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 other is cosmetic which involves correction of the deformities. Whenever the surgeon does rhinoplasty Surgery 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 that 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 the 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
Since 2003 I have been doing rhinoplasty surgery and over the last 15 years, the concept of rhinoplasty surgery and understanding has greatly changed. The anatomical studies and advances in techniques have greatly influenced the result. With better understanding, the results have greatly improved and now we have more control over the resulting predictability but not all.
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 continues 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.
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.