Nasal Transformation | Open Structure Rhinoplasty with Rib Cartilage

Struggle with Nasal Challenges

Recently, a 26-year-old female lady visited our Richardson’s Hospital with multiple functional and aesthetic nose-related complaints. She was very much bothered about the curves and contours of her nose. She had a very crooked and deviated nose. Also, the functional issues of breathing difficulty and a persistent nasal blockade had become her constraints. She had already undergone Rhinoplasty surgery elsewhere in the country a year ago but still was not satisfied with the correction, and her nasal appearance and also functional problems persisted.

Choosing Excellence

She was aware of Dr. Sunil Richardson and his team’s global reputation in rhinoplasty surgeries, so she placed her trust in Richardson’s Hospital for a life-changing nasal correction.

CBCT for Unveiling the Nasal Landscape

A thorough Cone Beam Computed Tomography (CBCT) scan was done to visualize the intricacies of her nasal anatomy. The report revealed a deviated nasal septum, and defects in both hard and soft tissues, showing a picture of the challenges that awaited correction. The deviated Nasal Septum was the main cause which led to recurrent block nose and breathing difficulty.

Open Structure Rhinoplasty with Rib Cartilage Harvesting

Dr. Sunil, after having the insights from the CBCT, structured the surgical treatment for an Open Structure Redo Rhinoplasty. This intricate procedure, coupled with rib cartilage harvesting, approaches to sculpt a new symmetric nose for her. Rib cartilage, delicately harvested, served as a tool, shaping the nasal framework to achieve symmetry, proper shape, and a correction of the deviated course.

Transformation | Moulding Symmetry and Shape, Dorsal hump, and Deviation Correction

As the bandages unraveled, the woman confronted her reflection in the mirror. Happiness, relief, satisfaction, and gratitude intertwined as the contours of her nose now mirrored the contours of her dreams. The once-persistent nasal blockade was treated for life giving her blockage-free breathing freedom.

New Reflection | Post-Surgery Revelation

She had 7 days of Hospital stay, healing was uneventful and on the 10th post-operative day, all her bandages and splints were removed. Attentive care and hospital staff attentiveness facilitated a swift and thorough recovery.

While returning to her home she met Dr. Sunil and his team and praised them for their precise surgical skills and thanked them for giving her that confidence back as her crooked nose was now no longer evident and replaced with a sharp balanced curve and was able to breathe freely. And she walked with a nose held high from our Hospital.

All You Need to Know About Rhinoplasty

Who requires Rhinoplasty?

Rhinoplasty, or nose surgery, is typically sought by individuals who wish to make aesthetic or functional changes to their nose.

1. Cosmetic Concerns: People may want to change the size, shape, or proportions of their nose to enhance their overall facial harmony.
2. Nasal Functionality or Breathing Issues: Some individuals seek rhinoplasty to address breathing difficulties or correct structural problems within the nose that affect airflow.
3. Trauma or Injury: Those who have experienced nose injuries or trauma and have a deformed nose may opt for rhinoplasty to restore the natural shape and function of the nose.
4. Congenital Conditions: Individuals born with congenital nasal abnormalities especially in cases of Cleft Nasal Deformities may choose rhinoplasty to correct these conditions for both aesthetic and functional reasons.
5. Ethnic Rhinoplasty: Ethnic rhinoplasty is performed to achieve a balanced and aesthetically pleasing outcome while respecting the patient’s cultural identity and preserving their heritage-specific nasal traits.

Is Scarring visible with Open Structure Rhinoplasty?

These incisions are given in nose creases and may leave minimal to no scar with time. The scar usually tends to fade over time. Surgeons take care to make the incision inconspicuous. Individual healing and scarring can vary, but skilled surgeons aim to minimize the impact on the outer appearance of the nose.

What is Open Structure Rhinoplasty?

Open structure rhinoplasty is a surgical procedure where the surgeon makes a small incision on the outside of the nose to access the underlying structures. This approach allows for more visibility and precision in reshaping the nose, making it useful for complex or detailed alterations. It’s like giving the surgeon a clearer view and easier access to achieve the desired changes while keeping the overall structure of the nose intact.

Why Is Rib Cartilage Graft Required for Rhinoplasty?

1. Structural Support: Rib cartilage is strong and provides excellent structural support. It is often used to reinforce or rebuild the nasal framework, particularly in cases where the existing nasal structure is weak or compromised.
2. Volume Augmentation: In cases where there is a requirement such as increasing the height or length of the nose, rib cartilage grafts can be employed to achieve the desired augmentation and projection.
3. Complex Revision or Redo Surgeries: In revision rhinoplasty or more complex cases, where there may be limited donor cartilage from the septum or ear, rib cartilage can serve as a valuable source for grafts to address multiple nasal issues.
4. Straightening the Nose: They are used in cases of crooked noses or correct deformities, providing a stable and long-lasting solution.

Post-Surgery Recovery

Swelling/Post Surgical Edema and Mild Nasal Ooze

Usually, swelling after Rhinoplasty lasts upto 7-10 days and eventually subsides in 15 -20 days. However, due to fluid retention and depending on individual recovery, slight swelling can remain for a long time i.e., for several months up to a year. Mild nasal /blood ooze is normal after the surgery and may persist for 7-10 days.

Bruising around the eyes

There will be some occurrence of bruising around the eye after a rhinoplasty plastic surgery. During the Nasal Osteotomy, the blood vessels around your nasal structure are disrupted giving your eye swelling and a reddish black eye appearance. It is normal and will be back to normal within a 20-day-1-month period.

Rib harvest site

Only a small chunk of rib cartilage is harvested during the procedure which will not give rise to any complications postoperatively. Mild pain can be expected for 7-10 days after the surgery which can be easily controlled by pain medications. No chest shape or symmetry change is seen. However, you should restrict heavy weight lifting and going to the gym atleast 3 months post-nose surgery which can put a strain on your stitches area.

Before surgery image showing the deviated nose with a dorsal hump which is corrected with surgery giving a smooth curve with a sharp pointed tip.

CT Image showing the Deviated Nasal Septum towards the Right causing Breathing Issues

Images of Open Structure Rhinoplasty Showing Incisions Given Increase to Minimize Scarring

An image showing the exposure of Nasal Septum and Septo- Rhinoplasty is done.

7th Rib Cartilage Harvest

Placement of Septal Extension Graft to straighten nose and Dorsal trimming done to reduce Dorsal Hump