Septorhinoplasty / Rhinoplasty

Septoplasty changes the shape of the nasal septum to allow an improvement in breathing; rhinoplasty changes the external shape of the nose that can be for breathing purposes (functional rhinoplasty) or cosmesis (cosmetic rhinoplasty), or most commonly, for both reasons. Septoplasty surgery is often performed in conjunction with rhinoplasty surgery as a septorhinoplasty. Both surgeries can be performed using an open (external) approach or a closed (endonasal approach). The closed (endonasal) approach (no scars) is used in Mr Harneys practice for most (>er 90%) of septoplasties, and for the basic rhinoplasty surgeries (approximately 20%). Most complex rhinoplasties require an open approach, as Mr Harney believes it gives superior control for the repair of difficult abnormalities.

Surgery that changes the shape of the nose for cosmetic reasons can be an emotionally charged experience for the patient. Expectation of perfection, while a possible outcome, is not an appropriate psychological stance to take prior to this surgery. The majority of patients have significant improvement post surgery, though the nose rarely takes the idealised form post-operatively that many patients may expect from their exposure to TV and magazines. 10-15% of patients will require revision surgery in the future. Patients with expectation of an improvement rather than perfection, with a clearly identifiable nasal abnormality, often attain high levels of satisfaction with this type of nasal surgery.

Rhinoplasty is a surgical procedure performed to repair or reshape the nose. It can improve the size, shape and the angle of the nose and create a proportion with the rest of your face. It is also performed to correct structural problems with the nose.

There are two main rhinoplasty techniques:

Open Rhinoplasty

Open rhinoplasty, also called external rhinoplasty, is an approached of rhinoplasty in which a small incision is made on the nose, over the columella between the nostrils, in addition to several other incisions inside the nose. The transcolumellar incision improves the surgical access to the nasal framework by allowing the surgeon to fold the nasal skin upward. This provides better visibility on the entire nasal framework, in its natural undisturbed alignment. Open rhinoplasty can be performed in patient with thick or thin nasal skin.

It is indicated in the following conditions:

  • Major augmentation with tip, columellar, spreader and/or shield grafts
  • Correction of complex nasal deformities
  • Revision rhinoplasty
  • Excision of nasal tumour
  • Treatment of internal nasal valve dysfunction
  • Nasal tip modification
  • Surgical repair of septal perforations

Closed Rhinoplasty

Closed rhinoplasty, also known as endonasal rhinoplasty, is an approach of rhinoplasty where all the surgical incisions are made inside the nose without any external incisions. Closed rhinoplasty is employed for the correction of aesthetic deformity of the nose as well as for the management of anatomic nasal airway obstruction.

Skin Cancers

The nose is one of the commonest sites for skin cancer. The most common type is called a basal cell carcinoma, which primarily spread locally. Squamous cell carcinomas are less common, but are more serious as they have the added risk of spreading to the lymphatic system or through the blood, though this occurs only in a relatively small percentage of cases. Surgical removal is recommended with a surrounding cuff of normal tissue. The defect can be repaired by direct closure with stitches, or in certain cases may need a graft or flap to repair the tissues (a flap moves tissue from one part of the body to another).