Topical issues of surgical correction of the nose

Among the many operations that plastic surgeons perform on their patients, one of the most requested, and at the same time, the most difficult, is the surgical correction of the nose. It was this surgical intervention that was dedicated to the second day of one of the most significant events for the world of plastic surgery - the Visiting Professor Program II conference, which was held in Kyiv in early September. Especially for estet-portal.com, the speaker of the event, Honored Doctor of Ukraine, Doctor of Medical Sciences, Professor Oleg Anatolievich Kompaniets spoke about the most pressing issues of surgical correction of the nose.

Oleg Anatolyevich, tell me, how often do you have to deal with the problem of a post-traumatic nose?

Most of my patients – These are just patients who are operated on after injuries. It should be noted that such injuries may be associated with some life situations, but previous operations in the patient's history are also injuries that we call iatrogenic.

There are a lot of such operations: two out of three rhinoplasties are revisions, and most of them are related to previous operations.

This fairly common situation is due to the fact that more and more surgeons enter our specialty and believe that rhinoplasty – this is one of those operations that they must master. But, on the other hand, this is one of the most difficult operations in plastic surgery: three types of tissues – bone, cartilage and skin must be combined. The number of repeated surgical interventions is associated with the complexity of the surgical correction of the nose.

In what cases is open rhinoplasty preferred, and in which cases closed rhinoplasty?

In my practice, in the vast majority of cases, I prefer closed technologies, because, from the point of view of patients, they have no drawbacks. And open technologies do not have advantages for the patient. Based on the interests of the patient, of course, you should try to perform closed rhinoplasty. There are no technical difficulties that cannot be met with a closed method. Yes, it is much more difficult, requires certain skills, but it is possible.

From the perspective of patients, the closed technology of nasal surgery should be preferred.

Of course, it is ideal when a doctor knows how to operate both openly and closed, and in each case chooses the best method.

In your opinion, how effective is the method of non-surgical nose correction with fillers?

You need to understand that this method cannot fundamentally change anything. In addition, nose correction with fillers is always an augmentation rhinoplasty, that is, associated with an increase in volume, because in this case we smooth out all the irregularities that are on the back of the nose by filling in the cavities and lack of tissues. In my practice, patients who ask for volume increase are extremely rare, so augmentation rhinoplasty is not so in demand. But there are cases when, for health reasons or other indications, it is impossible to perform surgical correction of the nose. In such cases, nose correction with fillers may well be the right procedure for the patient. But, firstly, a temporary, and, secondly, an increasing effect, make this procedure not as effective as conventional rhinoplasty.

Are there any defects that surgical correction of the nose cannot eliminate?

There are severe defects where parts of the nose are missing, or birth defects where it is very difficult to achieve symmetry or restore the nose pyramid. But if after the operation we still get an improvement, and if this improvement leads to an improvement in the patient's quality of life, he feels more relaxed, satisfied with the result, and receives those changes that relieve him of the psychological burden associated with his appearance – then this operation must also be considered successful.