Planning a Reconstructive Rhinoplasty

A rhinoplasty is a surgical operation to change the shape of the nose and/or improve its functionality. It can be performed for medical reasons to correct functional problems or post-traumatic or congenital deformities as well as for cosmetic reasons to change the shape and appearance of the nose. The structure of the upper part of the nose is bone and the structure of the lower part of the nose is cartilage. It is possible to change the bone structure, cartilage structure and skin structure by means of a rhinoplasty operation, in shape and size.

Rhinoplasty is one of the most difficult plastic surgery procedures with a high rate of revision. In revision rhinoplasty surgeries, the surgeon should find out the patient’s concerns and then confirm the possibility to satisfy expectations after complete internal and external examination of the nose. One of the main objectives for the surgeon who is to undertake a secondary rhinoplasty is to restore the structural support of the nose and to replace the lost volume of soft tissues. To achieve this purpose, the surgeon will often rely on grafts. An ideal grafting material must be easy to sculpt, resistant to trauma, infection and extrusion, mechanically stable, inert and readily available. For all these reasons, autogenous cartilage grafts harvested from septum, auricular concha and rib represent the first choice in rhinoplasty. In order to obtain a camouflage graft that provides natural contouring to the nose, fascia can be used. All these carefully prepared grafts are useful in tip revision surgery, in secondary surgery of the dorsum and to resolve or reduce functional problems.