scarring, minimal bleeding and swelling, a faster recovery time of a week, and less damage to the bone structures of the nose. This technique is best for those looking for more subtle results, as it will not be sufficient for a major reshaping. Most rhinoplasties are conducted under a general anaesthetic, but an ultrasonic rhinoplasty can be done with a local anaesthetic.

These procedures can be much shorter than the traditional open rhinoplasty, around one to two hours. After a rhinoplasty (not including ultrasonic rhinoplasty), the patient will have to stay in the hospital for two nights. Open rhinoplasty requires up to six weeks of healing, but less invasive techniques will need less time, around three weeks.

What are the possible complications of rhinoplasty?

Rhinoplasties are considered a safe procedure in the hands of qualified surgeons, but there are possible complications to consider. Rhinoplasty requires the cutting and breaking of nasal structures, which can lead to bone weakness, tissue tears, and the collapse of the nasal valves in the future. The surgery may alter the sense of smell, or the patient may suffer from heavy nosebleeds and difficulty breathing from the nose afterwards. The nose can get infected during the healing process, and as with all surgical procedures, there is the risk of blood clots forming and excessive bleeding.

If you are considering a nose job, consult with Mr Halsnad via his Top Doctor's profile