Aesthetics Journal: Non-surgical Rhinoplasty
Aesthetics Journal: December 2016
In the first of their two-part article, Mr Geoffrey Mullan and Mr Ben Hunter discuss the relevant anatomy for successful non-surgical rhinoplasty.
What is rhinoplasty?
Rhinoplasty is the permanent reshaping of a nose using surgical techniques that involve reshaping the nasal cartilages and sometimes nasal bones. Reshaping or trimming these structures in a reduction rhinoplasty or augmentation rhinoplasty, with cartilage and bone from the ear and ribs, allows for significant restructuring of the nasal anatomy.Surgical rhinoplasty procedures are in the top 10 most popular procedures for women and men in the UK, with 4,205 procedures recorded by the British Association of Aesthetic Plastic Surgeons in 2015.
Although surgical intervention has been indicated as popular among many patients, non-surgical rhinoplasty (NSR) can offer an alternative for those that require revision surgery such as saddle deformity, alar cartilage collapse or dorsal unevenness. who does not wish to subject themselves to the risks associated with surgery? NSR has many attractions, despite being a temporary treatment The soft tissue augmentation can give a very natural contour, even in thin-skinned patients, without the complications of surgery.For patients, the main attractions of NSR are that there is very little downtime compared to a surgical approach, a lower risk of complications. as well as it’s affordability. NSR involves the use of soft tissue augmenters such as hyaluronic acid (HA). These injectable products can be used to correct deformities that would otherwise require significant surgery, social downtime and a high cost. The use of fillers in the nose is a more subtle treatment that allows for a limited augmentation and correction of some defects and can also give long lasting results of an average of 13.5 months, however, there are reports of up to 30 months.
An interesting observation in NSR is that by adding volume to the nose, an NSR is always going to make the nose slightly larger. It is important that this is acknowledged and explained to the patient in the consultation so that they understand the procedure and outcomes. In contrast, the majority of surgical rhinoplasties or ‘reduction rhinoplasties’ are performed with the aim of refining or removing perceived imperfections or making noses smaller, although this is not exclusively so.
Although the nose can be generally treated safely, due to the nature of the blood supply in the nasal region, the short direct arteries and the anastomoses involved, it is essential that the practitioner is well educated on the anatomy and how to avoid complications if they occur. Even the best surgeons have experienced contractures and rotational deformities post surgery and injectable products can be useful tools for post-surgery complications. It must be noted that the post-surgery nose has a higher risk of complication due to altered anatomy and blood supply, so extra caution must be taken and the presence of a graft of any should be looked at as a contraindicatior most cases.
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