The rhinoplasty can treat the nose as a whole, or to focus on parts of the nose segmentally. It all depends on the defects presented by the patient’s nose and their expectations. The surgical project will therefore define for each area of the nose, the need or not for treatment, and the best operating strategy.
Rhinoplasty Techniques Have Only One Goal: A Natural Result
Talking about the natural result of rhinoplasty has become commonplace. Which Surgeon Would Like To Do Unnatural Rhinoplasties? None Of Course!
Rather, the questions are:
- How to set up an operative project that gives a natural result?
- How Can We Technically Ensure That In A Certain And Reproducible Way, The Result Is Natural, Regardless Of The Type Of Nose?
- What technical gestures will precisely make it possible to achieve this?
I have defined what I consider to be the key points at the technical level for an operative project that leads to a natural and harmonious result.
The Different Subunits Of The Nose To Be Treated
The nose is made up of 4 subunits
- the tip (yellow)
- the dorsum (green)
- the root of the nose above the dorsum (in red)
- nostrils (blue)
Each of these sub-units is subjected to a preoperative analysis, which should lead to the final project.
Surgical Techniques Treat The Nose Area By Area
Tip Of The Nose Rhinoplasty Techniques
The surgery of the nose tip is central in rhinoplasty. It treats all the anomalies of the tip:
- point too wide, round, without shape or on the contrary point too pinched
- point too thrown or on the contrary too far back
- falling point or on the contrary too raised
The techniques are based on Cartilage Grafts And Sutures.
Nasal Dorsum Rhinoplasty Techniques
It consists of harmonizing the profile line , according to the patient’s wishes: straight profile, slightly hollowed out or with a small remaining bump.
The Most Classic Is Rhinoplasty For Nasal Hump
The surgery of the nasal hump removes excess bone and cartilage forming the nasal hump, to redraw a clean and smooth profile.
A fundamental point to understand is that the reduction of the hump improves the profile, but has repercussions on the nose when viewed from the front. It is common for a pinch of the triangular cartilages to create an inverted V deformity after removal of a lump.
In order to avoid this, we systematically carry out spreader grafts to avoid this phenomenon, that is to say structural grafts of the nose that prevent the pinching of the triangular cartilages.
Rhinoplasty For Too Deep Nose Or Nasal Saddle
The noses that are too deep are unsightly, because they are often the signature of a previous poorly dosed rhinoplasty. The nasal brace can also be constitutional by insufficient growth of the proper bones of the nose.
The rhinoplasty for nose dug rely on transplants positioned along the dorsum under the skin.
Our preference today is for a compound graft called DCF , made of micro-diced cartilage taken from the ear or ribs, and temporal fascia. Because this graft is easily modeled because of its malleability, and thus gives excellent results.
Rhinoplasty To Reduce The Width Of The Bones Of The Nose
The bony base of the nose implanted on the face may be too wide. It is then necessary to reduce the bone base by targeted fractures of the bones in order to reposition them and thus reduce the width of the base of the nose.
Nose Root Rhinoplasty Techniques
The root of the nose is the upper part of the nose located between the eyes, that is, at the beginning of the nose from the forehead.
Surgery of the root of the nose is essential to harmonize the profile line:
- A too high root of the nose gives a too straight nose which starts from the forehead. It will therefore be necessary to reduce the root, by moving it back
- A root of the nose that is too low gives the impression of a nose that is too hollow and too long. It will therefore be necessary to perform a transplant to fill the root of the nose. In the event of a nasal lump associated with a hollow root, root filling may be sufficient to treat the lump by redrawing a straight profile.
Nostril Surgery Techniques
The surgery of the nostrils helps reduce the nostrils too long, or to reduce the nasal threshold if too nostrils.
It can also make it possible to correct the contours of the nostril wings when they are too retracted. This is often the case after a previous rhinoplasty which has resected too much cartilage.