What is an open rhinoplasty?
An open rhinoplasty refers to the creation of a small horizontally incision made across the columella (the soft, narrow part of the nose that separates the nostril openings). This incision is connected to an incision inside each nostril which then allows the surgeon to gently elevate the skin off of the nose to view the nasal tip anatomy with greater ease and less distortion than with more traditional approaches.
The many benefits of this approach include the ability to place sutures to shape the tip cartilages, apply cartilage grafts to better shape the tip or bridge of the nose and to better straighten severely twisted or deviated noses. The scar is typically almost invisible and heals very nicely. Each nasal surgeon will typically favor an open approach in selected cases requiring the additional visibility, particularly with re-do nasal surgery, difficult nasal tip cases and severe nasal deviation.
What is better - silicone implants or cartilage when having a rhinoplasty?
When building up a nasal bridge is required, Dr. Harrell frequently relies on a custom fabricated soft silicone nasal implant. He only uses the implant on the bridge of the nose - not for nasal tip elevation or projection. In cases where the amount of build up needed is minimal and there is adequate nasal cartilage to use as grafting material, Dr. Harrell will use nasal cartilage. Foreign bodies, such as silicone have a higher incidence of infection than the body's own tissue but their many advantages usually outweigh the small risk of infection. They typically look better-smoother and better tapered into the surrounding tissues. Infection is almost eliminated by good closure of the nasal incisions and irrigating the space the implant will be in with antibiotic solution. Overall the silicone nasal implant is an excellent alternative to cartilage grafts in most patients - saving them the additional surgery necessary to harvest the graft material.
Who performs rhinoplasty?
A: There are essentially two surgical specialties who claim expertise in performing rhinoplasty. First are the plastic surgeons and second are the otolaryngologists (ear, nose, and throat surgeons). In either camp there will be surgeons quite experienced in the performance of cosmetic nasal surgery and who have excellent artistic sensibilities.
Unfortunately there are many others that have neither the interest nor experience nor the artistic ability to do predictably good work. A plastic surgeon may be an accomplished breast surgeon but not a good nasal surgeon. Similarly, an ENT surgeon may perform a good septoplasty (nasal septum repair for breathing) but have no interest or experience in cosmetic nasal surgery.
In short not all surgeons are created equal when it comes to nasal surgery. Therefore make sure rhinoplasty is a substantial part of your surgeon's practice. If it is not, then move along until the right surgeon is found. Rhinoplasty can be a difficult procedure and requires a gentle hand and a trained eye - much more so than many other surgeries. Results are measured in millimeters. Higher rates of patient satisfaction are achieved by surgeons who routinely perform rhinoplasty and who have a love for this difficult but rewarding procedure.
If you are interested in learning more, please schedule a rhinoplasty consultation today with Fort Lauderdale and Miami plastic surgeon Dr. Jon Harrell online or by calling (954) 526-0066 today.