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The shape and the function of the nose are intimately related. A surgeon performing cosmetic rhinoplasty should have expertise in understanding how the nose works and what makes it work, and a surgeon performing functional septorhinoplasty should have expertise in the cosmetics of the nose.
The nasal septum is the mid line partition on the inside of the nose. If it is bent, buckled or deviated across one or both nasal passages it will block the nose.
Septoplasty is performed to straighten the septum and to reposition it in the middle of the nose. If the nasal bones are deviated it will not be possible to reposition the septum in the middle of the nose unless the bones are also repositioned in the middle. This is because the bones and the septum are connected to each other. When both the bones and septum are deviated septorhinoplasty is performed. In this operation as well as septoplasty the bones are broken so they can also be repositioned.
If the top edge of the septum is deviated or twisted the nose will look deviated or twisted on the outside.
If the front edge of the septum, which can be felt behind the columella skin between the nostrils, is deviated or twisted then the nostrils can look asymmetric and cartilage can be seen and felt in the nostril from underneath. Septoplasty or septorhinoplasty is performed to correct these problems.
The soft cartilage sidewalls of the middle of the nose can be weak or misshapen. This can cause a feeling of blockage high up in the nose.
These cartilages may need reshaping or strengthening with grafts shaped like small roof rafters. They are called spreader grafts. This rebuilding or reconstructing is also a type of septorhinoplasty.
The tip cartilages over the nostrils provide strength and stiffness to prevent the nostrils sucking in when we sniff in. If the cartilages are weak, deformed or in the wrong position they need to be corrected.
Cartilage grafts called lateral crural strut grafts are my preferred choice to correct these external nasal valve problems. This reconstruction is a type of rhinoplasty. If the grafts are made of cartilage from the septum the operation is another type of septorhinoplasty.
Many patients seeking secondary cosmetic rhinoplasty have breathing problems because too much cartilage and bone has been removed from the nose.
Reconstructive secondary septorhinoplasty will be needed. Rebuilding the nose will restore support for the skin on the outside and lining on the inside opening up the nose.
If you are considering a nose job or have any questions regarding the rhinoplasty procedure then get in touch with us on: 020 7118 3553 for our Harley Street clinic, or 020 7118 3553 for our Guildford clinic.
