5 November, 2019
Rhinoplasty is the oldest plastic surgery procedure known to have existed, and is still one of the most popular today. While techniques have improved since the first documented rhinoplasties during the time of the Ancient Egyptians, it’s purpose has stayed the same – to reshape the nose to the patient’s desired shape, size and function. A/Prof Mark Gianoutsos, Specialist Plastic Surgeon in Sydney has extensive experience in nose reconstruction and explains different techniques, which ones he prefers and what patients should keep in mind when planning a rhinoplasty.
A/Prof Gianoutsos says like most areas of cosmetic surgery, the key to rhinoplasty is a natural result that suits the patient’s face. “When planning a rhinoplasty it requires careful examination and assessment of not only the anatomy, but the wishes of the patient. As well as the aesthetic imperative of such surgery, functional considerations must also be taken into account. This often means that surgery to improve the nasal airway is performed at the same time.”
Generally, there are two approaches to rhinoplasty. Different surgeons prefer different approaches, and of course it also depends on the patient’s individual nose and the work involved to create the end result that can affect the approach, but A/Prof Gianoutsos says he largely uses an open approach. “This involves a small, stepped incision across the columella (the strip of skin and cartilage which joins the tip of the nose to the upper lip) and the skin being elevated to display the structural elements of the nose (bone and cartilage) which can be changed in shape, size and position to achieve the desired result. Often the nasal septum and turbinates are addressed at the same time to improve breathing.”
Dr Gianoutsos says it’s important to consider the individual patient’s face and anatomy as while Kate Middleton, the Duchess of Cambridge’s nose is one of the most requested, her size, shape and profile won’t suit everyone. “It’s about creating balance and harmony with the rest of the patient’s features. “This will help to avoid the ‘operated look’. We can certainly take inspiration from famous noses, but ultimately, it’s about what will suit the patient as an individual.”
A/Prof Gianoutsos says generally rhinoplasty surgery is performed under general anaesthesia as either a day surgery procedure or with an overnight stay in hospital depending on the patient’s wishes and difficulty of the procedure.
“A customised molded nasal splint is placed after the surgery and if the septum has been operated upon an internal splint is placed also. Following surgery you will have cool packs on your eyes to minimise swelling and bruising. Any pain can be managed well with medication and we generally recommend two weeks off work.”
To see more of A/Prof Gianoutsos’ patient before and afters go here, or you can also see more on his website. If you have any further questions for A/Prof Gianoutsos you can leave them in the comments section below and he will answer them for you.