Micromotor Assisted Complicated Rhinoplasty Operation
We performed an open technique, micromotor-assisted rhinoplasty operation + radiofrequency turbinate reduction on a female patient who had nasal congestion and a severe asymmetric appearance in the nose after a nasal trauma during childhood. The patient's pre-operative and 4-month post-operative photographs are shared above and below. Due to the nasal septum deviation that occurred in childhood and the severe nasal congestion that resulted from this, the patient's mouth and jaw structure were also affected. The following were detected during the patient's examination:
- Severe septum deviation
- Left caudal septum dislocation
- Nasal bone deviated to the right, nasal tip deviated to the left (a "C nose" appearance when viewed from the front)
- Asymmetry in both nostrils
- Hypertrophy was detected in the left inferior concha.
It was observed that all nasal areas of the patient were asymmetric.
In the planned treatment of the patient, it was thought that a total septal reconstruction procedure could be planned due to the severe deviation of the nasal septum.
Surgical Procedure Details
The operation was started under general anesthesia. After columellar incision, skin dissection was started. Cephalic resection of both alar cartilages was performed. Hump reduction was performed with the help of microdrill (micromotor). Dome points were changed. Graft was placed on the lateral crus of the left alar cartilage. Left spreader graft, left alar batten graft were placed. These grafts were sutured with 4/0 PDS. Median and bilateral low-to-high osteomies (bone cutting) were performed with a piezo device (ultrasonic device). The right side of the supratip area was drilled with a micromotor. The caudal part of the nasal septum was resected. The graft obtained from the septum was sutured to the caudal septum with 4/0 PDS using the tongue-in-groove technique. The medial crura of the alar cartilage were sutured to this graft with 5/0 PDS. The cap graft was prepared and sutured with 6/0 PDS. Bleeding control was performed. Limited amounts of radiofrequency were applied to both inferior turbinates. The columellar incision area was sutured. Internal nasal silicone splints were placed. The nose was bandaged and an external nasal splint was placed. The operation was terminated.
Crooked Noses Cannot Be Guaranteed Full Millimetric Symmetry with a Single Operation!
In crooked noses, there is serious asymmetry in both the bone area and the cartilages in the supratip and nasal tip regions of the nose. Cartilage and bone memory may cause previous asymmetries to appear, albeit partially, during the recovery period after an asymmetric surgery trauma. One of the questions that should be asked to patients who are planned to have a crooked nose operation before the operation is "What is your purpose in having surgery? Do you want full millimetric results?". If a patient says "I only want millimetric symmetry, I cannot accept even a little asymmetry", there are two ways for the surgeon:
1. Cancellation of the surgical process and rejection of the surgery
2. Health insurance covered rhinoplasty (guaranteed rhinoplasty)
In this second option, patients pay 7-10 times more before the operation and the costs of repeated revision rhinoplasty procedures are covered by the insurance company, the patient does not pay again.
When I usually talk to my patients, I emphasize that crooked nose aesthetic surgery has the highest revision risk among general rhinoplasty surgeries, and that some asymmetries from before the surgery may reappear after the surgery. If a slight asymmetry occurs in our patients, I emphasize in advance that I can perform the surgery again with only the hospital fee. In my nearly 25 years of surgical experience, approximately 12-13 of my patients required minor revision nose surgeries, and I performed these surgeries by only paying the hospital fees. Remember that there is a revision risk of around 10% in every rhinoplasty surgery. This rate may be higher in crooked nose jobs.
Why Can Asymmetry Occur After Crooked Nose Asymmetry?
In patients with crooked noses, one side of the nasal bone or cartilage must be treated more than the other side. For example, the nasal bone of the patient I shared with you on this page was curved to the right, while the tip of the nose was curved to the left. More bone shaping was done on the right side of the nasal bone. In the long term after the operation, when the healing process is complete, our body produces more bone tissue in the area where there is more damage to the bone structure, and in the long-term results, old asymmetries may reappear, albeit slightly, depending on the bone or cartilage repair process. This situation may be more pronounced in patients who smoke, are exposed to sunlight, or have aggressive healing characteristics.
Synonyms For Crooked Nose
Words that can be used for Crooked nose, with similar meanings. Similar to crooked nose, words such as twisted nose, scoliotic nose, deviated nose, C shaped nose, asymmetric nose are also used.
In patients with crooked nose features, the entire face may appear asymmetrical and when a successful operation is achieved, it may appear as if the entire facial structure has changed and the area has become symmetrical. You can take a look at the photos below.
On this website you can read the articles written by Dr. Murat Enöz about crooked nose >> https://www.ent-istanbul.com/search?q=crooked+nose (you can read all the articles by clicking "More Posts" at the bottom of the page).
Murat Enoz, MD, Otorhinolaryngology, Head and Neck Surgeon
Private Office:
Address: İncirli Cad. No:41, Kat:4 (Dilek Patisserie Building), Postal code: 34147, Bakırköy - İstanbul
Appointment Phone: +90 212 561 00 52
Appointment Phone: +90 212 561 00 52
Fax: +90 212 542 74 47
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