CONSERVATIVE RHINOPLASTY

It is very important that aesthetic nose job is conservative since it can change completely the face.

Nasal pyramid is the center and more prominent part of the face. The main goal of my technique is to correct shape defects, improving or at least not altering the function, avoiding operated looking nose.

Many trends currently plead for open rhinoplasty, raising the whole dorsal skin and sectioning the columella, in order to “see what we do”. We think that avoiding external scars in the columella and internal ones dissecting to much the skin is very important. But we agree with the importance of the previous statement (“is important to see what we do”) and for that reason we utilize the endoscopy. We utilize a 2 mm endoscope providing a magnified visualization of the operation without wide skin undermining.

In order to remove the dorsum, the skin has to be undermined to introduce the instruments required to perform the operation and to be able to see field. If we decide to remove the dorsum using a chisel, in order to introduce it into the tissue, we have to direct the chisel downward at the beginning and then upward resulting in a slide shape nose.

However, if we want to operate on seeing what we are doing, we have to dissect the skin and raise it using a retractor. After scarring, skin appears bright and attached. These two factors make a nose to look like an operated one showing a slide shape nose with a bright skin.

Conservative rhinoplasty assisted by endoscopy represents a step forward in nasal pyramid surgery. In this technique the dorsum is removed using a 2 mm rasp (or file), introduced through a small tunnel avoiding wide skin undermining, just 2 mm. In order to have a proper view of the field and avoid leaving irregularities, an endoscope is introduced into one side of the nasal septum after limited skin dissection. In this way we are able to build up a beautiful nose avoiding operated looking appearance.

Open rhinoplasty technique is used to treat noses with traumatic deformities and cleft lip sequelae.