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Septorhinoplasty for Twisted or bent noses

Patients wanting a nose job often have had some sort of injury to their nose that has caused some twisting or bending. External deviations of this type are usually accompanied by corresponding bends in the nasal septum inside the nose.Such individuals complain of a blocked nose and headaches and may snore at night.

Cosmetic surgery for this type of patient is technically very demanding. The internal septum has to be straightened first. Sections of nasal cartilage are often harvested during this process to be reused later on in the operation as splint material to enable straightening of the nasal bridge. The external part of the nose is then corrected and the nasal bones reset or reshaped if this is necessary. Cartilage is a living material and has a ‘memory’ so it may tend to bend slightly even after repositioning. This fact has got to be borne in mind when carrying out this surgery.

Often past nasal injury has caused death or necrosis of the nasal cartilage. Previous operations may have diminished the quantity of cartilage available. In these cases sections of ear cartilage may have to be taken to be used as structural grafts. Very occasionally cartilage may be harvested from ribs.

Septorhinoplasty in my practice is carried out on a day case basis and patients do not have any nasal packing. There is minimal discomfort and an external splint is applied for one week.

 

©Mr. Adrian M Agius

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