Rhinoplasty is an operation performed to restructure your nose. It involves both art and science. Rhinoplasty is one of the most popular cosmetic surgery procedures performed today. It is also one of the most technically challenging. It requires an experienced and skilled surgeon who can improve the appearance of the nose while maintaining or improving nasal function. Rhinoplasty is all about technical skill, experience, art, innovation, compassion and listening to the patient.
During the surgery, Dr. Bentkover restructures the nose by removing, adding, rearranging or reshaping the underlying cartilage and/or bony architecture of the nose.
Cosmetic Rhinoplasty is performed to improve the appearance of the nose. Functional or Reconstructive Rhinoplasty is preformed to improve breathing and/or correct a traumatic injury or birth defect involving the nose. Many Rhinoplasties involve both cosmetic and functional corrections. A successful rhinoplasty is the appropriate balance of form and function.
In a Septoplasty cartilage may be removed or re-arranged in the nasal septum, the cartilage and bony wall that separates one side of the nose from the other. This is major structural support for the nose. If it is deviated (i.e. crooked), this can account for difficulty breathing on one or both sides of the nose or a major deformity of the nose. Frequently a Septoplasty is performed simultaneously with a Rhinoplasty to improve breathing and appearance at the same time. The Septoplasty could also be done purely to provide cartilage grafts for the cosmetic restructuring of the nasal architecture. It may also be done to provide cartilage for improvement of what are called the nasal valves, two well defined areas in you nose that regulate the flow of air. When a Septoplasty and Rhinoplasty are performed together, the operation is commonly called a Septorhinoplasty. Because contemporary Rhinoplasty typically involves structural or cosmetic grafting to achieve an optimal result, most of Dr. Bentkover’s operations are Septorhinoplasties.
The approaches to rhinoplasty are known by the common terms “open” and “closed” (better called “endonasal”). Surgeons prefer one or the other of these approaches in different situations, but some surgeons prefer the open approach more often or the endonasal approach more often. This is a matter of personal preference and philosophy. Both approaches can employ incisions that are usually minimally visible after surgery. There can be tiny incisions over the side of the nasal bones and incisions to narrow the nostrils in both approaches. The incisions inside the nose in both approaches are usually very similar. In an open approach these “intranasal” incisions are connected across the skin separating the nostrils (called the columella). It is made in such a way as to be minimally visible when it heals. By connecting these incisions, the surgeon can elevate the skin of the nose and view essentially the entire nose in its native state. The pros and cons of each approach are not about the choice of incisions. They are about your surgeon using an approach in your rhinoplasty through which he/she can best accomplish the surgical goals that you and your surgeon have agreed upon. For most primary rhinoplasties, Dr. Bentkover uses an open approach. In this way, he feels he has the most flexibility to get an optimal balance of form and function.
Limitations of the Operation and Realistic Expectations
In the best of all possible worlds every rhinoplasty would yield a “perfect” result. Unfortunately, there is no such thing as a “perfect” rhinoplasty. While this is certainly always the goal, certain factors can adversely affect the cosmetic and functional outcome of your surgery. Above all it is important that you and your surgeon agree on the goals of the operation. Equally important is that you have realistic expectations about the likely outcome of the surgery. Make your objectives clear to your surgeon, but also listen carefully. It is important that you hear what he/she is saying about potential limitations in your particular operation.
Factors that may limit the surgeon’s ability to give you exactly what you want or what you saw in a magazine may include:
- Thick, oily skin
- Very thin skin
- A very crooked nose
- Poorly positioned nasal cartilages
- Nasal valve weakness
An experienced rhinoplasty surgeon can make certain changes to your nose to try to compensate for some of these factors, but results may vary from patient to patient. A successful rhinoplasty is a natural blend of form and function.