Types of the nose surgery - rhinoplasty
Rhinoplasty is performed through inner incisions; scars are in such case invisible inside the nose.
Second type of the surgery is open rhinoplasty. The surgeon leads the incision across the nasal septum. The incision is not straight but in shape of letter W. The scar is visible but very inconspicuous.
Advantaged and disadvantages of open method
Better approach and easier modeling leads often to this method. Necessary insertion of augmentation (refilling of tissue) is also an indication to choose this method. One of the disadvantages is long lasting swelling and visible scar. Usage of this method is very discussed and surgeons choose it mainly during re-operative procedures.
Surgery of soft nasal parts
Surgery of firm nasal parts
Nose is formed from cartilaginous and bony part. If the surgeon shapes only the cartilage and surrounding skin, it is then a surgery of soft nasal parts.
Shaping the columella
SURGERY OF SOFT NASAL TISSUES
The lateral wall of the nose is formed by nasal bone, cartilage of septum and wing cartilage. Incisions below, between and inside the cartilages are basic incision in surgery of soft tissues.
SURGERY OF FIRM NASAL TISSUE
Surgery of firm nasal tissue is associated with a change of bone structure. Special position has so-called septoplasty, when only a nasal septum is shaped and this procedure can be undertaken beside plastic surgery also at Otorhinolaryngology (the medical specialty that deals with diseases of the ear, nose and throat).
The surgeon decides if the surgery will be performed also with another surgical procedure. Usually performance of two plastic surgeries in the face at the same time is not recommended though. This part of human body is very sensitive to swellings and it could bring further complications.
Surgery of the tip of the nose: It is one of the most difficult procedures in rhinoplasty.
If we aim to lower the height of the tip of the nose, we remove middle part of wing cartilages
Narrowing of wide nostrils is solved by removal of lateral part of wing cartilage
If the nostrils are too upturned, it is possible to shape them into right curve with tiny cuts and sutures.
Grafts from cartilages can be used to add missing parts.
Augmentation of the tip of the nose can be achieved by suturing of two wing cartilages.
Surgery of wide nose
If nose is too wide from its root then the only possible technique is cutting part of the bone from the middle of nasal tip.
Surgery of hump on the nose (gibus)
At first the surgeon tries to separate skin on the bridge of the nose and the mucosa from the bony part. He/she uses one of the access incisions: incision below the wing cartilage or across nasal septum. After that an incision is lead inside the nasal cavity above the wing cartilage and the surgeon gets between the skin and nasal bridge. He /she chops nasal hump with cutter. In some cases the chopped part of the tissue is used to reshape the bridge of the nose. It is then necessary to fix the tissue implant against its shift with for example special glue, micro screw or suture. Sometimes as a prevention of dislocation serves only external plaster. In smaller odds it is possible just to grind the bone.
According to approach it is possible to operate through open or closed method. Septoplasty is a complicated procedure. One of the techniques septoplasty is breaking the bony part of nasal septum and its fixation (through tamponade or other devices) in the right position. Less frequent is the method with taking out of the cartilage, reshaping it outside of the nose and then implanting it back. The easiest technique of septoplasty is with tiny incisions that help the surgeon to shape the septum well with tamponade. Sometimes outgrowths and humps occur on the septum, they can be easily removed by chopping.
Shortening of the nose and turning the tip upwards
This result can be achieved by removal of wedge part of lateral side of wing cartilage.
Surgery of movable nose by mimic
Movements of nose cause tiny mimic muscles that are connected to nasal cartilage. Movement of nose is totally physiological although in some cases the muscle is too short and causes excessive movements. This movement can be eliminated by breakage of the spot where the muscle is fixed. The nose surgery is performed through inner method with incision across cartilage of nasal wing. Second muscle that pulls the tip of the nose downwards can be cut by access from the mouth cavity between upper gum and lip.
Lateral cut-out of the bone serves to reshape and lower the nose. Shaping of the change from forehead to nasal bridge can be deepened by side removal of a bone from lateral wall of the nose. Depression of nose is a complex procedure that needs cut-out of part of the bone from nasal septum and lateral sides.