The advantage of this approach is that it gives the greatest visibility and access to the structures of the nasal tip. Therefore, in cases where there is need for extensive reshaping of the nasal tip, this might be a preferred approach.
The disadvantage of Open Rhinoplasty is the scar over the columella and the longer time that it takes for the swelling of the nasal tip to subside.
Is The Nose Packed After a Rhinoplasty?
A typical cosmetic Rhinoplasty does not require nasal packing and patients are able to breath through their nose immediately. Despite this, there is going to be some drainage of blood and mucus from the nose that can obstruct the nose if not cleaned routinely.
With a Functional Rhinoplasty that involves a Septoplasty and Turbinectomy, the nose is packed with a soft moist sponge which is similar to a tampon. This packing is basically the bandage for the surgery that is performed for the internal nasal structure. It prevents formation of scars and adhesions between different nasal structures, and lessens the chance of bleeding. I usually instruct my patients to remove this packing in one and a half days after surgery and to start cleaning and irrigating their nasal passageway then.
Who is a Candidate for Nasal Implants?
Nasal implants are generally used to augment the nasal dorsum or bridge. Many Asians and those of African descent don't have prominent noses and at times are deficient in the height of the nasal bridge. In addition to wanting to enhance and balance their facial features, they often complain that their glasses slip off their nose because they don't have a strong nasal bridge!
Esthetically speaking, lack of nasal dorsal or bridge height tends to make the nose look short and fat. It also makes the eyes appear too far apart. Finally, lack of forward nose projection also tends to make the face look too flat and round. Augmentation of the nasal bridge will help elongate the nose and gives the face a more refined and balanced appearance.
What materials are used for Nasal Augmentation?
Most plastic surgeons prefer to used natural material for nasal augmentation, especially that from the patient themselves. This material is called an autologus graft, and is often harvested from the nasal septal cartilage, ear cartilage, ribs, or bone. While autologus grafts have the advantage of better acceptance by the patient's body and less chance of infection; they do partially re-absorb or shrink.
Besides requiring added surgery to harvest these grafts from a patient's body, often the amount of tissue available for harvest might be limited and not enough to achieve the desired augmentation. On the other hand, synthetic grafts or implants are abundant and come in a variety of shapes and sizes. They don't require added surgery to harvest a graft, and don't re-absorb or shrink after implantation. Unlike autologus grafts, synthetic nasal implants carry a higher chance of infection or extrusion. These implants are typically made from Silicone, Gortex or PTFE.
How Is Nose Augmentation with Nasal Implants Performed?
This is a procedure that should be performed only by a highly skilled plastic surgeon, with experience in ethnic nasal surgery or rhinoplasty. Generally, the surgery involves the creation of a nasal pocket for insertion of the specially designed implant. The incision is made inside the nose, with dissection along the dorsum or top of the nose to create the appropriate space for the implant. Rarely, sutures are used to hold these implants in place; instead a tight fit pocket will hold in the nasal implant in the appropriate place. After surgery, the implant is kept in the correct place by wearing a nasal splint for a week. |
