Nasal surgery can have a dramatic effect on one's appearance. Patients are welcomed for a Rhinoplasty assessment at any age but it is important to bear in mind that nasal development is not fully achieved until 14-16 years of age. For this reason, our younger patients may be advised to wait until they have reached maturity before having Rhinoplasty surgery.
Rhinoplasty and Breathing Problems
In cases where the primary goal of surgery is to correct internal structures of the nose causing breathing problems, some patients also elect to carry out cosmetic nose reshaping at the same time. When considering Rhinoplasty surgery (a Nose Job), it is invaluable for the patient and Dr. Parag to develop a decisive concept of the desired changes to the nose. Equally vital, is for the patient to know that there may be several constraints as to what is achievable in cosmetic nasal plastic surgery, often depending on one's ethnicity and skin type. In all cases of Rhinoplasty surgery, issues of aesthetics and function are equally paramount and require that each patient's case be carefully considered and that the full range of one's unique facial attributes be carefully assessed.
Primary Rhinoplasty surgery is nasal surgery performed on a nose not operated on before. It can vary in complexity from simple procedures where just a bump is reduced, to complex reshaping of the entire nose. No matter how simple the procedure, the surgery needs precision and skill to get the best results. Even the simplest Rhinoplasty operation done by an inexperienced surgeon can lead to poor results.
Rhinoplasty surgery is either 'reduction' or 'augmentation/addition' in nature
Reduction Rhinoplasty is a type of surgery with the aim of reducing the size and enhancing the shape of the nose. Generally in these cases, the Rhinoplasty can be achieved by reshaping the existing cartilage and bone on the nose and, if needed, use the excess cartilage from the nasal septum (the partition of the nose) to achieve the desired results. In the majority of reduction Rhinoplasty cases there is no need for foreign material or grafts from other parts of the body. is a type of surgery with the aim of reducing the size and enhancing the shape of the nose. Generally in these cases, the Rhinoplasty can be achieved by reshaping the existing cartilage and bone on the nose and, if needed, use the excess cartilage from the nasal septum (the partition of the nose) to achieve the desired results. In the majority of reduction Rhinoplasty cases there is no need for foreign material or grafts from other parts of the body.
Augmentation / Addition Rhinoplasty/ Non Caucasian rhinoplasty
Augmentation or addition Rhinoplasty is a surgery with the aim of building up the nasal bridge and possibly adding strength to the nasal tip. In these cases, cartilage grafts or synthetic implants maybe needed. Augmentation rhinoplasty describes the rhinoplasty procedure required by most patients of African or Asian descent. Read more on ethnic Rhinoplasty.
Noses that have sustained trauma, prior nasal surgery, or have a congenital deformity may require nasal Reconstruction.
Nasal reconstructive surgery generally requires rebuilding damages nasal structure with cartilage grafts from a patient's nose, ear or rib. In certain situations fibrous tissue known as fascia which is taken from a small incision in the scalp is utilized as a soft graft to reshape the nasal tip or fill in imperfections along the nasal bridge. Dr. Parag prefers using a patient's own natural tissue, but in some reconstructive or augmentation Rhinoplasty procedures the use of implant material such as Gore-Tex or Medpore may be a good option. Cartilage from the ear is good for the nasal tip reshaping and reconstruction, but it often lacks strength and support needed for certain reconstructive Rhinoplasties, Revision Rhinoplasties and augmentation rhinoplasty procedures. Ear cartilage grafting is performed through a small incision in front of the bowl of the ear or from an incision from the back of the ear. The scar typically heals nicely and is generally not noticeable. Ear cartilage grafting does not typically change the shape of the ear. Rib cartilage is the most ideal source for cartilage if multiple, sturdy or large grafts are required. Grafting cartilage has its downside: harvesting a rib for a cartilage graft can cause chest wall discomfort for a number of weeks. Patient's may be unwilling to accept a chest incision; and the graft may potentially shrink or bend with time. Typically Dr. Parag performs rib graft incisions just below the breast so as they heal they are not noticeable. However in certain cases where a large portion of rib including boney rib and cartilaginous rib are needed the incision may be lower down on the chest wall. Over the years the use of rib cartilage, has become recognized as a reliable, safe choice for cartilage grafting in complex reconstructive, augmentation and revision rhinoplasty procedures.
Some patients choose to use surgical grade implant material because of limited natural tissue or an unwillingness to remove cartilage from their ear or rib. Synthetic implants especially gortex can in some cases be ideal for nasal augmentation. Synthetic implant material does carry a small potential risk of rejection or infection quoted as between one to three in a hundred or "one to three percent".. These risks will be discussed with you by Dr. Parag if you are a candidate for its use. The two commonly used implant materials for reconstructive or augmentation rhinoplasty procedures are Gortex and Medpore. These materials are very different. Gortex has been used for many years for vascular surgery and has a high safety record. It comes in one to two millimeter sheets and can be sutured and cut to specific shapes to achieve extremely natural cosmetic results. Gortex is a soft material and should be used for nasal bridge augmentation and not be used in the nasal tip. Medpore is a firmer substance which has been used in craniofacial surgery for many years. It is ideal for providing strength and support to the nasal tip. In Dr. Parag opinion it must be covered by cartilage to ensure that it is not in direct contact with the patients skin. When used appropriately these surgical grade materials can be extremely useful in rhinoplasty surgery. Dr. Parag often uses these materials in Asian, and African American augmentation Rhinoplasty procedures.