Nasal Shape Aesthetic Correction (Rhinoplasty)

Aesthetic rhinoplasty is a procedure that can be used for nasal re-contouring, narrowing nasal tip, removing nasal hump, refining septal contour, altering dorsal thickness and correcting nasolabial angle.

Rhinoplasty Consultation.

It is very important to ensure that both surgeon and patient are on the same page concerning the goals and realistic expectations. Patient can explain his/her ideal appearance to the doctor, using pictures from magazines or other sources which might make the process easier. In return, the doctor will examine the nose carefully considering nasal projections, with all related angles and degrees to explain what can and can not be done. Patient’s pictures are then used to develop a 3D computer model of the face and discuss possible changes based on the surgeon’s skills, experience and specific the individual’s facial features. The generated model can also save the patient from any unrealistic expectations of the surgery. Although sometimes it is possible that the computer version of the rhinoplasty forecast is considerably different from the vision of the future nasal shape as seen by the patient. That is a good reason to reconsider complicated and difficult to forecast surgery. It is good to remember that a large but regular contour (shape) nose is always the best option.

Congenital nasal humprmity
After surgery result.

Operative technoque:
The operation can be performed under local or general intravenous anesthetic.
The reshaping and resizing of bony/cartilaginous structures can be addressed without skin accession across the skin strip at the base of the nose separating the nostrils (columella) – The closed approach, or using small "W" type incision across the columella – The open approach. Experienced surgeons should be able to master both techniques and choose the one that best guarantees the desired result. 
Nasal reshaping surgery should be performed by team of 2 surgeons (aesthetic and ENT) who do nose surgery together to treat both cosmetic and functional aspects of the disorder thus simultaneously improving appearance and function. More than 70% of our patients usually require ENT care having a diagnosis of: deviated septum, vasomotor and hypertrophic rhinitis, polyposis, internal nasal adhesions, nasal adhesions, adenoid, nasal cysts, debrides and chronic inflammations of paranasal sinuses, maxillary sinusitis, ethmoiditis, frontal sinusitis or sphenoiditis.
The surgery may take 2-4 hours - depending on what is required and may consist of two steps:
1st step functional (ENT) – offers endoscopic correction of intranasal structures in order to improve nasal function qualities (correct airway impairment). The surgical procedure is focused on nasal septum as main supporting structure of the external portion of the nose. 
2nd step aesthetic - If the “open” technique is used, a doctor makes extremely small incisions in the nasal skin in order to reshape the cartilage and bone.
Nowadays there are a great number of surgical techniques to take care of nasal aesthetic and functional problems. However the required choice should depend upon specific case conditions of this or that patient. We nominally divide all our patients into 4 categories.

• 1st group – Patients without severe (prominent) external nasal deformities but who would like to optimize the aesthetics of the nose, so called image surgeries.
• 2nd group – Deviated septum of traumatic origin
• 3rd group – Congenitally deviated nose
• 4th group – revision rhinoplasty. That is the most complicated group of patients who require a surgical corrections after an unsatisfactory result from previous nasal surgery.

In some cases, while the cosmetic result is pleasing, there may be a functional problem that hinders a person's breathing. In other cases, the nose may perform well functionally but be cosmetically unacceptable. In most revision surgery cases the nose’s skeletal support has been overly weakened from excessive removal of cartilage and bone. During revision surgery, the surgeon usually encounters scar tissue inside the nose which is very difficult and time consuming to operate.