Reduction Rhinoplasty – Long Nose Cosmetic Correction
Young lady who has long desired to undergo cosmetic nose correction for long nose The patient is a 23-year-old female from Nagpur in Maharashtra, India. She has always felt that her nose was not in harmony with her cheek bone structure. Feeling that it did not suit her facial features, she had long desired long nose cosmetic reduction surgery. Her parents had said that she needed to finish her studies before she underwent this procedure. Having finished her studies, they decided that this was the ideal time to do this. They had approached a leading plastic surgeon in her hometown for this. He undertook various facial analyses to study her nose and its relationship to her face. Realizing that this needed to be performed by a rhinoplasty specialty surgeon, he had referred them to our hospital. Our hospital is a leading facial cosmetic surgery hospital in India. We perform both cosmetic nose surgery as well as nasal deformity surgery. Cleft rhinoplasty correction is a superspecialty offering in our hospital. Cleft lip nasal deformity rehabilitation has restored the lives of many patients. We have two state of the art operating theaters for performing all surgeries. Many successful celebrities from fields as diverse as media, films and sports have undergone corrective rhinoplasty at our hospital. The patient and her family immediately got in touch with our hospital manager. She said that she wanted a cosmetic nose job. They were asked to report to our hospital for an initial consultation. Initial presentation at our hospital for definitive correction of her long nose deformity Dr SM Balaji, cosmetic rhinoplasty specialist, examined the patient and obtained a detailed history. She expressed her displeasure at the length of her nose. Another issue that bothered her was the breadth of her nostrils, which she felt were excessively flared. She desired to undergo cosmetic correction of these two issues. A closed rhinoplasty would be the ideal approach to avoid scar formation. He then ordered detailed facial measurements along with nasal dimensions for the patient. Various cephalometric and other parameters were then utilized to determine the best nasal form for the patient’s face. The patient was educated about cosmetic surgery and what to expect from it. Time was spent listening to the patient to understand her expectations better. A detailed treatment plan was then formulated to address the patient’s issues. This would involve reduction of the nasal cartilages to reduce the length followed by Weir excision for alar reduction. The procedure was explained to the patient and her parents who consented to the surgery. Successful reduction of the length of nose to a perfectly esthetic form The patient was prepped and draped for surgery. Careful measurements were made pertaining to all the surgical landmarks. Under general anesthesia, intranasal incisions were made and the lower lateral cartilages were reduced. This was then followed by reduction of the upper caudal part of the nasal septum. A T-shaped strip of cartilage was then removed through an intranasal transcartilaginous incision to reduce the length of the nose. This was followed by stripping of the perichondrium. All incisions were then closed with sutures. Attention was next turned towards correction of the broad alar base. Measurements were made and this was then corrected through a Weir excision procedure. Incisions were again closed with sutures. This resulted in a nasal form that was in perfect harmony with the patient’s facial features. Total patient satisfaction with the results of the cosmetic nasal correction The patient who works in the media was ecstatic over the results of the surgery. She expressed that she now has the nose that she had always desired. Her parents were also very happy with the results of the surgery. She said that she would now be able to concentrate on her profession with a greater level of self confidence. The patient stated that being in the media required being confident about one’s appearance. They expressed their heartfelt gratitude before final discharge from the hospital. Surgery Video
Parry Romberg’s Nose Lip and Chin Asymmetry Correction with Reduction Rhinoplasty
Mechanism of Parry Romberg syndrome explained Parry Romberg syndrome is a rare neurocutaneous syndrome of unknown origin. It causes progressive hemifacial atrophy. This is often sporadic in its course. It leads to shrinkage of tissues underneath the skin. Only one side of the face is often affected. It also rarely extends to other parts of the body. Females are most commonly affected by this disease. Onset is often between 5 to 15 years of age. Other associated morbidities include those of a neurological, ocular and oral nature. Severity of this condition varies between patients. Patient with Parry Romberg syndrome referred to our hospital This middle aged male from Tirupati presented to our hospital for management. He has undergone previous surgeries elsewhere. The patient presented with nose, lip and chin asymmetry. He desired establishment of symmetry to the face. Treatment planning and surgery explained to the patient Dr SM Balaji examined the patient and ordered diagnostic studies. He explained that fascia lata graft from his thigh needed to be harvested for this surgery. The patient agreed to the treatment planning and consented to surgery. Successful surgical correction of the patient’s facial asymmetry Under general anesthesia, an S shaped incision was first made on his lateral thigh. The incision was then closed after harvesting a fascia lata graft. Attention was next turned to the chin asymmetry. A vestibular incision first made in the anterior mandibular region. Dissection was then carried down to the chin and an osteotomy done. The osteotomized piece of chin bone was then repositioned and screwed in place. This resulted in establishment of chin symmetry. The incision was then closed with sutures. Attention was next turned to the upper lip. A midline incision was then made on the inner aspect of the lip. The fascia lata strip was then tunneled from the corner of the lip on the left to the midline incision. This was then sutured and secured. This resulted in establishment of lip symmetry. Attention was then turned to the nasal asymmetry. Intranasal incisions ensured absence of any visible scars. Lateral osteotomies were then performed of the nasal bone. The medial cartilage was then partially excised from the nasal septum. This resulted in good nasal symmetry. The patient recovered from general anesthesia without event. He expressed his happiness at the results before final discharge from the hospital. Surgery Video