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Dr. Denton's Plastic Surgery Blog for Vancouver BC
 

Tip Refinement and Deprojection During Rhinoplasty

These three sets of photographs show before and after images of a patient that underwent open septorhinoplasty to address several concerns she had regarding the appearance of her nose.  Specifically, she was unhappy with the appearance of the tip from all angles (boxy, over projected and long) and the height and irregularity of the bridge.  Thin skin also added further challenges to this case.

During open septorhinoplasty the bridge of the nose was reduced to give the nose a more online pharmacy best feminine profile.  The tip was modified to make it more triangular and refined.  As is the case with any rhinoplasty I perform, as little cartilage and bone is removed as possible thereby maintaining the structural integrity of the nose.

Before & After Tip Refinement & Deprojection of the nose - Front View

Before and After Rhinoplasty*

Before & After Tip Refinement & Deprojection of the nose - Front View

Before and After Rhinoplasty*

Before & After Tip Refinement & Deprojection of the nose - Front View

Before and After Rhinoplasty*

Revision Rhinoplasty to Remove and Repair Damage from Silastic Nasal Implant

Nasal augmentation – essentially making the nose larger – may be indicated if the bridge of the nose is too low or the tip of the nose too short.  Generally, this is more common during Asian and African American rhinoplasty.  In many parts of the world, the augmentation is achieved by using a silicone or silastic implant.  These implants are inexpensive and readily available in a wide range of shapes and sizes.  They can be inserted quickly with immediate and often pleasing results.  So what’s the downside?  There are several as it turns out, however, the main issues with these implants is that over time, the implant can shift and distort the nose.  Also, if the implant chosen was too large to begin top online pharmacy no prescription with, or the patient’s skin too fragile,  the implant can actually work its way through the skin of the tip of the nose.

When performing augmentation rhinoplasty, my preference is to use the patients own cartilage  where at all possible.   If a synthetic/man-made implant is required to augment the bridge of the nose, I prefer a custom carved ePTFE (Goretex) implant that is specifically designed for each individual patient.  At no time should the synthetic implant be allowed to contact directly the undersurface of the nasal tip skin.  The result is a long lasting and safe nasal augmentation.

Before & After Revision Rhinoplasty Nasal Augmentation - Front View

Before and After Revision Rhinoplasty*

Before & After Revision Rhinoplasty Nasal Augmentation - Side View

Before and After Revision Rhinoplasty*

Before & After Revision Rhinoplasty Nasal Augmentation - Underneath View

Before and After Revision Rhinoplasty*

Before and After Rhinoplasty – 5 year follow up

Before & After | 5 year follow up | Closed Rhinoplasty | Side View Before & After | 5 year follow up | Closed Rhinoplasty | Front View Before & After | 5 year follow up | Closed Rhinoplasty | Lateral View

Above are three sets of before and after photographs of a patient who underwent closed septorhinoplasty surgery 5 years ago*. Even though the closed rhinoplasty technique is not commonly used in my practice (mainly because the open approach provides superior access and control to the various nasal structures that require modification during complex rhinoplasty cases) this is an example of a great and long lasting result from a closed rhinoplasty.

In this case the objectives were to straighten the nose, narrow the tip, deproject the tip and rotate the tip – all of which canadian online pharmacy no rx were met nicely in this case. The one main advantage of closed rhinoplasty over the open approach is that the closed approach avoids the transcolumellar incision at the bottom of the nose. However, in my experience this is rarely if ever an issue.

Healing time generally is comparable between the two. Most patients will require 7-10 days off of work or school and two weeks off of the gym or other significant exercise.

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