Primary Rhinoplasty: Getting it Right the First Time

Session Description

Rhinoplasty is a challenging operation in which both functional and aesthetic considerations are always present. Every nose is different with its own unique anatomic, aesthetic, and functional characteristics that mandate careful assessment so as to facilitate formulation of an individualized treatment plan. Skin texture, thickness, elasticity, and vascularity; cartilage stiffness, shape and abundance; and airway size and configuration are all critical parameters that present potential impediments to a successful rhinoplasty outcome. Hence, a thorough pre-operative nasal examination is a critical component of every operation. Then, following a careful cosmetic assessment, and an equally careful delineation of the patient’s aesthetic desires, the information is collated and juxtaposed against the various anatomic and functional limitations to create a tailored and individualized treatment plan. In the past 2-3 decades, surgical intervention has steadily evolved to emphasize the preservation of existing skeletal structures and the avoidance of skeletal excision whenever possible. Skeletal repositioning, redistribution, and reinforcement is now used as an effective alternative to excisional rhinoplasty techniques that often destabilize the skeletal framework leading to delayed cosmetic and functional morbidity. Only a strong and shapely skeletal framework with adequate airway dimensions will lead to predictable and durable rhinoplasty outcomes.