What is Reconstructive nose surgery?

Reconstructive rhinoplasty is usually referred to a surgery that nose is disfigured in some way (primary surgery, accident, … ) and it’s necessary to perform another nose surgery. In another word Reconstructive means rebuild the nose, whatever that may mean for each individual case.

For some patients, this is done with a simple gel injection. For other patients, this may require a full open rhinoplasty surgery and complex reconstruction involving the entire nasal structure.

The difference between reconstructive surgery and primary surgery and how to do it

How is secondary nose surgery performed?

In this surgery, according to the existing problems, the following measures are performed:

• To remove the remaining hump, the nasal bone is cut enough to improve the shape of the nose and remove the hump.
• In noses where the tip of the nose is drooping, the cartilage is strengthened to eliminate the problem of drooping. In this case, a cartilage transplant must be performed, and if there is not enough cartilage in the nose, the cartilage is removed from the patient’s eardrum or ribs.
• If the middle septum of the nose is deviated, it is smoothed with the help of surgical techniques to eliminate the deviation of the nose.
• The nasal tubes are also symmetrically shaped to make the holes look as uniform as possible.
• All factors that cause breathing problems should be identified and addressed.

What methods are used to correct the nose?

In reconstructive surgery, like the initial operation, two open and closed surgical techniques are used.

Open method:

 The advantage of this method is the open and wide field of view of the surgeon and the surgeon can make deeper changes without error and with more space. For this reason, this technique is a better method for rhinoplasty, which is more sensitive than the first operation. Also, if the surgery is performed delicately and carefully, no sutures will remain on the nose.

Closed method:

 This method is done in a closed way, i.e. without cutting and opening the nose. Rhinoplasty is one of the most difficult operations in the field of cosmetic surgery, which requires a lot of delicacy and precision. When the skin of the nose is not removed, the surgeon has very limited access to the structure of the nose and therefore cannot make many changes. Most specialists recommend open revision surgery to give the surgeon more access to the nasal structure.

Strengthen nasal cartilage

Use of graft (tissue transfer) in rhinoplasty

 In rhinoplasty, the doctor has to use tissue transfer from other parts of the body to strengthen the nasal cartilage. In primary rhinoplasty, the surgeon usually does this with the help of the nasal cartilage (also called an auto graft); But in the second surgery, if there is not enough cartilage in the nose, the surgeon will have to use cartilage in the ear or ribs. This does not cause any problems for the patient and the incision is very small and will not cause pain.

Use of artificial prosthesis for repair

 If the surgeon finds the amount of nasal cartilage insufficient and on the other hand finds that the thickness of the cartilage in the ear and ribs causes the nose to be deformed, the artificial prosthesis will replace the graft method. These prostheses are silicone and come in different qualities. A good surgeon chooses the best type of prosthesis to prevent problems caused by the prosthesis.

What is the difference between nose repair and primary surgery?

In the second surgery, the patient’s condition is different, both in terms of the structure of the nose and in terms of mood, and for this reason, the doctor has to work harder. The most important differences between this surgery and the first operation are:

Nasal structure is damaged

 In the first operation, all tissues and skin of the patient are healthy and the ENT specialist can easily apply the desired changes. But in the second surgery, these tissues were changed and damaged. For this reason, the surgeon must be more delicate and precise so that the changes cause the least damage to the nasal tissue.

Dissatisfaction of the patient with the first operation

When a person wants to operate on his nose for the first time, although he is naturally anxious and stressed about the final shape of his nose, he has high hopes for the outcome of the surgery. However, most people who want to have rhinoplasty for the second time come to the operating room in a weaker mood and worry that the result of rhinoplasty will not be satisfactory again. On the other hand, these people may have been reprimanded or ridiculed by those around them for tolerating the inappropriate shape of their nose after the first operation, and as a result, they may have lost their self-confidence. A good reconstructive surgeon should give the patient morale and hope that the condition will improve.

Long duration of operation

 Another difference between the second operation and the initial operation is the long duration of surgery. Due to the complexity of the secondary operation, the surgeon needs more time to make changes. This may take up to 3 hours.

read more : What is Reconstructive nose surgery? - beauty magazine (butmag.com)