|
Rhinoplasty or Nasal Reconstruction Nasal surgery can have a lasting effect on a patient. Breathing difficulties can be alleviated and confidence can be increased. The length and shape of the nose can be changed considerably by reconstructing the bridge, tip, and/or nostrils. Underlying bone and cartilage is reshaped and the nasal skin is redraped over the underlying foundation. Incisions are made inside the nose; therefore scars are invisible in most cases. After surgery, the patient usually wears a small splint on the outside of the nose. Some swelling and possible bruising will distort the immediate postoperative result; however, the majority of swelling and bruising will be gone two to three weeks following surgery. Most patients return to work one week after surgery. Minimal pain is reported following surgery; this is usually controlled with mild analgesics. Strenuous physical activity is usually restricted for about three weeks. Rhinoplasty
is 'sculpture' of the nose Of
all the procedures performed by facial plastic surgeons, rhinoplasty
calls for the highest sense of artistry.
Why? Because the goal is not just to improve the appearance of the
nose but also to enhance the harmony of all the features of the
face. By sculpting a natural-looking nose, the surgeon draws attention from the nose to a more important feature of the
face-the eyes. Just
as a sculptor begins his work by studying the piece of marble from
every angle and becoming familiar with its every flaw, the first
step to planning a rhinoplasty procedure is a thorough examination
of the nose itself. Your
facial plastic surgeon may focus particularly on the tip of the
nose. This is because
the surgical approach-the incisions that will be made and the
technique that will be used-depends to a large degree on the anatomy
of the nasal tip. Facial
plastic surgeons are skilled in feeling the external nose and
visualizing the cartilage and skeleton beneath.
Your surgeon will determine whether the nasal tip is
symmetrical or not, whether it projects too much or not enough, and
whether it needs to be turned up at the tip or lengthened.
The strength and resilience of the cartilage and the
thickness and quality of the skin also are considered. If
the cartilage of the nasal tip shows good symmetry and projection,
the surgeon will use what is called an "endonasal"
approach. With this
technique, the incisions are placed inside the nose.
On the other hand, if the nasal tip is too broad, snubbed,
too long, or asymmetrical, the surgeon may use an
"external" approach.
With this technique, the surgeon makes an incision between
the nostrils in order to gain access to the nasal tip to correct it. Facial
plastic surgeons are trained to do everything possible to promote
quick healing and minimize scarring.
Incisions are placed along planes in the nose where natural
separations occur. Skillful placement of the incisions makes nasal surgery
nearly bloodless and allows scars to be hidden in natural creases. A nice thing about nasal surgery is that the patient sees a continuing improvement after the surgery. Most people are comfortable appearing in public about two weeks after surgery, but swelling continues to subside over the next six to 12 months. Deeper healing of the nasal tissues takes even longer, and subtle refinements may still occur a year or more after surgery has been performed. Art plays
large role in facial plastic surgery Is facial plastic surgery an art or a science? Must a facial plastic surgeon also be an artist, or can any surgeon trained in the techniques perform facial plastic surgery successfully? The fact is that facial plastic surgeons are indeed artists. Their medium, one might say, is living flesh and bone. Although true beauty is thought to be ageless and universal, beauty is not the same for all people. An artistic sense, therefore-a sensitivity to aesthetics and an awareness of cultural attributes and current trends in beauty-is an important attribute for all facial plastic surgeons. Facial plastic
surgeons are trained to analyze bone structure and facial symmetry.
The methods used are scientific; the face itself or profile
and full-face photographs are measured, scrutinized, and
mathematically evaluated to deter-mine deviations from
aesthetic norms. One
such mathematical formula, the Golden mean, is based on a proportion
discovered by ancient Greek mathematicians.
Based on thirds, the Golden mean occurs repeatedly in nature
as well as in the human form. The
perfect face, according to this principle, can be divided into equal
thirds. (See figures on the right.) Scientific
analysis, however, is not enough.
Many facial plastic surgeons take art courses and
|
|
John D. Seifert,
M.D., F.A.C.S., F.I.C.S.
|
