ASMS Members Corner
ASMS: The American Society of Maxillofacial Surgeons
ASMS: The American Society of Maxillofacial Surgeons

Leaders in the Education, Art, and
Science of Facial Reconstruction

ASMS/ASPS Annual Meeting, October 5-9, 2017
Rhinoplasty

Background
Surgery of the nose is known as rhinoplasty, a term derived from the Greek word “rhinos,” meaning "nose," and “plastikos,” meaning "to shape." Rhinoplasty not only enhances the aesthetic appearance of the nose, but also corrects functional problems. Rhinoplasty is usually performed by a surgeon with advanced training in plastic and reconstructive surgery. Simple rhinoplasty can be performed as an outpatient surgery in an ambulatory surgical center, or in a surgeon`s office. Most procedures take only an hour or two, and most patients go home soon after. Complex procedures may take longer and are most safely performed in hospitals.

Diagnosis
Patients seeking to straighten a crooked nose, diminish or augment nasal size, reduce the width of the nostrils, alter the bridge or tip of the nose, or change the angle between the nose and upper lip can benefit from rhinoplasty. Patients may possess these deformities from birth (congenital) or receive them from a traumatic injury. Patients wishing to improve obstructed nasal breathing may also benefit from rhinoplasty or related nasal surgery.

Treatment
Rhinoplasty involves the surgical manipulation of the nasal bones and cartilage. The surgery can be performed under general anesthesia or a local anesthetic, depending on patient and doctor preference. The surgeon can either operate by only making incisions inside the nose (closed rhinoplasty), or by making a small additional incision across the skin that separates the nostrils (open rhinoplasty). The surgeon first separates soft tissues of the nose from the underlying structures, then reshapes the deformed cartilage and bone. In some cases, the surgeon may harvest a small piece of the patient`s own cartilage or bone and use it to strengthen or increase the structure of the nose. Sometimes this is done for cosmetic reasons, or it may be done to improve breathing and function of the nose. In rare cases, a synthetic implant may be used to reconstruct the nose if the normal structure is badly damaged or weakened. However, synthetic materials are often associated with long-term complications such as infection, migration or extrusion. Alternatively, cartilage from the ear or rib may be used.

Septoplasty is a corrective surgical procedure that straightens the nasal septum, the midline structure that separates the two nasal cavities. Turbinate surgery reduces the size of the turbinates to relieve nasal obstruction and improve breathing. Turbinates (inferior, middle, and superior) are located on each side of the nose and function to clean and humidify the air as it moves through the nose to the lungs.



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