Closed Rhinoplasty can be an ideal option for patients requiring less extensive nasal work. The technique gives surgeons more maneuverability to alter cartilages and bony structures without upsetting their natural relationships, says our plastic surgeon
As this procedure also protects venous and lymphatic channels in the tip skin sleeve from being compromised, which are important in providing tip support, it also avoids their destruction.
The Anatomy of the Nose
Your nose plays an essential role in providing air for breathing, serving your sense of smell, and protecting against dirt and other particles entering the body. Its structure includes stratified squamous epithelium with flat cells covering an outer basement membrane made up of resilient fibers lining its cavity, says our Best Rhinoplasty surgeon in India.
The nasal septum, composed of thin bone and cartilage walls, separates the interior of your nose into two sections. On either side of this wall sit curved bone structures called turbinate’s, covered by mucous membrane ridges to keep air warm and moist while you breathe it in.
Rhinoplasty changes to one or more structures of your nose can dramatically impact its appearance and function. By scheduling a private consultation with at his Irvine or Beverly Hills offices, you’ll discover how closed rhinoplasty can achieve your cosmetic goals for long-lasting results. While its surgical process is similar to open rhinoplasty, there may be subtle variations. As such, selecting a surgeon experienced with both approaches is recommended.
Internal Nasal Valve
The internal nasal valve is a narrow opening between the nose and upper part of the septum that serves to open up nasal passage upon inspiration. If this valve becomes weak due to over reduction of septal cartilage during reduction rhinoplasty or trauma with an avulsion of upper lateral cartilage avulsion or congenital weakness it could result in breathing difficulties for inspiration.
An internal nasal valve collapse is typically recognized by its pinched appearance and medialization of upper lateral cartilage towards the septum upon inspiration, often best seen using the Cottles maneuver or with breath-inducing devices such as Breathe Rite strips.
Our Best Rhinoplasty surgeon in India offers many solutions for correcting this pathology. Spreader grafts may help widen the angle of the nasal valve; when these don’t do enough, other methods like flaring sutures have been created, which use multiple passes of suture thread from maximum nasal valve collapse back towards an absorbable or no absorbable implant at the superior nasal dorsum.
Lower Lateral Cartilages
Lower lateral cartilages (LLC) help shape the nasal tip. Part of tip rhinoplasty or “tip-plasty” surgery includes restructuring these lower lateral cartilages.
Position of LLCs is fundamental for proper functioning of the external nasal valve (ENV). Concavity of the lateral crore leads to poor support for alae and can lead to ENV insufficiency during deep inspiration1.
Cephalic malposition of the LLC may lead to its tip appearing pinched and isolated. When this occurs, it is essential to reposition its cartilages – one effective technique is the use of an LLC strut graft made of septal cartilage; this not only reduces fullness but also improves parentheses appearance and supra-alar retraction. For optimal results, fix this at the base of lateral rim before augmenting it if necessary with either ear or rib cartilage grafts
Nasal Tip
The nasal tip provides the upper portion of the nose with shape. A weak or undefined tip may be improved through various techniques including cartilage removal, dissection, repositioning and augmenting, confirms our plastic surgeon in Mumbai.
This patient presented with a dorsum hump and bulbous, asymmetric nasal tip. Following Rhinoplasty surgery, she now sports an attractive nose featuring natural-looking dorsum contours and an enhanced tip shape.
Patients suffering from a bulbous nasal tip often have lower lateral cartilages that are too large and distant from each other, creating an overly-round and poorly defined nasal tip. Can make the tip less round by creating an “Incision Delivery”, extracting cartilage from this pocket then either suturing it back in its proper position or repositioning it for improved nasal tip contours.
Conclusion
Errant nasal tips may be addressed through various means, including repositioning of the nasal septum and shortening lateral cartilages or inserting an autogenous cartilage graft from either the septum or ear to provide more support to the nose tip.