Operative Details in Rhinoplasty
Dr. Hughes will perform a thorough internal and external exam. Nasal photographs are taken for preoperative analysis.
The Operation (Closed Rhinoplasty – Scarless Rhinoplasty)
The patient will arrive about 30 minutes prior to the surgical start time. Dr. Hughes will meet with you again to determine if there are any additional changes you would like to make to the operative plan. Also, Dr. Hughes will confirm with you the items of the nose that will be addressed as well as those items you would like to be unaltered.
The rhinoplasty operation will be performed under general anesthesia. The operation will last one hour or so. Extremely challenging secondary or tertiary rhinoplasties may last 1.5 hours or so.
Dr. Hughes will inject local anesthetic with epinephrine to help with pain control and minimize bleeding. Dr. Hughes will used his closed approach to rhinoplasty so that the patient will have no scars that are visible. He will make incisions along the rim inside and at the junction of the upper and lower lateral cartilages. Dr. Hughes will trim the lower lateral cartilages called a cephalic trim. This will reduce the apparent size of the nasal tip and will help the tip rotate upward. Thus, this technique can raise a droopy tip.
Sometimes, Dr. Hughes will trim a little bit of the cartilage at the lower portion of the septum to help reduce apparent droopiness or columellar hang.
At this point, Dr. Hughes will reduce the cartilaginous portion of your hump if you have one. Next, he will reduce the bony portion of your hump. Next, Dr. Hughes will infracture your nose to both narrow the width of your nose and close the open roof caused by removal of the bony dorsal hump. If your dorsum does not require any surgery, these steps will not be performed. In addition, you will likely not have any bruising if no osteotomies are performed and very little if they are.
Next, Dr. Hughes will proceed to refining your nasal tip.