The nose is the most prominent part of the human face. It is a transition between the upper face (forehead and eyebrows) and the lower face, and it provides balance for the mid-face. The relationship of the nose to other facial features, especially the chin, is responsible for a balanced, attractive look. 

Important Concepts:

  • Rhinoplasty is the most complicated and technically demanding facial surgery
  • The first surgery provides the best chance for success and correct planning and surgical precision are equally important
  • Understanding of the nasal anatomy is critical for achieving the desired results
  • Appearance and function go hand in hand with nasal surgery.
  • The nose continues to change with aging and continuous evaluation of the rhinoplasty patients is important
  • In children, Rhinoplasty procedures should be performed when the facial skeleton and soft tissue has reached adequate development, which in healthy individuals is after the age of 15. Patients with severe trauma and craniofacial conditions are exceptions.
  • In young adults, the psychological development should be taken into consideration and the procedure should be planed after certain maturity has been reached
  • A nasal condition in adults is often resulting of poorly treated or untreated nasal fractures in an earlier life.
  • Disorders of the internal nasal valve are frequently missed in evaluation of difficulties with nasal breathing
  • Deviated nasal septum is a frequent trigger point for migraine headaches with onset behind the eyes 

Most Common Complaints in Rhinoplasty patients:

  • Hump of the nasal bridge
  • Crooked Nose
  • A thick, full or hanging nasal tip
  • Nose out of proportion to the rest of the face
  • Difficulties breathing through the nose in absence of cold and allergies

Rhinoplasty approaches:

  • Closed rhinoplasty-the surgical incisions are hidden inside the nose with incision trough the columella (the structure between the tip of the nose and the upper lip). Used for correction of minor to moderate nasal deformities.
  • Open Rhinoplasty- Incisions inside the nose are combined with incision trough the columella. Allows complete visualization of the nasal structures. Used for correction of extensive problems.
  • Minimally invasive Rhinoplasty; Injectable fillers such as Restylane®, Perlane®(Resylane Lyft), and Radiesse® are used to improve the shape of the nose

Procedures frequently associated with Rhinoplasty:

  • Septoplasty (straightening the nasal septum). Integral part of any rhinoplasty 
  • Out fracture of Turbinates (reduction of the turbinates)

Management of nasal bone Fractures

  • Nasal fractures are the most common fractures of the face. The injury involves the nasal cartilages and the nasal bones.
  • The part of the nose most commonly injured is the septum.
  • A large percentage of septal injuries go unnoticed, explaining the high percentage of unsatisfactory results associated with the treatment of nasal trauma. 
  • Closed reduction in the acute stage Days 1-7 reduces the need for more complicated surgery with approximately 80%
  • The younger the individual the more conservative should be the approach

To learn more about Rhinoplasty, call our practice at 908.221.1136. If you’re planning to arrange your one-on-one consultation with Dr. Evdokimow, please fill out our online Request an Appointment form. 

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