While you might be excited about the final result of a rhinoplasty, some people also want to know exactly what happens while they are under anesthesia. Read on to learn more about what happens when you get the rhinoplasty procedure in our Fort Worth office. At North Texas Plastic Surgery, our plastic surgeons are highly trained and can answer any questions you may have about this intricate but very common surgery.
The basic steps involved in a rhinoplasty procedure in Fort Worth depends on the approach being used. For an open rhinoplasty, which is the most commonly utilized technique, a small transverse incision is made just underneath the nose on the small portion that divides the nose into the left and right side, known as the columella. The skin is then carefully dissected off of the underlying cartilages of the nasal tip that are called the lower lateral cartilages.
The skin is then elevated back and retracted to expose the upper lateral cartilages, which make up the nasal sidewalls and the septum, which is the central piece of cartilage that separates the two sides of the nose. Once they have access to the septum, the plastic surgeon can then follow that up to expose the nasal bones which sit between the two eyes. Then with the columella, lower and upper lateral cartilages, septum and nasal bones all visualized, the surgeon can begin the work of reshaping the nose.
The surgeon will take down the hump of the nose, if needed, by removing excess nasal septal cartilage and nasal bone, taking care to leave enough behind to support the nose. Depending upon the patient’s desire, the surgeon can create a ski slope shape to the bridge or a very straight bridge. In general, a ski slope or “swoop” to the nose will give a softer more feminine appearance, while a very straight bridge will give a more rugged, masculine appearance.
Next, the surgeon will work to open up the breathing passages, if necessary. This will be done by first removing and straightening and deviated portions of the central nasal septum. Then, if needed, cartilage can be placed as spreader grafts between the septum and the upper lateral cartilage to further open the airway. Finally, the surgeon may reshape the turbinate bones which help regulate airflow through the nose.
Tip refinement can then begin with performing a cephalopods trim of the “tip” or lower lateral cartilages. The purpose of the cephalic trim is to thin out little portions of the lower lateral cartilages so that they are not so bulky. The bulky lower lateral cartilage often gives patients the appearance of a bulbous nasal tip.
Next, the tip is either elevated or brought in by either adding or removing cartilage support to the columella. Once the desired amount projection to the tip is achieved, precise suturing is performed to create a beautiful narrow diamond shape to the tip.
The nasal bones are then refined using a combination of a rasp (think of a really strong nail file), osteotomes (ultra-precise chisels), and a piezotome (ultrasonic tool that uses sound waves to break apart the bone). Depending upon what is needed, these tools can be used to lower, narrow, and straighten the bone.
Once all of that is complete, everything is sewn together, and nasal splints are placed into the patient post-operatively, both inside the nose and outside the nose. The nasal splints on the inside of the nose are sewn in and usually stay for one week. Then, a splint is placed on the outside of the nose to hold the nasal bones in place that were reshaped. That cast also usually stays on for one to two weeks after the rhinoplasty.
Nasal surgery is one of the most common types of cosmetic surgery in the world. Our Fort Worth surgeons can answer any questions you have about the rhinoplasty procedure or the post-operative period. Schedule a free consultation with us, or at one of our other locations in Dallas, Plano, and Southlake.
