Rhinoplasty was first performed in India thousands of years ago, using only a few simple tools. As the techniques for the procedure evolved throughout the centuries, tools were slow to change. While technology has advanced a great deal and provided today’s surgeons with a number of innovative tools, some classic implements are still used. If you are interested in undergoing rhinoplasty surgery, or are simply curious about how this complex and popular surgery is performed, read on to learn more about the tools of the trade. Tools today may seem basic, but this is because the surgeon’s technique is the most important factor in rhinoplasty surgery. The tools currently in use are meant to create the best possible lasting outcome with the least amount of discomfort for the patient.
The scalpel is used for making incisions. These incisions are made internally and externally during an “open” rhinoplasty or internally during a “closed” rhinoplasty. Scalpel blades are very sharp and strong to help minimize scarring following the procedure. Even “open” rhinoplasty only leaves a very small and discreet scar that often fades so it is nearly imperceptible.
Manual and powered rasps and diamond drills are used to smooth and trim nasal tissue. Rasps are commonly used to help file down and even out bony dorsal humps. Depending upon the size and shape of the hump, the bone may be cut or broken with the aid of an osteotome (description following) before rasping is performed. For small humps, sometimes this is unnecessary.
Osteotomes (Bone Knives)
For many nasal reshaping procedures, the nose must be broken or nasal bones are cut and moved. The osteotome, or bone knife, can help with these maneuvers. These are very sharp so as to disturb the surrounding tissue as little as possible. Osteotomes are also useful for narrowing the nose or correcting twisting. When bones must be broken, osteotomes are often used along with a mallet.
These tools are different from one another, but serve similar purposes. Forceps, retractors, and skin hooks can pull tissue out of the way, separate, and allow the surgeon to see what he or she is working on.
As with most operations, sutures are nearly always necessary to close wounds and facilitate proper healing. Some surgeons use absorbable material for suturing, while others prefer sutures that must be removed following surgery.
Power Tools Reduce Trauma
Manual tools have given good and even excellent results for skilled doctors in the last century, but the newer rhinoplasty power tools offer many benefits to both the surgeon and the patient during and after rhinoplasty. New power tools such as saws and rasps are often superior to their manual predecessors, as they minimize trauma to the nose and allow the surgeon to work more quickly and precisely. Manual rasps, though they produce beautiful results when used by a competent surgeon, often cause temporary damage to soft tissue in the nose. This cancan increase the necessary healing time, cause more swelling, and/or causing aesthetic irregularities. Power rasps are less likely to disturb surrounding tissue, and are efficient to use. Other power tools in use currently are saws and drills.
Other Tools: Imaging Software
An important piece of equipment that is used before the surgery is even scheduled is imaging software to help doctor and patient get a preview of what the nose should resemble after surgery. It is very important for rhinoplasty patients to have realistic expectations about the surgery, and imaging technology greatly reduces misunderstandings between patient and surgeon, allowing for better communication and planning. Of course, the finished product will never look exactly like the image preview, but this preview can give the surgeon a template to work from. You will also appreciate having these images, along with before and after photos, to compare your outcome to.
The Most Important Tool
The most important tool in a surgeon’s arsenal is his or her own skill. The success of a rhinoplasty largely rests on the surgeon’s experience, technique, skill, and artistry. It is not always easy to find the right surgeon for you, but it is essential to the success of your eventual outcome that you find a board certified rhinoplasty expert you feel comfortable with and whose outcomes appeal to you. You should perform a great deal of research on prospective surgeons before you attend consultations with your top picks. If you are not sure where to begin, consider speaking with acclaimed rhinoplasty specialist Dr. Stuart Bentkover in Worcester (508-363-6500) and Stoneham (617-247-0033), MA. Rhinoplasty is Dr. Bentkover’s passion, and he has a high rate of patient satisfaction that speaks for itself. Dr. Bentkover developed his own power rasp in the 1990’s and now uses a diamond drill to help assure a very smooth profile. Under direction, vision during an open rhinoplasty he smoothes down the hump of the nose. He also uses the diamond drill to precisely shape cartilage grafts.To schedule a rhinoplasty consultation with Dr. Bentkover, contact Bentkover Facial Plastic Surgery at either location above or visit Dr. Bentkover’s website to learn more and request an appointment.