Excisional Rhinoplasty? Your Techniques

asked 1 year ago by sparklestar222 in florida
Latest answer by Rod J. Rohrich, MD
Question viewed 346 times
Tags: cartilage, technique

From mild research, I've read about techniques applied by plastic surgeons in the past on the subject of rhinoplasty, including "excisional rhinoplasty" which is the complete removal of certain segments cartilage/bones to create a new shape.. However, I have heard that this technique over time can weaken the nose. Do you apply a new technique? Such as using the patient's own cartilage/bone to "stabilize" the new noses construction? Thank you for your time!

10 answers to Excisional Rhinoplasty? Your Techniques

Excisional Rhinoplasty

Many years ago large amounts of cartilage and bone were frequently removed from the nose which resulted in a low profile line with an over-rotated, pinched tip. Today, with state of the art rhinoplasty, we remove far less of the underlying structure, changing contour and maintaining a strong, well-defined nose.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon

www.bevhills.com

Excisional Rhinoplasty? Your Techniques

Some older techniques involve removal of certain pieces of cartilage that then rely on scar contracture to shape the nose. Sometimes, these maneuvers look good for some time, but then may start to show irregularities or asymmetries. More modern techniques are based on maneuvers that preserve the structure and stability of cartilage and may be more reliable, with more predictable outcomes, in the long term.

Matthew Bridges, MD
Richmond Facial Plastic Surgeon

www.matthewbridgesmd.com

Excisional rhinoplasty..... Technique?

By and large I do not perform excisional rhinoplasty procedures. I perform open rhinoplasty where I do not remove much tissue if any at all. I would rather preserve cartilage and tissue by doing graduated reduction of any dorsal nasal hump(s). The goal in modern rhinoplasty is not to remove or destroy tissue but to reshape and AND RESTORE NASAL CONTOUR Excisional and/or transectional procedures are something of the past.

Rod J. Rohrich, MD
Dallas Plastic Surgeon

Excisional rhinoplasty

Excision rhinoplasty technique is just referring to a reduction rhinoplasty, such as a hump removal. On some occasions we use the patients own cartilage that was removed and we insert it as structural support when needed to improve the functionality of breathing through the nose. The most common of these are spreader grafts placed in the mid vault of the nose to prevent collapse of the upper level of the cartilage.

William Portuese, MD
Seattle Facial Plastic Surgeon

www.seattlefacial.com

Techniques in rhinoplasty

Rhinoplasty surgery is individualized to each patient's anatomy and desired results. There are numerous techniques available to change the shape of the bone and multiple cartilages in the nose, including resecting some portions or using grafts to reinforce certain areas or change the appearance. Discussion with a board certified plastic surgeon is extremely important before undergoing any surgery.

Olivia Hutchinson, MD
New York Plastic Surgeon

Rhinoplasty Techniques

Hi ss, Rhinoplasty is considered the most difficult of all facial plastic surgical procedures (well, before total face transplants were performed). Every rhinoplasty is different, requiring different techniques. The most important point which your question addresses is the underlying structural support that is left remaining after rhinoplasty. As the nose heals, the overlying skin will "shrink-wrap" around the bony and cartilaginous skeleton. ... more

Michael A. Persky, MD
Los Angeles Facial Plastic Surgeon

Excisional or Reduction Rhinoplasty

Dear Sparklestar, Rhinoplasty surgery has come a long way in the last 20 or 30 years. It was previously believed that removing cartilage and bone was the way to a good cosmetic rhinoplasy result, the "excisional rhinoplasty". Current techniques in rhinoplasty surgery now involve an assessment of the patient's actual anatomy, go figure! Based on that assessment and the patient's goals we come to a surgical plan that will most likely provide the... more

Kenneth R. Francis, MD
Manhattan Plastic Surgeon

Reduction rhinoplasty

It is not uncommon to remove tissue when narrowing the tip or reducing the size of the nose or rotating the tip. These techniques are excisional in nature. I prefer to suture define the tip and only remove when necessary. Often times I will combine excisional techniques with supportive ones as there is a fine balance in rhinoplasty between reduction and support. Typically, in most patients both components may be required to receive the most optimal results.

Scott Trimas, MD
Jacksonville Facial Plastic Surgeon

Old School Technique of Excisional Rhinoplasty

What you described as an 'Excisional Rhinoplasty' technique is also referred to commonly as a 'Reductive Rhinoplasty' technique. Both terms imply that portions of the underlying nose framework (cartilage and bone) are removed in an attempt to reshape the nose. As you pointed out, removing critical portions of the nasal framework can indeed compromise the structural support of the nose and lead to unwanted weakening. These noses often look scooped, pinched and over rotated... more

John M. Hilinski, MD
San Diego Facial Plastic Surgeon

www.drhilinski.com

Absolutely!

Rhinoplasty is not just about removal but also about rearrangement and replacement and even addition. Rhinoplasty is THE most complex of all surgeries due to numerous factors with the most important being scar tissue and healing changes over years after surgery.