Rhinoplasty and Septoplasty
In Rhinoplasty or nose surgery, the surgeon reshapes and/or resizes the nose to make it more attractive, symmetric, and balanced with the other features of the face. Functional rhinoplasty can be performed at the same time as cosmetic rhinoplasty to restore air flow by correcting such breathing problems as a deviated septum, issues with the turbinates, or nasal valve collapse.
Dr. Velargo’s unique training and experience as a head and neck nasal surgeon and cosmetic rhinoplasty surgeon makes him an expert in the latest rhinoplasty techniques that not only correct cosmetic problems but also restore breathing, while maintaining structure and function.
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A “nose job” is a highly specialized and individualized procedure that requires considerable skill on the part of your surgeon. Each case must be evaluated carefully to determine the best way to create the result you want. Even in surgeries solely for cosmetic reasons, function and nasal structure must be taken into account.
In older patients, rhinoplasty is sometimes performed along with a face lift for a more comprehensive makeover. As we age, the nose begins to droop. Dr. Velargo is skilled at performing “rhino-lifts” to bring the nose back into harmony with the face.
Dr. Velargo may recommend that other procedures, such as chin augmentation, be performed as an adjunct to rhinoplasty to further refine and balance facial proportions.
Noses that have been severely injured (as from athletic injuries, or an accident), those which are markedly crooked, or those which have had a previous operation which left the patient with an unsatisfactory result, are technically more difficult to correct. Although some surgeons would approach these problems with two operations scheduled approximately six months apart, we try to make the necessary corrections in one operation. We succeed in the vast majority of cases, but additional procedures are sometimes required six months to one year later.
Like faces, every nose is different; some noses are too long, some too wide, some have large humps, some project away from the face, and so on. Since rhinoplasty surgery is as much artistic in nature as it is scientific, rarely are any two of our patients’ noses identical.
Dr. Velargo strives to make each patient’s nose fit his or her face. The alterations he recommends will be determined by many factors, including one’s height, age, skin thickness, ethnic background and configuration of other features such as the forehead, eyes, and chin. All in all, he strives to achieve a natural-looking nose rather than one that appears to have been operated upon. No patient really wants an assembly line “nose job,” but a nose individually tailored to their own features. Dr. Velargo is particularly attuned to these desires.
Septoplasty and Sinuplasty
The septum is the partition that separates the nose into right and left sides. It is comprised of both bone and cartilage. Most people actually have some degree of deviation in their septum, which contributes to breathing difficulties. In most cases, septoplasty is performed in the same setting as the rhinoplasty. Septoplasty not only allows Dr. Velargo to correct the deviation and improve breathing but also allows for him to harvest any cartilage that may be needed to support and give structure to the nose during the functional and cosmetic rhinoplasty.
In select patients with chronic sinus disease, Dr. Velargo may utilize a procedure called Endoscopic Balloon Sinuplasty to open the sinus passages. This can be done in the same operative setting as septoplasty and rhinoplasty.
What can rhinoplasty and septoplasty accomplish?
- Correct a hump on the bridge of the nose
- Straighten a broken or crooked nose
- Make the nose shorter or longer
- Make the nose narrower
- Reduce the size of the nostrils
- Build up a nose that is too small, flat, or out of proportion with the rest of the face
- Correct nasal airway obstructions
- Correct nasal airway obstructions
- Straighten a crooked nose
What Happens During Rhinoplasty?
Rhinoplasty is either performed using general anesthesia or a local anesthetic with IV sedation in a community-based outpatient surgery center. Dr. Velargo uses either a closed rhinoplasty or open rhinoplasty technique depending on your case.
Most of the work is done through the nostrils from the inside of the nose (closed rhinoplasty). A closed rhinoplasty may need to be converted to an open rhinoplasty with a small incision made on the collumela below the tip of the nose. With time, this incision becomes inconspicuous. Usually, a severely deformed nose or cases of revision rhinoplasty dictate an open approach to rhinoplasty. Dr. Velargo will counsel you on the approach necessary during your consultation.
A question often asked by patients contemplating rhinoplasty is: “Do you have to break my nose?” In Dr. Velargo’s technique, he makes an incision into the nasal bones when they need to be repositioned, thereby eliminating the more antiquated technique of “breaking” the bones and resetting them. He feels this technique allows for better control of the operation and reduces the patient’s anxiety about having surgery. Incisions into the bone are necessary to narrow the nose or reconfigure the nasal structure after “hump” removal.
Excess bone and cartilage are removed from the bridge of the nose to remove “humps”. Dr. Velargo takes care to not remove too much, which could damage the nasal structure or create an unnatural scooped-out appearance. When the size of the nose is too large, excess bone and cartilage are removed as necessary.
As mentioned earlier, septoplasty is often performed in conjunction with rhinoplasty. This procedure involves removing the mucous membrane lining from the cartilaginous and bony septum. The deviated or “crooked” portions are identified and removed with care to preserve an adequate amount for nasal support and structure. The excised cartilage is saved for later use as cartilage grafts.
The mucous membranes are then reapproximated and sutured together, eliminating the need for deep nasal packing. This technique has been one of the greatest advances in nasal surgery, reducing much of the undesirable post-operative discomfort that packing has caused patients.
If the nose needs to be enhanced or strengthened, cartilage grafting will probably be used to build up that area. The cartilage can be taken from the septum, other parts inside of the nose, or from the ear. If Dr. Velargo thinks that ear cartilage will be necessary, he will discuss this with you in greater detail during your consultation. Rest assured that your ear will not look different after the operation, and the resulting scar will be inconspicuous. This technique is often used to support the tip, open the airway, strengthen the nostrils, or build up the bridge of the nose, among other things.
If it is necessary to make flaring or wide nostrils smaller, an incision can be made in the crease where the side of the nostril adjoins the upper lip and cheek. Because this is located in a natural body fold, the scar is practically invisible within a few weeks.
If simultaneous Endoscopic Balloon Sinuplasty to open the sinus passages is indicated, a small camera is inserted into the nose, and a balloon catheter is introduced into the main sinus openings. The sinus openings are dilated with the balloon, and the sinus cavities are cleaned and washed out.
Does insurance cover septoplasty or rhinoplasty?
If you are receiving septoplasty, functional rhinoplasty, or endoscopic balloon sinuplasty, some insurance plans cover that aspect of the procedure. Contact your insurance carrier for information. Note that cosmetic rhinoplasty is never covered by insurance plans, and even if your insurance covers a simultaneous septoplasty, functional rhinoplasty, or endoscopic balloon sinuplasty, a separate charge will be generated for the cosmetic component of your surgical plan.
Contact the New Orleans Center for Aesthetics and Plastic Surgery today to find out more about expert rhinoplasty.