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					Rhinoplasty
  Asma’ ALBesher
    207001176

    Dr. Kamal
    Dr.Usama
Objectives:
•   History of rhinoplasty
•   Anatomy of nose
•   Definition of rhinoplasty
•   Indication
•   Rhinoplasty technique
•   Duration of operation
•   Steps of operation
•   Complication & risk factor
Rhinoplasty

•Rhinoplasty : 'Rhinos' means Nose and 'Plassein'
means to shape.

•This is a surgical method of improving either the
function or giving the nose a better shape.
    History of rhinoplasty
• First rhinoplasty was performed in the year 1887 by
  John Orlando Roe” father of aesthetic rhinoplasty”.
  Later in 1898, Jacques Joseph used it as a cosmetic
  surgery procedure…
• Rhinoplasty became very popular during the First
  World War. The surgeons had to perform this
  surgery on these soldiers to give their noses a better
  shape or to heal them. During this time, many
  surgeons made rapid technological advancements the
  process of rhinoplasty was made safer
Anatomy of nose:
What is Rhinoplasty?
• is surgery to reshape the nose. The procedure can
  make your nose straighter, wider or narrower, longer
  or shorter. It can change the shape of the tip or
  bridge. It can change the angle between the nose and
  upper lip or narrow the nostrils.
• Rhinoplasty is the third most common cosmetic
  procedure among both men and women.
Indication:
• Aesthetic Rhinoplasty

• Functional Rhinoplasty
• Aesthetic Rhinoplasty
• For anyone suffering from self-consciousness as a
  result of their nose means if you feel it
  uncomfortable. Rhinoplasty aims to balance the face
  and draw misplaced attention away from the nose and
  to refocus it on the eyes. This process is called
  'harmonising', adjusting the nose in relation to the
  rest of your facial features so that the face is in
  harmony.
Rhinoplasty can address the following concerns:
• Size: if the nose is too big or too small
• Length: if the nose is too long or too short
• Width: if the nose is too wide, too fat or too narrow
• Tilt: if the tip is hooked downwards or angled
  upwards
• Tip: if the nose looks too bulbous, pinched or has a
  cleft tip
• Symmetry: if the nose is crooked or generally
  asymmetrical
• Nostrils: if they are too close or too far apart, look
  flared or pinched, or if the cartilage and skin
  between the nostrils (the columnella) hangs down too
  far
• Shape: if the nose is humped, has a bump or a dip
• Scarring: if the nose has excessive scar tissue or
  other superficial surface markings
Hooked nose
                 Bulbous nose   Hump nose




              Bump nose
• Functional Rhinoplasty
• Nose reshaping surgery is also useful in correcting
  breathing problems or any other damages affecting
  the nose for that matter. If a person suffers from
  breathing difficulties, especially with narrow nasal
  passages, then nose reshaping can open or widen
  these passages allowing greater ease when breathing.
Rhinoplasty Techniques:
• There are two types of rhinoplasty procedure which
  can be performed:
• the closed technique, best for minor nose reshaping,

• the open technique, better when a more major nose
  reshaping is required. In both cases general
  anaesthetic is used to prevent you from feeling any
  pain
Closed Rhinoplasty
• The surgeon will make small incisions within the nose
  to access and expose the bone and cartilage.
• This is done by inserting through the internal
  incisions an instrument which separates the skin from
  the structure of the nose and then removing the
  cartilage and bone.
• Once removed they are both then rearranged into the
  desired shape and reinserted.
• The nasal tissues are then spread over the new
  structure and the initial incisions closed up to
  complete the surgery.
Closed rhinoplasty makes incisions to the inner parts of the
nose. The main advantage is that the scars are invisible
Open Rhinoplasty
• Open rhinoplasty is a technique where all of the
  network of cartilage and tissues underneath the skin
  on your nose are exposed to the plastic surgeon.
• The surgeon makes an additional incision to the
  columella
• From that incision, they pull the skin up and clip it up
  so that the structure of the nose is exposed while
  they are operating on you
• The main disadvantage of open rhinoplasty over
  closed rhinoplasty is that the scar in the columella
  may be noticeable even
• Advantage of open rhinoplasty over closed
  Birmingham rhinoplasty is that the plastic surgeon can
  work on tissues, cartilages and and over-all structure
  of the nose better because they can see the whole
  nose.
• There is no general rule that open rhinoplasty or
  closed rhinoplasty is better. Each has to be used
  depending on the need.
How Long Does a Rhinoplasty Procedure
Take?

• Your nose job operation will likely take 1 to 2 hours
  with the possibility for a lengthier procedure if the
  alterations to your nose are extensive.
• Typically closed technique nose jobs take less time
  than open technique nose jobs, which can take up to
  4 hours in some cases.
 The steps of rhinoplasty operation:
• Step 1: Anesthesia - before the rhinoplasty
  operation
• Medication is administered before your rhinoplasty
  procedure begins. The two options available to you
  are intravenous anesthetic or general anesthesia.
  Your surgeon will be able to recommend the best
  form of medication for your particular procedure.
• Step 2: Incision – closed or open nose surgery
• Depending on whether it is a closed or open technique
  rhinoplasty surgery, incisions are made only inside the
  nose (closed technique), or are made both inside and
  outside the nose (open technique). Once the incisions
  are made, during rhinoplasty, cartilage is reformed
  and tissues are raised to allow for restructuring and
  alterations.
• Step 3: Reshaping – the magic of rhinoplasty
• The nose is reshaped, reformed, altered, reduced or
  augmented in size. It is in this phase of the
  procedure where surgeons work their magic to give
  patients the noses they always wanted.

• Step 4: Deviated Septum

• It is at this step of the process that if there is a
  deviated septum, it is corrected and all projections
  inside the nose are reduced to improve breathing and
  open the airways of the nostrils.
• Step 5: Closing
• Once the nose has been reshaped, redesigned and
  restructured, the skin and tissues are put back in
  place and the incisions are closed.
• Step 6: Recovering from the Rhinoplasty procedure
• Full recovery usually take a few weeks, although in
  some cases it can be quicker. The legnth of your
  recovery vary from patient to patient and from
  procedure to procedure. As mentioned earlier
• closed Rhinoplasty usually heal quicker. During the
  recover process you may also experience swelling and
  bruising over the next couple of weeks...
• Enjoy the Results of your Nose Surgery!
• This is the most exciting step of all. Whatever the
  reason for your Rhinoplasty are, after the healing
  process you will be able to enjoy your new and
  improved look.
congenital hump of the nasal bones
Deviated nose
Bulbous nasal tips
Complications & Risks of Rhinoplasty


• Infection- By carefule treatment of your nose after
  surgery we can dramatically reduce the risk of
  infection.
• Post surgery bleeding- By keeping your head elevated
  as much as possible for the 48 hours immediately
  following your surgery, heavy bleeding can be avoided.
• Skin numbness- There is a slight chance that nerves
  may be aggravated during surgery, in which case, skin
  numbness can occur.
• Persistent pain- Pain may persist longer than
  expected especially in cases where recovery
  recommendations are not followed.
• Scarring worse than expected- Although scarring is
  typically barely noticeable at all after recovery,
  depending on the nature of your body’s healing
  process and skin type, scarring may be worse than you
  expected, but there are ointments you can apply to
  further reduce any chances of noticeable scarring.
• The need for a revised surgery- In very rare cases,
  the nose may not comply with all of the desired
  alterations during rhinoplasty surgery and may
  require a second surgery in the future to restructure
  the shape once again to induce permanent change
References:
• http://www.rhinoplastybirmingham.com
• http://www.healthcentre.org.uk/cosmetic-
  surgery/rhinoplasty-types.html
• http://www.rhinoplasty-newyork.com
• http://www.rhinoplastyonline.com
THANK YOU

				
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posted:4/18/2012
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