DEFINITION OF RHINOPLASTY SURGERY (NOSE JOB)
Rhinoplasty surgery in simple terms is the procedure to correct the shape of the nose. Rhinoplasty surgery is also known as the nose job. There are two things in rhinoplasty Surgery one is the functional aspect of rhinoplasty which involves correction of the nasal passage and the other is cosmetic which involves the correction of the deformities. Whenever the surgeon does he has both thing in mind that is to correct both the functional and aesthetic problems.
Whenever the nose job surgery is done the patient then realizes how much the changes can be done. the procedure involves taking care of the skin which can either be thin or thick. Then we have to consider whether to change the existing structure or use the cartilages, bone or fascia from other places. the structures to be placed in such a masterly fashion so that the nose looks perfect. Truly speaking rhinoplasty surgery is to be done by the surgeon who is dedicatedly doing rhinoplasty surgery procedures and not by some person who seldom does it.
PHILOSOPHY OF RHINOPLASTY SURGERY
Dr. S.S. Gambhir
OPEN VS CLOSED RHINOPLASTY SURGERY
There has always been the debate that rhinoplasty surgery to done either closed or open. to the layman, the terms seem confusing as to what to decide once given a choice. one thing is clear that no matter what method of approach you choose the results should be satisfactory.
This involves approaching the nose inside by giving the incision inside along the upper lateral cartilage and then joining the two incisions together or by rim incision and not joining along the columella. this limits our visibility to see inside and continuous traction over the skin to see inside can cause slight deformity. with the adversity of endoscope, the visibility criteria are somewhat limited.
Open method This involves giving the rim incision and joining at the columella. this gives good exposure to the inner structures. All the deformity can be corrected under visualization this approach is good for patients who have severe deformity, secondary revision rhinoplasty Surgery, and cleft rhinoplasty surgery.
There is always been worry regarding the visibility of columellar scar but over the years I have experienced that the scar is nearly invisible whether it is Asians, Indians, Caucasians, Arabs, etc. As a rhinoplasty surgeon in Delhi, my preferred approach is open rhinoplasty is the best surgery.
Why choose us for rhinoplasty in Delhi?
• Rhinoplasty is a very complicated procedure and should be performed by an experienced surgeon. Surgeons performing nose surgery must have a good understanding of which procedures are best suited for Indian skin. Read more about rhinoplasty in India (Grafting and surgery in India and its benefits)
• Dr. S.S Gambhir is a cosmetic surgeon with more than 17 years of experience. He is regularly conducting rhinoplasty courses in India and also teaching rhinoplasty to his students and fellows. He regularly participates in the various rhinoplasty courses in India and abroad to upgrade his skills.
• We have made a special augmentation system that is proven to be most suitable for Indian skin. These grafts are complex. These are done in very few rhinoplasty centers. In addition, few surgeons are able to perform these procedures.
• We regularly do tip correction / drooping tip, increase the tip of the nose, create a diamond tip, improve nose protrusion, deformity correction, ultra-tip fracture surgery, and other aspects.
• A prominent nose can really change someone’s personality. If someone is involved in an accident and suffers from a nose injury, rhinoplasty is the only option to solve the problem. Other reasons for doing this very complex process are:
▪ Correct bump
▪ Other defects mentioned below
Facial deformities can cause serious problems. It brings problems to individuals’ personal and professional lives. Surgery and reconstruction surgery can improve facial harmony and make life better.
Rhinoplasty can make a difference
At present because of the advent of digital media and social presence looking good is the need of the hour. With demand the procedure have changed the results have improved and patient satisfaction rate has increased.
In the past: these reconstructions are not safe
Facial reconstruction and surgery have been considered unsafe for the past two decades. They are surrounded by the myths of being.
• It is expensive and has sequelae after surgery.
• Almost no one will consider looking and feeling good under the knife
Rhinoplasty: Why do it at all?
The patient comes for the functional and cosmetic correction of the nose. The deviated septum can cause cosmetic and functional deformity and once you correct this the functional and cosmetic results improve so these patient are not cosmetic patient but are septal framework correction surgery patients
Rhinoplasty usually involves
• Nasal cartridge modification
• Bone modification
• Septum ,
Conclusion for Rhinoplasty in Delhi
Crooked nose Job correction Delhi
Newer advances in rhinoplasty surgery As part of the teaching programme in rhinoplasty surgery Dr Gambhir is doing what is the latest technique to give excellent result. The newer is diced cartilage graft for dorsum of the nose job. This graft gives more control of the dorsum and give natural aesthetic result.
Cosmetic Rhinoplasty Surgery In Delhi
Tip correction- the tip of the nose is most important structure. The tip can be broad, bulbous, bifid , drooping. This all needs to be corrected.the tip height need to be maintained for there is ratio of height to length of the nose which needs to be achieved in correction.
Dorsal hump and depressed tip correction
Dorsum of nose
Dorsum of nose the dorsum of nose may have varying problem of broad dorsum, dorsum hump, depressed dorsum(saddle nose) and crooked dorsum.The above are the common problem for which the patient comes to us . the patient is first assed and then the plan is made to correct the problem.The photographs of common problem is given below.
Frequently Asked Questions (FAQs)
It is the surgery of the nose which involves correction of the septum and correction of external deformity to have the normal breathing and cosmetic pleasing nose.
Yes there are two approaches of rhinoplasty exposure. One is closed approach in this the incision are given inside the nose but the exposure is limited. If we are doing open approach there will be a small columellar scar which is not visible but exposure to nasal anatomy is good . Now a person going for rhinoplasty who is concerned with result should not be bothered by the inconspicuous scar in the columella.
Definitely the overlying skin makes a difference in the result but planning is important so patient with thick skin are given extra care in augmentation as the result is depend on the height and fine work is not very visible and they require lot of cartilage. The result is satisfactory and nowadays we are giving isotretenoin to decrease the thickness of skin and results have definitely improved.
Ideally we prefer to give general anaesthesia as it is comfortable for the patient. It is very safe and is given by a board certified anaesthesiologist. The anaesthesia is given by I.V drugs and then patient is intubated . Once the surgery is finished the patient comes to conscious immediately
Sometimes we use local anaesthesia for tip work. In this we are using the local injection to block the nerves and sometimes we give iv sedation to comfort the patient.
Once survey is done the result are immediate but next day swelling occurs and it takes about 2 months to have good result and the result will keep on improving for next 4 to 6 months
Yes breathing will definitely improve if you have problem before for in rhinoplasty we are correcting the septum as well as all the nasal valve so the breathing improve. Nowadays it is call nasal framework correction. Dr. Gambhir is trained in both the septal framework correction and nasal framework correction so the cosmetic and functional aspect of nose is corrected at the same time.
Normally we prefer that after one rhinoplasty procedure you should wait at least one year before the next surgery as result improve with time and also the tissue get softened so that they can be manipulated in better way. For revision rhinoplasty dr. Gambhir is best as his experience is very vast in this field.
We prefer to do cosmetic rhinoplasty in female at age above 15yrs and in male above 16 yrs as the nose is in growing phase before then. In case the patient has severe functional breathing problem we can operate at 12 to 13 yrs of age.
Normally in younger age group it give good result but above 60years of age the healing is slow and cosmetic results are not good . These patient because of ageing skin may develop functional problem they definitely require rhinoplasty.
Normally after full cosmetic rhinoplasty there is a small bandage over the nose and slight bruising under the eyes. This normal is there for 1 week so patient having desk job can go back to work after this and those who have physical activity will require additional 1 week. Strenuous exercises are to be avoided for at least 4 weeks.