Asma’ ALBesher 207001176 Dr. Kamal Dr.Usama 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 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

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