Dott. Armando Boccieri
ATRAUMATIC SEPTORHINOPLASTY

Rhinoplasty is different today.

  Rinoplastica soft

In the past: the day after
   
Rinoplastica soft

Today: the day after (left)
The fifth day (right)

While a great deal has been said about the surgical techniques used to obtain the best functional and aesthetic results in the field of septorhinoplasty, equal attention has not been focused on the postoperative period and the techniques that can make it as atraumatic as possible. The progress in nasal surgery over the last few years has been linked to the improvement not only of techniques but also of postoperative care.
Patients who undergo septorhinoplasty often complain still today of terrible problems in the immediate postoperative period largely connected with the use of highly traumatic techniques. The most significant of these appear to be pain, bruising, hematomas, oedema, bleeding, lacrimation, and blocked nasal respiration. All this can scare patients to the point where they decide to forgo the operation or are unable to face it with the necessary calm.
The postoperative period of septorhinoplasty can instead prove nontraumatic and the patient can present a pleasant and socially acceptable appearance even on the day after. Attainment of this objective depends on the use of some intraoperative procedures designed to make the operation as “soft” as possible.
At the same time, while the open approach may seem more aggressive, in actual practice it involves fewer postoperative sequelae on the whole, probably as a result of improved control over bleeding and the absence of incisions inside the nose. Interruption of the internal mucosa disrupts the delicate vascular balance of arteriovenous and lymphatic drainage between the superficial and deeper anatomical areas, thus causing a thickening of the tissues that takes a very long time to disappear.
With a view to avoiding the traditional nasal packing, particular importance attaches to the execution of precise hemostasis, seeking out and blocking the points of most frequent bleeding. Internal and external suturing of all the incisions can also help to eliminate the need for packing except in particular cases.

The surgical protocol proposed for nontraumatic septorhinoplasty has proved particularly effective in ensuring an acceptable postoperative period essentially free from pain and problems. In actual fact, use of the above procedures makes it possible for patients to have a pleasant and presentable appearance as from the day after the operation.

For further details, readers are referred to my article ‘Atraumatic Septorhinoplasty’, European Journal Of Plastic Surgery, 2005, 28, pp. 343–53.