Archive for the ‘Rhinoplasty’ Category

Rhinoplasty requires great attention to detail. It is best, however, not to postpone the surgery indefinitely. The overlying soft tissue on the bridge of the nose is not sufficient to conceal even the slightest irregularity. With aging, the skin loses elasticity and may not adapt to the new shape. Development of scar tissue beneath the skin may alter the result desired by both patient and surgeon.

The concept of an attractive nose is very individual – what one person likes, another does not. A nose may protrude too much or not enough. It may be hooked or depressed. The tip may be bulbous or pinched; it may turn up or turn down. The septum may deviate, or it may be markedly crooked. The nose is rarely symmetrical; even the beauty queens of Hollywood constantly request that the cameraman take their “best” side.

It is necessary for the surgeon to understand exactly what the patient is looking for. The patient’s desires and the surgeon’s abilities can be clarified by the study of black-and-white photographs. The desired changes can be drawn on the photos until both surgeon and patient are satisfied.

Rhinoplasty can be done under local or general anesthesia. Young people often prefer to be asleep during the operation. If general anesthesia is used, endotracheal intubation is performed: a breathing tube is inserted through the mouth into the trachea (windpipe) to prevent blood from getting into the lungs while the patient is unconscious. When general anesthesia is used, most surgeons also inject local anesthesia containing epinephrine into the tissues to limit bleeding that may obscure the operative field. The anesthesiologist must be able to prevent excessive bleeding, which is not only dangerous for the patient but difficult for the surgeon.

The surgery itself is performed through incisions within the nostrils unless the nostrils themselves are to be decreased in size or otherwise shaped. Through these incisions, the soft tissues are separated from the underlying bone and cartilage. The cartilage of the tip is modified and the undesirable bone hump is removed by saw or chisel and filed for smoothness. The lateral nasal bones are fractured inward to recreate the pyramidal form of the upper part of the nose.

If, on the other hand, the dorsum (ridge) of the nose needs to be augmented, cartilage or bone can be inserted into the pocket between the bone and skin. Nasal septal cartilage is often used. Large defects can be filled with some type of synthetic material.

When crookedness of the nose is caused by deviation of the septum (the cartilage on the inside of the nose that separates the two nostrils), a modification or resection of the septum is indicated.

Endoscopy is a surgical technique used for many years to perform knee operations and gall bladder operations. It has only recently been applied to rhinoplasty. In this innovative procedure, tiny incisions are made in the skin through which are inserted small straw-sized tubes containing a viewing scope and microsurgical instruments. The viewing scope, which functions like a camera, is connected to a video monitor onto which it projects a greatly magnified image, enabling the surgeon to operate by viewing the surgical site on the screen.

Michael Russell

Your Independent guide to Cosmetic Surgery

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Michael Russell – EzineArticles Expert Author

The cost of a rhinoplasty procedure can vary greatly from region to region, city to city and doctor to doctor. Just as in any field, including medicine, there are groups and people that provide low cost, operations for large volume client bases on low budgets and higher cost operations to superstar medical personalities willing to pay astronomical prices. After doing research beforehand and paying attention to published reports on plastic surgery, one can easily find the names of plastic surgeons in the Southern California area, or any area, who have worked on famous celebrities. However, whatever your budget and approach, you can save money by researching the topic, making an informed decision and consulting with several doctors or groups until you find the one who makes you feel comfortable, and who is charging what you are willing to pay for the procedure.

Simply stated, without honing in on a specific location or naming a particular doctor, rhinoplasty costs should range from a minimum of $3,000 to no more than $12,000. This is the cost of hiring the surgeon only – there are a variety of other fees involved in the procedure regardless of who performs the work and where it is performed. The amount of work necessary is also a predominant factor in the final cost.

By using this simple cost analysis, dividing the total amount of money spent on rhinoplasty cost over several years compiled by the American Society of Plastic Surgeons (ASPS) and arriving at an average total cost, each rhinoplasty performed in America averages out to approximately $4,500. That total appraisal includes the surgeon, the anesthesiologist, the facility fee and any other charges that a particular doctor or group of doctors may charge. If your quote from a doctor you have consulted with is substantially lower than the average, be sure to ask questions and ask to speak with former clients. Find out if this man has a philanthropic approach to medicine. Find out if there have ever been lawsuits filed against him. Keep asking until you leave or until you feel comfortable enough to proceed further in the relationship. Just like anything else in life – if it sounds too good to be true, it usually is.

In general, unless your rhinoplasty procedure is of the most minimal type, perhaps a small bump or growth being removed or altered, you’re going to need to be asleep for the procedure and that requires the skill of a good anesthesiologist. Usually, when you hire your doctor, you don’t have a choice over the anesthesiologist – you simply use the one he’s got on his staff or the one that he’s most comfortable working with. In general, an anesthesiologist should charge approximately $700 to keep you safely asleep for the time necessary for the operation. Remember to tell everyone you speak to if you have any allergies to any medicines or if you are currently taking any medicines as they may unfavorably interact with the anesthesia.

No matter where the doctor and the anesthesiologist are going to perform the surgery, there will be a cost for the facility. This cost includes and nurses or other staff necessary for the procedure, equipment and supplies to be used and the facility’s general overhead. If the work must be performed in a hospital, there is going to be a higher charge involved than the fee charged for a simpler office procedure. Finally, this fee will include any costs involved in the anticipated recovery after the surgery. If a small procedure has been performed and a local anesthetic was administered the patient may be up, walking around, feeling fine and ready to leave after a final examination by the surgeon. However, if the work was more complex, if an anesthetic was necessary to keep the patient asleep for several hours, and if the pain quotient is expected to be higher due to the nature of the problem being addressed, it will be several more hours before the patient is examined and allowed to leave. All of these factors will affect the facility fee and should be completely discussed beforehand.

In some instances, the doctor may be offering a package price. If this makes you uncomfortable for any reason or if the total price for the work you are requesting does not feel proper, ask for a breakdown. If his breakdown does not conform with these averages, or if his explanations do nothing to allay your concerns, get a second opinion.

Rhinoplasty Info provides comprehensive information on preparing for and recovering from rhinoplasty, as well as costs, surgeons, and procedures, including revision rhinoplasty. Rhinoplasty Info is the sister site of Dental Implants Web.

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While most people have heard of rhinoplasty or nose surgery, most do not know what the procedure entails once you enter the hospital operating room.

Once you are in the operating room and have spoken with the people who will take care of you during the surgery, the anesthesia will be administered. The exact type of anesthesia used will depend on the duration and complexity of the surgery about to be performed, any allergies you may have to any of the anesthesia drugs available, and the preference of the surgeon and anesthesiologist. Before any incisions are made, before any intrusive procedures begin, the nose is anesthetized with a local anesthesia either lidocaine or marcaine with epinephrine. This is used to numb the tissue, the surrounding cartilage and facial bones and further protect the patient from feeling any of the surgery. In addition, many surgeons use a diluted form of cocaine possibly mixed with epinephrine to shrink the mucous membranes inside the nose as well as to seriously reduce blood flow to the area.

There are two basic approaches to rhinoplasty and depending on the artistry and sophistication of the surgeon and the type of work required, either approach may be employed with equally indiscernible success.

1. Internal (endonasal) rhinoplasty – here the surgeon makes incisions only on the inside of the nose, opens the skin up and proceeds to do his work without making any incisions on the external facia. Internal rhinoplasty requires more skill and artistry to perform and can only be properly employed in cases where the amount of surgery being performed is minimal or at least of such a nature that all of the work can be reached from the interior of the nose.

2. External rhinoplasty or open-tip rhinoplasty means the doctor is making incisions on the outside of the nose, at the crease where the nose joins the face so that there is no discernible scarring after the procedure has been completed. Open-tip rhinoplasty is usually employed where the surgery requires more extensive removal or manipulation of the skin and cartilage tissue.

Either of these procedures can be performed utilizing a local anesthetic or a general anesthesia and can usually be completed anywhere from two to four hours again depending on the complexity of the work being performed. Using either the internal or the external incision methods, the skin and cartilage of the nose is exposed and the surgeon can then begin the artful process of sculpting the existing tissue to achieve the desired goals of the patient.

Remembering that rhinoplasty is really more art than surgery, the doctor will frequently refer to the photographs and notes he has made prior to the procedure. He will carefully check the symmetry of the shape of the nose and make sure that the changes he is making are the right ones to achieve the desired result. Very small alterations, incisions as small as a millimeter or two, can make large differences after the swelling has gone down in the overall appearance and balance of the finished look. This is the artistry of the surgeon you have selected.

When the surgeon has completed the sculpting process, he will carefully check the blood vessels in the area to see if they have been affected by the surgery, he will measure the nostril openings to see if they conform to his pre-op notes and measurements and then he will begin the process of closing up the nose. Small sutures will be used to close the incisions made during the procedure whether internal or external. These incisions are similar in size and form to the ones employed by heart surgeons when they are closing up small veins and arteries after cardiovascular surgery.

Finally, a small protective splint is placed around the nose. Your surgeon will have fitted you for the splint prior to the surgery and you will be expecting it when you awaken. After about 24 to 48 hours, on your next visit, the splint will be removed and your new nose will be ready to “face” the world. You’ll be left with some swelling, a small amount of pain and some antibiotics to ward off infection.

Rhinoplasty Info provides comprehensive information on preparing for and recovering from rhinoplasty, as well as costs, surgeons, and procedures, including revision rhinoplasty. Rhinoplasty Info is the sister site of Dental Implants Web.

Article Source: http://EzineArticles.com/?expert=Kevin_Stith