Nasal Surgery - Process and Procedure

The Process

Typically, septal surgery is performed through internal nasal incisions. The septum is composed of cartilage (towards the front) and bone (in the back and along the bottom). After elevating the delicate mucus membranes, cartilage can be removed, as long as an "L" shaped strut is preserved to support the tip and the bridge. The cartilage that is removed is sometimes recycled for grafting elsewhere in the nose. The nasal valve can be modified with such grafts; the surgery is tailored uniquely to each patient.The turbinates can be pushed to the sides or trimmed to increase the amount of room availa ble in the nose for airflow. These procedures are not designed to change the appearance of the nose, but rather are strictly for functional improvement.

Surgery of the external nose can be done with internal nasal incisions, or sometimes with similar internal incisions connected to an incision on the columella, the tissue below the nasal tip. This "external" approach allows for an unparalleled opportunity to diagnose and treat the problems of the nasal tip, and the scar fades rapidly in a few weeks.

Regardless of the incisions, the tip can be made narrower or more refined, can be turned upward or downward or displaced forward or backward, depending on the individual needs of the patient. The tip is made of small cartilages, the lower lateral cartilages. Thes e can be modified by removing portions, augmenting them (with cartilage from the septum, for example) or by sewing them in precise ways with sutures.

The Procedure

The nasal bridge can be narrowed, straightened or widened as needed. The nasal profile can be raised or lowered, as appropriate. The bridge of the nose is comprised of cartilage (the top of the nasal septum in the center, and the paired upper lateral cartilages on the sides) and the nasal bones. While the cartilages can be shaved smaller, the bone is removed by fine files or by precisely cutting the bones. It is usually this work on the nasal bones that generates the bruising usually seen under the eyes after rhinoplasty. For nasal bridges that are too narrow or too low, cartilage grafts or implants can be use d to achieve excellent results.

The exact techniques used during a particular nasal operation depend on the individual needs for the patient. No two surgeries are alike, as each nasal operation is tailored to the specific needs of the patient. Nasal surgery demands careful analysis, a thorough understanding of the anatomy and physiology of the nose and an artistic understanding of the interrelation of the nose with the rest of the face.