Open Rhinoplasty- An Advancement in Modern Nasal Surgery

Serving Chattanooga, Tennessee

osmetic nasal surgery is a powerful tool in improving facial aesthetic appeal. Formally known as rhinoplasty, it can also present some technically demanding problems to the nasal surgeon.

Most patients with cosmetic issues concerning their nose arrive at their surgeon’s office with one thought in mind--- make my nose look better. It is only after some coaxing that we begin to define each patient’s specific concerns. The first issue that must be handled is nasal function. The field of rhinoplasty has evolved immensely in the last decade. Gone, thankfully, are the days of the cookie cutter nose-job which worked for some people, not for others, and actually created some functional deformities.

The premier task of the top shelf nasal surgeon is to combine functional assessments and improvements with aesthetics. Your surgeon should be concerned with how you breathe at rest and with exertion. Considerable study has been made of nasal air flow dynamics and how surgical interventions can improve or worsen this balance.

Examination of the nose should include a thoughtful assessment of all the structures of the nose. This includes an external as well as internal evaluation. Note should be made of all deformities which are both functional and cosmetic. With this information in hand, an informed approach to alteration of the nose can be undertaken. I like to take the patient through sketches of the disturbed anatomy indicating how each operative intervention is designed to produce its intended effect. A computer imaging system is helpful in giving each patient an idea of the external changes; however, it is equally important that the functional changes are also grasped.

Rhinoplasty is an outpatient procedure, and I typically perform it under a general anesthesia. I believe that one of the greatest recent advances in nasal surgery is the open approach. Open rhinoplasty involves using an incision in the column between the nostrils to expose all the external and some of the internal structures of the nose. With the soft tissue and skin elevated from the underlying cartilages and bones, very exacting control can be exerted on their structure.

This includes operatively controlling their shapes, moving the nasal bones as desired, and adding specific supportive cartilage grafts where needed. All these maneuvers have now become the standard for excellence in cosmetic and functional nasal surgery. Facility with these techniques allows the surgeon to produce reliable results in wide ranging nasal deformities. The open rhinoplasty offers the surgeon the ability to envision the postoperative result while in the operating room by directly visualizing the altered nasal structures.