RHINOPLASTY
Many people see rhinoplasty as a cosmetic intervention or almost as getting a new haircut. Actually, we are talking about an intervention that very often has functional implications for the coexistence of breathing difficulties and psychological problems, due to the presence of aesthetic defects accompanied by lack of confidence and insecurities. These psychological problems are present at a young age also due to gossip or mockery that accompany patients in their growth and lead to a medical consultation to rediscover the aesthetic harmony of their face. In these cases I intervene, after appropriate examinations and simulations, with a primary rhinoplasty, i.e. a rhinoplasty operation performed for the first time, for aesthetic or even functional purposes.
Similarly, serious psychological problems are frequent in patients who have already been operated or who have not resolved the pre-existing nasal defect, or who have even experienced a worsening of their conditions after surgery. If you too have had problems with primary rhinoplasty surgery, you can book an appointment in my office in Rome and I will carefully evaluate whether it is the case to perform a secondary rhinoplasty to correct the first surgery. You do not have to resign yourself to a choice that has maintained or worsened a small aesthetic defect, but you must know that it is possible to recover a harmonious shape of the nose (in harmony with the face) thanks to a secondary rhinoplasty operation.
RHINOPLASTY
PRIMARY AND SECONDARY
PRIMARY RHINOPLASTY
SECONDARY RHINOPLASTY
Medicina 33 – Dr. Armando Boccieri
Here are two interviews with Medicina 33, a health-related in-depth Tv program that is part of the national TV News Program TG2.
The first interview focuses on secondary rhinoplasty.
"The incongruous and excessive removal of cartilaginous tissue of the nasal pyramid during a rhinoplasty can lead to both aesthetic and functional problems. In general, the functional ones are due to the collapse of the structure, which no longer allows the patient to breath normally.
With the open approach, through a small incision in the columellar area, we can obtain a large exposure of the nasal pyramid and employ auricular cartilage grafts to reconstruct the missing parts."
The second interview focuses on primary rhinoplasty for the outcomes of a nasal trauma.
"Road accidents or sports injuries are among the most frequent causes of a deflected nose with aesthetic deformities and breathing difficulties. The surgical difficulty consists in ensuring a stable result over time, because after the operation the deflected cartilaginous structures tend to return to the previous flawed position.
The most modern techniques make use of grafts taken from the nasal septum and fixed in the dorsal part of the septum, in order to restore the right central axis and maintain its position over time."
A CHARMING CHANGE
(Hold and swipe right to see the before and after)
I operated on the patient Adina F. in October 2019, during the Rome Nose Week international course, for which I was one of the organizers. The very complex intervention of reconstructive functional septorinoplasty was performed in live-surgery. The patient presented the results of a previous rhinoplasty operation with respiratory and aesthetic functional deficits represented by an extremely short nose with a "surgical" tip that was upwardly rotated. The intervention was carried out with the use of a rib from the Tissue Bank in order to obtain the reconstructive grafts for the missing structures. The use of the Tissue Bank is a modern procedure that allows to avoid taking the rib from the patient, which would entail another intervention during the main intervention. This also avoids thoracic scars and further discomfort in the patient's postoperative period. The result of secondary rhinoplasty brought the patient back to normal with a natural aesthetic result, without the evidence of an excessively large nose as sometimes seen after the use of a rib graft.
(Hold and swipe right to see the before and after)
In this case, the patient Maria Cristina N. had an extremely twisted nose and a prominent hump. She complained about respiratory and aesthetic problems for several years, with inevitable psychological implications. The patient had waited several years before deciding to undergo surgery because of the great concern of not being able to obtain the desired result. The primary rhinoplasty surgery, with the use of "guide grafts" of cartilage from the patient's 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 sweeter expression than before. It is important to report the recovery of the smile from the first days after the surgery. This testifies that once the desired aesthetic improvement has been achieved, patients change their attitude towards the world, demonstrating greater positivity and self-confidence in human relationships.
(Hold and swipe right to see the before and after)
Before the operation, the patient Silvia M. had a long and important nose in all its components (back, width, tip) without a real specific deformity. The primary rhinoplastic surgery has reduced the size of the nose, leaving an extremely natural result and enhancing the other parts of the face that previously remained in the background, because all the attention was drawn to the nose. In cases like this, it is essential to be careful during preliminary visits, in order to understand exactly what the patient wants. For this purpose, it is useful to carry a computer-generated simulation of the rhinoplasty forecasted result. I believe that the surgeon should not take personal initiatives, but rather be at the patient's service in order to achieve his/her goal, if he/she wants to share it. Silvia wanted to get an absolutely straight and natural nose that was similar to hers, but smaller. A nose that was a little more dug in the profile could perhaps have been equally pleasant and technically easier, but would not have satisfied her fully.
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