Home, Rhinoplasty (Nasal Surgery), Videos

June 12, 2011

Dr. Mele discusses Rhinoplasty (aka: Nasal Surgery, Nose Surgery or the Nose Job) on the San Francisco Bay Area's News Station, KRON4.

So what is the latest in Rhinoplasty Walnut Creek? San Francisco Bay Area plastic surgery patients want to know. I explore the topic with an eye on history because new nasal surgery techniques come and go, but the truly great ideas persist. The basics of the “modern” rhinoplasty have been around for centuries; however, the advent of safe and effective anesthesia has allowed us the operative time to work on the fine details with high patient satisfaction.

Closed Rhinoplasty vs. Open Rhinoplasty

The debate over which technique is better, closed rhinoplasty or open rhinoplasty, continues to this day. Each provides some advantages and disadvantages, and the final determination of which technique is best for your nose will depend on an careful, professional evaluation by a Board Certified Plastic Surgeon or Board Certified Otolaryngologist (also called Facial Plastic Surgeons though the ABMS does not recognizes this as a separate Board Certification).

Closed Rhinoplasty

Prior to the 1900’s, most rhinoplasty was performed “closed”. Pioneers like Joseph, Freer, Killian and Cottle showed us what can be done with the closed rhinoplasty technique, and many of the instruments used for septoplasty today, still bear their names.

The closed rhinoplasty avoids the small incision between the nostrils necessary for the open technique, and closed nasal surgery works well for dorsal reductions and narrowing of the boney and cartilaginous nasal sidewalls. For these standard rhinoplasty modifications, the open technique does not provide much advantage.

Since the closed technique incisions are all inside the nose, they are hidden. However, the small external scar needed in the open technique usually heals extremely well and is very difficult to see in most circumstances. The closed technique may have less post-operative tip swelling, but when similar operations are performed, it is difficult to demonstrate the difference.

Open Rhinoplasty

Open rhinoplasty was advanced by Rethi, Padovan and Goodman for the tip rhinoplasty, and was advocated for its superior visualization of the nasal anatomy.

The difference between open nasal surgery and closed nasal surgery is the 1/4 inch incision made between the nostrils. This small incision allows the nasal skin to be lifted, like the hood of a car. While the nasal tip cartilage can be seen with the closed approach, it is necessary to deliver one side at a time for tip work. The open technique reveals both sides simultaneously, and facilitates the symmetry of the result.

Nasal Autografting

Another leap forward in the advancement of the 21st century rhinoplasty was the use of autografting. Cottle, Skoog and more recently Sheen, described combining resection of the nasal dorsum (the bump on the nose) with augmentation to achieve an aesthetic nose. The technique involves removing cartilage from where there is an excess, and adding it to areas of deficiency. Sometimes the amount removed is insufficient, and additional cartilage is borrowed from the nasal septum, ear and less commonly the rib.

Nasal Surgery (Rhinoplasty) Video

Below is a nasal surgery (rhinoplasty) video from a recent appearance on KRON, channel 4. The show is Body Beautiful with host, Vicki Liviakis. Be certain to tune in to channel 4 tomorrow, at 11:00 AM, for my next appearance.

What follows is final segment of a special presentation on cosmetic nasal surgery (nose jobs). The 800 number in this nasal surgery video was only for the live show so viewers could call in with their questions. If you have questions about nose surgery, please give me a call at (925) 943-6353, or use the contact form on the left. Additional information and links are available at the end of this post.

Nose Job Video on KRON4’s Body Beautiful

Rhinoplasty (Nasal Surgery) Questions

This Rhinoplasty (Nasal Surgery) Video includes:

Do all Rhinoplasties look the same?
Cookie cutter vs. personalized nasal surgery?
The role of Computer Imaging in planning for cosmetic surgery of the nose?
Treatment of the broken nose.
What is Rhinoplasty revision surgery?
How often is revision of a nose job needed?
What is secondary rhinoplasty?

Additional Information on Nasal Surgery, Rhinoplasty and Nose Jobs

This is part 4 of 4 in a video series on Rhinoplasty (Nasal Surgery) in the San Francisco Bay Area. Additional segments can be found here:

Nasal Surgery (Rhinoplasty) San Francisco Bay Area Nose Jobs

Click the links below for additional information on: