The KKR ENT hospital has recently started its cosmetic surgery clinic. It largely concentrates on the aesthetics of the nose i.e., plastic surgery of the nose.  Prof. K.K. Ramalingam and Prof. Ravi Ramalingam have established this new endeavour headed by Dr. Sreenivasa Murthy TM.

What is Rhinoplasty?

The surgical procedure that refines a nose's size and shape, and improves obstructed breathing is called Rhinoplasty. Nothing has a greater impact on how a person looks than the size and shape of the nose. The goal of rhinoplasty is to create a natural, unoperated look, so that the nose fits in harmoniously with the other facial features.

KKR ENT Hospital is a center for treatment of ear, nose and throat & head and neck problems, and hence patients can advantageously be treated for both functional and cosmetic concerns at the same time. Patients will need to undergo both cosmetic and functional assessment. The functional assessment includes the taking of a full history and an endoscopic examination of the nose, sinuses and throat. CT scans of the nose and paranasal sinuses may be needed as well.

Issues such as nasal obstruction, sinusitis, allergies and snoring can all be addressed, while improving the appearance of the nose. Patients are often as delighted with their improved breathing and nasal function as with the cosmetic result.

What Can Rhinoplasty Do?

• Reduce a nose that is too large or long.
• Narrow a nose that is too wide.
• Straighten a nose that is crooked.
• Eliminate unsightly bumps.
• Reshape the tip.
• Improve the angle between the nose and the upper lip for a more youthful look.
• Alter unsatisfactory changes that occur with age.
• Increase the air flow where obstructions in the nose are causing breathing and sinus problems.

The Consultation: Factors taken into consideration

• The degree of the cosmetic concern.
• The degree of function of nasal structures
• The structure of the nose, both internally and externally.
• How the shape of the nose relates to the contour of the face.
• How the shape of the nose relates to other facial features.
• Skin texture and thickness.
• The individual ability of skin tissue to heal.
• Age and ethnic background, as this may affect healing.
• Medical history.

Rhinoplasty planning means creating a nose that is right for that patient's face. Matters such as age and gender, and the racial and cultural background of the patient have to be carefully considered. The personality of the patient is also a very important factor when planning changes to the face.

How is it Done?

There are two ways of doing this procedure :  closed and open structure rhinoplasty. The open-structure method is favoured. Open-structure rhinoplasty is not frequently executed, but we believe it is the best way to perform nose surgery. It involves a small incision between the nostrils, which leaves an almost imperceptible scar. This technique affords the best access and results, especially for a twisted nose and for tip deformities. The tip of the nose is the most difficult part of the procedure to achieve a good result with because it is made of soft cartilage, which has to be sculpted into place. Open-structure rhinoplasty is ideal for these candidates.

• First, incisions are made in the inside of the nose, where they are not visible. For open structure approach an incision may be made in the area of the skin separating the nostrils.
• Underlying amounts of bone and cartilage are removed or adjusted to provide the nose's new shape.
• The skin is then redraped over the new frame and all incisions are closed.
• A small cast is placed on the nose after the surgery is completed. A very small absorbable dressing may be placed just inside the nostrils for one day. Large packs are not used.
• Small silastic splints may also be applied for additional support. They are usually removed after 7 days.

Rhinoplasty is performed under a general anaesthetic and takes around two hours. When patients wake up, they are often surprised that pain isn't a big feature in the postoperative period, but they may have black eyes. Patients are required to wear a splint over the top of their nose and have a little stitch under their nose until both are removed at seven days.

After two weeks patients usually look completely normal but the final result can take a few months; and up to a year if it has been an extensive procedure. These final changes are usually only minor and can only be noticed by the surgeon and patient. In the short term there is a risk of bleeding and infection, but these are most unlikely. It is also rare for the patient not to be satisfied with the outcome, particularly if preoperative preparation has been thorough.

Combining Procedures

For an optimal outcome, sometimes a rhinoplasty can be teamed with other procedures. These include Thread lifts, blepharoplasty (eye surgery), lip augmentation, otoplasty (ear surgery), face lifts, facial implants, and even other rejuvenating options as simple as Botox.

Other surgeries of the nose and paranasal sinuses too can be combined in case the functional outcome is to be improved simultaneously.

Conclusion

The nose serves as the axis of the face: the static structure around which the expression, dynamism and beauty of the face find axis. For cosmetic surgery to succeed, the surgeon must strike a delicate balance between artistry and medical science. Perhaps more than any other procedure, rhinoplasty highlights the delicacy of both aspects of surgery - the art and the science - and the interconnectedness of form and function. A better nose tends to improve your health AND your looks.

The information available about this procedure is extensive. The best method of determining your personal options is to schedule a personal consultation

The information in this article is only intended as an introduction to this procedure and should not be used to determine whether you will have the procedure performed nor as a guarantee of the result.