RHINOPLASTY (Nasal Surgery)

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Orange County rhinoplasty surgeon Dr. Jazayeri uses the open technique in majority of his rhinoplasty (nasal ) surgeries. This technique allow for excellent visualization of the entire nasal framework, thus minimizing the chance of asymmetry.

The open technique is also used for correction of severely deviated nasal septum and for reconstructive nasal surgery due to previous trauma or rhinoplasty surgery.

Rhinoplasty (nose surgery) is a procedure for improving the shape and the functional aspect of the nose. The shape of the nose is primarily dependent on genetics and racial background. Most patients seeking rhinoplasty are looking for a nasal shape which is proportional to their face. It is important, however, for the patient to have realistic expectations and realize the final shape of the nose is limited by anatomy and skin thickness.
Two types of rhinoplasty approach are used: closed and open.

The closed method, which is the traditional method, involves making all the incisions inside the nose and the nostrils (the holes of the nose). The advantage of the closed technique is less dissection and swelling and, potentially, faster recovery. However, the view of the entire nose is limited and the chance of asymmetry is higher.

In the open technique, the same incisions are used with the addition of an extra incision at the columella (the bridge of skin which connects the middle of the nose to the face). This allows the skin to be separated form the entire nasal frame work, allowing full view of the nose. Currently, this is the most common approach used for noses which require “the works”. The advantage of this technique is better chance of symmetry and allows certain procedures to be performed which are not possible with the closed approach. The disadvantage is the increased chance of swelling, which may take longer to subside. The columella scar is also a concern. However, if the procedure is performed by a well-trained board certified plastic surgeon, the risk of unsightly scarring is rare to non-existent, assuming a normal post-operative healing process.

It is important to realize when the outside (visible) portion of the nose is altered, it is important to address the inside of the nose as well. Typically, patients have slightly deviated septum (the supporting cartilage in the middle of the nose) and may have enlarged turbinates. The turbinates resemble worms which outline the inside of the nose, across from the septum. They are lined with nasal mucosa and help humidify the air we breathe. Typically these turbinates may become enlarged due to allergies or a significantly deviated septum. If the nasal shape is refined without addressing the septum and turbinates, the patient may end up with significant breathing problems.

After a full rhinoplasty, the patient will have a splint on the nose and packing inside. Typically, the splint and the packing are removed 7-8 days after surgery. The patient should refrain from wearing glasses or engage in any moderate to heavy physical activity for 4 weeks. Although the improvement in the nasal shape is immediately apparent, it will take at least 6 months for the final result.