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Rhinoplasty 2012


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Rhinoplasty by Dr Paulose

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Published in: Health & Medicine, Education
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Rhinoplasty 2012

  1. 1. Rhinoplasty in India Dr.K.O.Paulose FRCS DLO Consultant ENT SurgeonJubilee Hospital, Trivandrum, Kerala, India.
  2. 2.
  3. 3. Rhinoplasty in Jubilee Hospital
  4. 4. The procedure
  5. 5. Types of Rhinoplasty Rhinoplasty can be done by the Open (External) or closed (Internal) technique. This will depend on where the incisions are made. Reduction and Augmentation
  6. 6. Open:External Rhinoplasty
  7. 7. Introduction Rhino (Latin for nose) and plasty (Greek for molding or forming) Greek word plastikos meaning to give something shape or form. Rhinoplasty is a surgical procedure used to modify the size and shape of the nose in order to give it a more pleasant look. Harmonize your nose and show off a really proportionate face.
  8. 8. Rhinoplasty in Ancient India Noses were symbols of pride Tempting targets during warfare. Amputation of the nose -offenses, including adultery. Sushrutha, (600 B.C.) ‘Sushrutha Samhitha‘-surgery in detail
  9. 9. Sushrutha:Rhinoplasty
  10. 10. Rhinoplasty Anatomy
  11. 11. Nasal anatomy
  12. 12. Rhinoplasty Anatomy
  13. 13. Columella Incision
  14. 14. External Rhinoplasty Procedure
  15. 15. External Rhinoplasty:Osteotomy
  16. 16. Surgeons at work
  17. 17. Surgeons at work
  18. 18. Local or GA if your nose only needs a little reshaping, you can probably have local anesthesia. If you need more extensive work, you will probably need general anesthesia.
  19. 19. Post op period Recovery may not be comfortable. Pain Bruising-swelling-edema Black eye Nasal blockage Blood stained nasal discharge
  20. 20. Complications Infection-Signs of an infection include redness, severe swelling, discharge, a foul smell, severe pain or a fever over 100.5º F. Bleeding ,hematoma ,seroma . Numbness Anosmia-temporary General Dissatisfaction
  21. 21. External Rhinoplasty Procedure
  22. 22. Rhinoplasty:Reduction
  23. 23. Rhinoplasty preoperative aesthetic evaluation The goals of aesthetic surgery are a satisfied patient and surgeon Occasionally, the patient suffers from a psychiatric illness. understand the motivation of the patient Digital images of nose and face Step ladder principle
  24. 24. Step ladder principle One cannot climb more than one or two steps in a ladder Ugly nose can be made better nose Normal nose can be made pretty nose Ugly nose cannot be made pretty Nose
  25. 25. Nose sculpturing:Types Techniques Closed and open Rhinoplasty Open Rhinoplasty better Dorsal hump reduction Shortening of lower lateral cartilage Sculpture of nasal tip
  26. 26. Septoplasty with Rhinoplasty Septal Correction Always done if needed Septoplasty corrects the functional issues of nasal airway
  27. 27. Septoplasty pre and post op
  28. 28. Septoplasty
  29. 29. Removing Maxillary Crest
  30. 30. Rhinoplasty Under GA
  31. 31. Tip Sculpturing Making the tip shorter Done by External Rhinoplasty See pre and post op pictures
  32. 32. Iliac crest and conchal graft
  33. 33. Final Suturing and packing Suturing by5x0 Ethilon and 3x0 catgut Nasal Packing: Merocel – Compressed gel-for internal nasal pack. Internal Silastic Splint- This keeps the septum in place, and removed after 5-7 days time. External Thermpolastic Splint. It will be removed in 7 days time.
  34. 34. Final suturing and packing
  35. 35. Surgery over
  36. 36. Post op recovery
  37. 37. Post op ward
  38. 38. Pre and Post op pictures
  39. 39. Pre and post op pictures
  40. 40. Pre and Post op picture
  41. 41. Pre and Post Op pictures
  42. 42. Pre and Post op pictures
  43. 43. Unrealistic Expectation Selection of patient Pre op counseling “film star Nose”
  44. 44. Pre and post op picture
  45. 45. Pre and Post op picture
  46. 46. Pre and Post op pictures
  47. 47. Pre and Post Op pictures
  48. 48. Pre and Post Op pictures
  49. 49. Best Candidates for Rhinoplasty Those looking for improvement, not perfection Those that are physically healthy, psychologically stable, and have realistic expectations Age -not to operate on teenagers until after they have completed their growth spurt.
  50. 50. THANK YOU,