Complex rhinoplasty refers to rhinoplasty that involves more than just routine techniques or focused only on cosmetic outcomes. Many of these patients have and prior surgery other than rhinoplasty or have had serious trauma to the nose resulting significant anatomic abnormality. Prior surgery most often includes septoplasty which can make subsequent rhinoplasty more challenging. In cases of trauma, these abnormalities are amplified if the injury occurred at an early age or if multiple injuries were experienced. In addition to problems with the appearance of the nose, the cosmetic component, many of these patients have poor nasal function in terms of reduced airflow through the nose.
Open rhinoplasty is generally required as the approach for complex problems in the nose. This technique permits improved visualization of the nasals structures. In cases where significant damage to the septum has been experienced an open septoplasty may be required to permit the best correction of the septal deformity. As the septal cartilage may be seriously disrupted cartilage for the ears or ribs may be required generate the grafts needed to complete the goals of the rhinoplasty. This is also true in cases or prior surgery were the portions of the septum have been removed.
- Additional fellowship training in Rhinoplasty by one of the world’s most respected rhinoplasty surgeons
- Published scientific contributions regarding rhinoplasty technique improvement
- Speaking engagements on nasal surgery at major scientific meetings and a nationally ranked medical schools
Complex rhinoplasty generally requires general anesthesia but is usually performed on an outpatient basis. A small splint is applied on the outside of the nose. Often soft plastic splints are placed inside the nostrils. Packing is not routinely used. The splints, both internal and external, are removed at about one week. Bruising and swelling is generally mild and lasts about 7 days. Patients generally return to school or work at about that time. A mild amount of discomfort will be felt at the ear if cartilage is borrowed from that location. Generally no change in the shape of the ear is noted. If cartilage is borrowed from the ribs there will be some mild soreness on the chest as well.