Archive for March, 2008

What is a graft and what is it used for?

March 03rd, 2008 | Category: Rhinoplasty Techniques

A graft is any tissue that is taken from the body to use in another area of the body of the same person or another person. When we talk about grafts in the nose, we are talking about cartilage, soft tissue (fat and fibrous tissue), or sometimes bone that is used to improve the structure and shape of the nose. Sometimes synthetic materials such as Silicone or Goretex are also used in the nose as implants. There are differences in the properties and uses of these materials. In general, the majority of grafts that are used in the nose are usually made of cartilage.

Cartilage grafts are small bits of cartilage that are carefully carved and shaped. They are used to either reinforce weak tissues or replace tissues that have been lost to trauma or removed during surgery. Most patients who require a number of grafts are seeking revision rhinoplasty to fix things after their nasal tissues have been too aggressively removed. Or, they may have a small nose or flattened bridge to begin with and wish to have it augmented, such as in some ethnic rhinoplasty. In these cases, it’s not uncommon for many different types of grafts to be used in the same nose, each playing its own unique role. Patients seeking primary (first-time) rhinoplasty for reduction of a bump or for refining their features usually do not need grafts.

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Why don’t you use nasal packing after Rhinoplasty?

March 02nd, 2008 | Category: Rhinoplasty Recovery,Rhinoplasty Techniques

Want to know the most significant complaint we hear about after Rhinoplasty surgery?

It’s not pain, pressure, headache, or even discomfort. In fact, rhinoplasty is rarely very painful.

The symptom we hear about most is nasal congestion.

nasal packing after Rhinoplasty photo

The picture above shows one technique that some surgeons still use to pack the nose. Most surgeons still use some form of packing or splint, which can either be merocel, gauze, xeroform or a variety of other forms. The end result unfortunately is more discomfort for the patient.

While not being able to breathe through your nose is not earth-shattering, it is extremely annoying. Think of it like a bad head cold that lasts. So, anything we can do to prevent this symptom is meaningful to you, and therefore important to us. And the biggest thing we can do to help, is to avoid nasal packing.

Packing is routinely used by some to help prevent excessive bleeding or dripping. We find we almost never need it. By handling tissues exceedingly carefully and gently, we find that we can generally keep bleeding, bruising, and swelling to an absolute minimum…and the benefit to you is an earlier return to breathing through your nose, less blockage from the beginning, and no painful removal of crusted packing.

We really have a passion for rhinoplasty, and we do all we can to help make your experience with us the best it can be… so we encourage you to come in and experience the difference.

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Is Rhinoplasty or Revision Rhinoplasty even worth it?

March 01st, 2008 | Category: Rhinoplasty Philosophy

That’s an odd question coming from a Rhinoplasty surgeon, we know. But, it’s a question we face a lot in our practice. If you spend time on Rhinoplasty discussion forums, you will leave feeling very depressed about your chances for the nose you’ve always wanted. These sites are chock full of nightmare stories of bad results and even worse interactions between the patients and surgeons. Having had a bad result already, many patients find themselves understandably bitter, suspicious of doctors, and despairing for the nose they had. It’s enough to scare off someone considering a first-time Rhinoplasty. More sad is that many Revision Rhinoplasty patients are so scarred from their experience that they are too scared to even think about jumping in the pool again after they’ve almost drowned, even if they can afford to take the chance!

And, the picture may not appear much brighter if you read our blogs. Patients say, “You talk about high revision rates and how hard the surgery is…is it even worth it?”. There are few surgeons who make a practice of doing Rhinoplasty, let alone Revision Rhinoplasty….the technical challenges seem insurmountable in many cases and it can also be very hard to win back a patient’s trust. Well, the story should not be one of doom and gloom. Just because Rhinoplasty and, especially, Revision Rhinoplasty are challenging does not mean that they cannot be consistently done well.

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Why does my nose look different than when I was younger? I now seem to have a hump that I didn’t have when I was younger.

March 01st, 2008 | Category: Aging nose,Rhinoplasty Techniques

The effects of aging on the nose have been classically described.

Aging Man picture

Its obvious when we look at our grandparents that their noses age as well. These changes have all been classically defined and at Profiles we have developed a conservative surgical algorithm which removes most of the signs of an aging nose without making you look dramatically different.

In general terms, you will note that newborns have a nasal dorsum that is concave (naturally scooped) with an upturned tip while in the elderly, the tendency is for the dorsum to appear convex with a ptotic (droopy) tip. Not all people will experience age-related changes to the same degree nor will all patients necessarily find this cause for concern.

As we age, the nasal tip often droops, resulting in an apparent dorsal hump. All we need do to see this is to look at photographs of our grandparents in comparison to their younger counterparts. It always appears as if a hump has grown with time; in truth, this is an optical illusion since our noses don’t grow substantially after the age of maturity. Rather, as the tip drops creating an acute nasolabial angle, the dorsum appears more prominent in contrast to the tip.

To correct these changes, here at Beverly Hills Profiles we follow a specific surgical sequence which we have found allows us to optimally restore your nose to its more youthful appearance. We encourage you to read more in our Modern Rhinoplasty textbook under Aging Nose.

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