These days beauty is really important ! In some cultures people prefer to live less, but more beautiful, and that’s why rhinoplasty is absorbing large capitals. In this article i want to talk about general and essential information about nose surgery which we called it RHINOPLASTY . Read about essential information of Rhinoplasty .
History of Rhinoplasty
500BC – Susruta nasal reconstruction (original text described cheek flaps)
1000AD – Indian Forehead flap
1800s – Von Graefe and Dieffenbach refined both the Indian and the Tagliacotian methods
1887 – John O Roe introduced intranasal approach
1898 – 1898 Jacques Joseph pioneered nasal reduction
Assessment for Rinoplasty
1. Establish what the patient wants.
2. Previous trauma or surgery to the nose.
3. Airway problems? Snoring?
Essential information of Rhinoplasty
· Inspection and palpation are important.
· Intranasal examination must be done.
· Examine the nose in relation to the face and the patient as a whole.
· Midface hypoplasia, chin relationships
· Go region by region:
1. Naso-frontal angle and bridge (radix)
2. Dorsum: excess or deficient, convex or concave
3. Tip: width and projection
4. Alae: width and shape
5. Deviation of the nose
6. Columella: shape, position and length
7. Skin cover: thin or thick and sebacceous
8. Nostril: size, shape, symmetry
9. Septum (straight or deviated, in groove or out)
10. Turbinates and nasal floor
11. Nasal valves and airway
Patient selection for rhinoplasty
· This is important in all cosmetic procedures, especially rhinoplasty.
· Beware the super-secretive, the one unable to identify his or her desires, who requests urgent operation, is overly concerned with minor deformities, has secondary motivations, is excessively demanding, carries a number of photographs describing his/her preferred nose, is extremely indecisive, and the male patient
· SIMON acronym, which stands for Single, Immature Male, Overly expectant, and Narcissistic.
· four anatomic variants that strongly predisposed to unfavourable results (Constantian)
low radix/low dorsum
inadequate tip projection
alar cartilage malposition. – normal lateral crura diverges away from tip about 15°. If diverges more, then tendency to transect crura during the infracartilagenous incision. Common to get tip deformities and notching of the alar rims.