[Nose Surgery] Everything About Rhinoplasty That No One Tells You - Nose Surgery Q&A Time!

Hello.

This is April 31 Plastic Surgery.

Today, we will bring you a

Nose Surgery Q&A Time

that no one has told you about before.

Q. My first nose surgery!

At what age is rhinoplasty possible?

In general, it is said that midface growth stops around

age 17–18.

These days, people tend to mature earlier,

so in conclusion, for a simple nose surgery,

it is possible for high school students.

In Korea, we inevitably have to consider fields such as college admissions and auditions,

so depending on the type of surgery and psychological readiness,

simple procedures can also be done earlier.

However, considering various social and cultural factors,

it is possible during the high school years depending on the pace of growth,

but we usually recommend delaying it if possible.

Q. Nose surgery can’t be done just once?!

That is not true.

Except for deformities caused by congenital anomalies or trauma,

general cosmetic rhinoplasty is performed on the principle of doing it once.

However, you often see many people around you who undergo revision rhinoplasty.

There are broadly two reasons for revision rhinoplasty:

dissatisfaction and complications.

If a problem occurs after surgery and it has to be done again,

revision surgery is necessary.

But in the case of revision surgery performed because of dissatisfaction with the appearance,

it may be a kind of right to enjoy cosmetic surgery as a modern person,

so I do not think it is wrong.

For this reason,

we explain expectations and narrow the range of what can be done,

so we tend to recommend revision surgery.

Q. For a first surgery to raise the nose,

is it okay to use autologous dermis?

It is possible,

but considering the donor-site scar

and accounting for the absorption rate and engraftment rate,

it is generally not recommended for a first nose surgery

that raises and shapes the nose.

The side effects of implants vary depending on the paper,

but they are reported to be around 6.5%.

This includes all side-effect figures for the unstable silicone materials

used for more than 100 years,

as well as the L-shaped silicone implants that had many side effects.

Therefore, when only silicone is used for the nasal bridge,

as in recent trends,

the probability of side effects is thought to be even lower than that.

To avoid the small chance of side effects,

harvesting autologous dermis for a first surgery

is not recommended when weighing the risks and benefits.

However,

1. People who strongly dislike implants
2. People with a crooked nose who need osteotomy and also want a higher bridge
3. People with a low nasal bridge and a hump

can still create a natural-looking nose with autologous dermis,

even for a first nose surgery.

Please think carefully about what is most important to you

and discuss it with the medical staff.

Q. If the skin is thick,

is it hard to make the nose tip look pretty?

Compared with thin skin, thick skin is a little more difficult to shape,

but with advanced techniques,

the nose tip can be made beautiful.

Thick skin means there is a lot of subcutaneous fat,

or the dermis, including the SMAS layer just beneath the skin, is thick.

Even if the cartilage tissue that makes up the nasal tip is carefully refined,

it does not show well,

so procedures are applied to address this.

The fat layer is effectively removed,

and the cartilage layer may be shaped more sharply or grafted cartilage may be placed more precisely.

Sometimes the thin fascial layer called the SMAS is also carefully released.

Q. If not the nasal bridge, but only the nose tip and columella volume are being increased,

is autologous dermis good to use?

We do not harvest autologous dermis from the buttocks

just to add volume to the nose tip and columella.

That amount is sufficiently achievable with other autologous tissues,

not buttock autologous dermis.

To reinforce thinned nose tip skin

or to add volume to the columella,

we harvest and use fascia from behind the ear.

It is harvested through the incision line behind the ear, that is, the ear cartilage harvest site.

There is no burden from scarring,

and although not as much as buttock dermis,

an amount sufficient to reinforce the nose tip or columella can be harvested.

It can both reinforce thin skin and add volume.

Depressions or deformities of the columella or nose tip are difficult to repair,

but sometimes fascia from behind the ear is grafted first to create volume,

and after time has passed for surrounding scars to soften,

they are corrected later with a simple secondary scar revision.

Q. What kind of anesthesia is used during nose surgery?

Anesthesia for nose surgery depends on the type of surgery

and what kind of autologous biological material is used,

but in general, the surgery is performed under sedative sleep with local anesthesia,

in a state where pain cannot be felt.

In some cases, such as reconstructive surgery,

if a large amount of costal cartilage needs to be harvested,

the procedure may be performed under general anesthesia.

Today, we had a Q&A session about rhinoplasty

that is not explained anywhere else.

We will come back next time with useful content.

April 31 Plastic Surgery

does not simply follow trends,

but strives for natural beauty while thinking about the next 10 or 20 years.