RHINOPLASTY
Part of public opinion sees the rinoplasty as a cosmetic surgery or almost like getting a new haircut. In reality we are talking about an intervention that very often has functional implications for the coexistence of respiratory difficulties and psychological problems due to the presence of aesthetic defects accompanied by complexes and insecurities. These psychological problems are also present at a young age due to gossip or teasing that accompany patients in their growth and lead to a medical consultation to find the aesthetic harmony of their face. In these cases I intervene, after appropriate examinations and simulations, with a primary rhinoplasty, that is a rhinoplasty operation performed for the first time, for aesthetic or even functional purposes.
Equally, serious psychological problems are common in already operated patients who have not resolved the pre-existing nasal defect or even had a worsening after surgery. If you too have had problems with a rinoplasty primary surgery, you can book an appointment at my office in Rome and I will carefully and sensitively evaluate whether to perform a secondary rhinoplasty to correct the first surgery. You do not have to resign yourself to a choice that has kept unchanged or worsened a small aesthetic defect, but you should know that it is possible to recover a harmonious shape of the nose (in harmony with the face) thanks to a secondary rhinoplasty surgery.
RHINOPLASTY
RHINOPLASTY AND REVISION RHINOPLASTY
Medicina 33 – Dr. Armando Boccieri
Here are two interviews I gave to Medicina 33, the in-depth health program of Tg2.
The first interview has as its topic secondary rhinoplasty.
"The incongruous and excessive removal of cartilaginous parts of thenasal pyramid, during a primary rhinoplasty, can lead to aesthetic and functional problems. In particular, the functional ones are due to the collapse of the structure, which no longer allows normal breathing.
Through a small incision in the columellar area, we can have a wide exposure of the nasal pyramid and use cartilage grafts taken from the auricle.
The second interview has as its topic rhinoplasty in nasal trauma outcomes.
"Car accidents or sports traumas are the most frequent causes at the origin of a deflected nose with aesthetic deformities and breathing difficulties. The surgical difficulty consists in giving a stable result over time because the deviated cartilage structures tend to resume their vitiated position after surgery.
The most modern techniques make use of grafts taken from the nasal septum and fixed in the dorsal part of the septum to restore the right central axis and maintain it over time."
A CHARMING CHANGE


(Hold down and scroll through the photo, to see the whole before and after) The patient Silvia M. before the operation presented a nose too long and important in all its components (back, width, tip) without a real specific deformity. The rhinoplasty primary intervention decreased the size of the nose but left an extremely natural result and enhanced the other parts of the face that before remained in the background because the attention was attracted by the nose. In cases like this it is fundamental to be attentive during the preoperative visits to understand exactly what the patient wants and to this end the simulation of the result of the rhinoplasty performed with the computer is useful. I believe that the surgeon should not take personal initiatives but should be at the service of the patient to achieve her goal if she shares it. Silvia wanted to achieve an absolutely straight and natural nose that was similar to her own but smaller. A nose that was a little more hollow in profile might have been equally pleasing and technically easier but would not have fully satisfied her.


(Hold down and scroll through the photo, to see the whole before and after)
I operated on patient Adina F. in October 2019, during the International Rome Nose Week course, which I was one of the organizers. The very complex functional reconstructive septorhinoplasty surgery was performed in live-surgery. The patient presented the results of a previous rinoplasty surgery with functional respiratory and aesthetic deficits represented by an extremely short nose with a "surgical" tip very rotated upwards. The surgery was performed using rib from Tissue Bank to obtain reconstructive grafts for the missing structures.
The use of Tissue Bank is a modern procedure that avoids the removal of the patient's rib, which would involve another operation during the main surgery. This also avoids thoracic scarring and further discomfort in the patient's postoperative period. The result of the revision rhinoplasty brought the patient back to normal breathing with a natural aesthetic result, without the evidence of an overly large nose as sometimes seen after a rib graft.


(Hold down and scroll through the photo, to see the whole before and after)
In this case, the patient Maria Cristina N. presented an extremely crooked nose in the frontal view and a conspicuous hump in the profile. In this girl, respiratory and aesthetic problems coexisted and "went hand in hand" for several years, with inevitable psychological implications. The patient had waited several years before deciding to undergo surgery for the great concern of not being able to obtain the desired result. The surgical intervention of primary rhinoplasty, with the use of"guide grafts" of cartilage from the patient's own nasal septum, made the nose straight and stable in the right position over time. Aesthetically, the removal of the hump gave the patient a feminine and delicate profile with a softer expression than before. Important is to report the recovery of the smile since the first days after the surgery. This testifies that the patients, once they have achieved the desired aesthetic improvement, change their attitude towards the world, demonstrating greater positivity and confidence in human relationships.