Among professionals, rhinoplasty is considered one of the most complex and delicate operations. It requires careful preparation and an extremely careful approach. About what secrets can be used to achieve the most aesthetic result of rhinoplasty, what role 3D modeling plays in predicting the results of rhinoplasty, especially for readers of estet-portal.com, the doctor of medical sciences, a surgeon of the highest category, a full member of the European Academy of Facial Plastic Surgery and American Association of Plastic Surgeons - Andrey Kharkov.
What methods allow you to accurately predict the result of rhinoplasty?
AH: Rhinoplasty has been performed since the 6th century BC, so this operation is more than 8 thousand years old. Naturally, all this time, surgeons have been looking for ways to increase the predictability of the expected results.
With the advent of 3D technologies, it became possible to mathematically analyze the aesthetic proportions of the face, as well as predict the result.
To obtain a qualitative and aesthetic result, it is also necessary to take into account the data of such research methods as computed tomography and four-phase rhinomanometry. Since the main secret of harmony lies in the alliance of the anatomical, functional and aesthetic features of the individual.
How to prevent nasal breathing problems after rhinoplasty?
A.Kh.: During aesthetic rhinoplasty, it is always necessary to control the preservation of the nasal breathing function. Because any change in the shape of the external nose is accompanied by a change in the shape of the airways.
In this regard, when performing rhinoplasty, you need to clearly imagine what will happen to the structures of the ostio-meatal complex, and to prevent changes that can interfere with nasal breathing, smell, air warming, and its purification. Therefore, it is important to calculate & nbsp; cross-sectional area of the nasal passages through which air passes from the entrance to the nose to the nasopharynx.
Patients ask about rhinoplasty access: open or closed. What are your preferences?
А.Kh.: Closed access can be used in primary rhinoplasty, if the patient does not pursue filigree accuracy in the expected result. With a closed approach, there is no scar on the skin part of the columella, but there is also no binocular vision control over the structures of the nose.
With closed access, there is no possibility of adequate fixation of the nasal elements in the middle position and the correct proportional relationship between them.
If the patient has special requirements for the aesthetics of the result and its stability, I choose open rhinoplasty. Firstly, it gives pronounced guarantees of the stability of the skeleton, and consequently of those tissues that follow its contours. In the case when it is a repeated rhinoplasty, or a nose job after an injury, it is also advisable to choose an open approach in order to understand the anatomy of the nose and return its structures to normal proportions and ratios.
"Revision Rhinoplasty" – very common procedure. What mistakes lead to such a need?
A.Kh.: In the USA and South America, revision rhinoplasty is performed in 10-15% of cases, in European practice — 35%, a in the practice of novice surgeons, this figure often reaches 60 percent. Rhinoplasty is a complex operation, since the nose consists of a huge amount of tissues that are restored and regenerated in an absolutely special way: these are bones, and mucous membranes, and skin, and muscles, and fatty tissue. Rhinoplasty — this procedure is not for beginners, it requires fundamental preparation, good training, analytical thinking, spatial imagination, a lot of skills in terms of surgical dissection and very gentle tissue care.
Rhinoplasty — this is one of the most integral procedures, as it involves a major surgical intervention, which must be carried out taking into account all the functional features of the nose.
Successful rhinoplasty requires experience, because just as people differ from each other, their anatomy can be just as variable. And, of course, rhinoplasty — this is creativity, because the aesthetics of the face requires a special artistic look.
As Georg K. Lichtenberg said: “The most interesting surface on earth for us — it is a human face». In a word, this is a very difficult task, which must be approached conscientiously and carefully, and it is necessary to enlist the support of the Almighty in order for everything to be successful.
Thus, the doctor's experience, his ability to think abstractly are the key to the success of any surgical intervention. Trusting Andrey Kharkov nose plastic surgery, you can count on the most aesthetic result. After all, the artistic approach on the part of the surgeon – it is always beauty and harmony as a result.
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