How are these corrected in revision rhinoplasty, and what causes nasal bossae? Is this something that is treated with shaving down the high points and placing fascia?
Answer: Bossae are too-prominent tip cartilages. It's not really shaving that's done... See the morph I made from your photos. Click on the "Learn more" link, just below my response, or go here: FacialSurgery.com/RealSelf/RealSelf_zzzz12345.html I made a computer morph of your nose, and an animation of the morph, to show the changes that are possible with a revision of those bossae.You can't just shave down the prominences, because the prominences are arches of cartilage, and shaving them will distort the tip even more. The goal is to modify the arches so they aren't as prominent, move them a little closer to each other, and then fill in the depressions between and above and to the sides of the prominences, so the tip looks more uniform, and less like those tip cartilages are just pushing out against the skin, trying to be seen and identified. That all make sense? See if you think the morph captured what you're looking for. You should understand that the changes I demonstrated in the morph require advanced techniques, techniques that most plastic surgeons cannot handle. Be sure to read the section in the "Learn more" link on how to stay out of trouble while searching for a rhinoplasty surgeon, and read the essay on how to tell whether your previous surgeon should be performing your revision. Rhinoplasty is an exquisitely difficult operation to get right, and you should only have surgery if you are able to make yourself very confident in your surgeon's skills. Finally, at the *very* bottom of the "Learn more" page is a link to instructions on taking and sending photos that are comprehensive and useful for an online consultation like this, in case you'd like a more complete evaluation.
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Answer: Bossae are too-prominent tip cartilages. It's not really shaving that's done... See the morph I made from your photos. Click on the "Learn more" link, just below my response, or go here: FacialSurgery.com/RealSelf/RealSelf_zzzz12345.html I made a computer morph of your nose, and an animation of the morph, to show the changes that are possible with a revision of those bossae.You can't just shave down the prominences, because the prominences are arches of cartilage, and shaving them will distort the tip even more. The goal is to modify the arches so they aren't as prominent, move them a little closer to each other, and then fill in the depressions between and above and to the sides of the prominences, so the tip looks more uniform, and less like those tip cartilages are just pushing out against the skin, trying to be seen and identified. That all make sense? See if you think the morph captured what you're looking for. You should understand that the changes I demonstrated in the morph require advanced techniques, techniques that most plastic surgeons cannot handle. Be sure to read the section in the "Learn more" link on how to stay out of trouble while searching for a rhinoplasty surgeon, and read the essay on how to tell whether your previous surgeon should be performing your revision. Rhinoplasty is an exquisitely difficult operation to get right, and you should only have surgery if you are able to make yourself very confident in your surgeon's skills. Finally, at the *very* bottom of the "Learn more" page is a link to instructions on taking and sending photos that are comprehensive and useful for an online consultation like this, in case you'd like a more complete evaluation.
Helpful 3 people found this helpful
Answer: Fix nasal bossae? If your problem is congenital it is caused by the lower lateral cartilages being extremely tightly curved inward. This is also referred to as knuckled in. Treatment is by either relaxing the curve section or cutting to the segment depending on the size or shape of the overall cartilage. Sometimes a batten graft would need to be used. If you had previous surgery you were over resected and grafting would definitely be need. You also would benefit from grafting elsewhere on the nose.
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Answer: Fix nasal bossae? If your problem is congenital it is caused by the lower lateral cartilages being extremely tightly curved inward. This is also referred to as knuckled in. Treatment is by either relaxing the curve section or cutting to the segment depending on the size or shape of the overall cartilage. Sometimes a batten graft would need to be used. If you had previous surgery you were over resected and grafting would definitely be need. You also would benefit from grafting elsewhere on the nose.
Helpful 2 people found this helpful
June 29, 2018
Answer: Correcting the Nasal Tip Bossa I would not recommend shaving the bossa that is very obvious in the pictures posted because there is a risk of tip collapse unless this is a previously placed tip graft which can be repositioned. Fascia could be used if you have very thin skin.
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June 29, 2018
Answer: Correcting the Nasal Tip Bossa I would not recommend shaving the bossa that is very obvious in the pictures posted because there is a risk of tip collapse unless this is a previously placed tip graft which can be repositioned. Fascia could be used if you have very thin skin.
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June 29, 2018
Answer: Nasal tip bossae and its treatment options? Nasal tip bossae, a recognized complication of rhinoplasty, are irregular, knob like protuberances of the alar cartilages that create visible or palpable asymmetry of the nasal tip. If conspicuous, such a complication can tarnish an otherwise aesthetically pleasing result—an event that is equally distressing to both patient and surgeon alike in around 26% of Rhinoplasties in one study. There is an anatomical structure called “dome.” that is a part of Lower lateral cartilage ( the cartilage that forms the tip of the nose ).Dome of right and left side meeting together in the midline with those who has normal well defined good looking tip.In others, with large bulbous tip, these domes are wide apart and are then reduced in size surgically and placed together. The correction of this trouble is to directly address the lower lateral cartilage under vision by open tip plasty and reduce the size of dome surgically by weakening it or excising it and realign the dome at correct height and position.There are several dissolvable stitches are used to fix these cartilages in position. The space here is not enough to describe endless surgical procedures that can be done on these cartilages to reach the goal. I hope this answers your questions
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June 29, 2018
Answer: Nasal tip bossae and its treatment options? Nasal tip bossae, a recognized complication of rhinoplasty, are irregular, knob like protuberances of the alar cartilages that create visible or palpable asymmetry of the nasal tip. If conspicuous, such a complication can tarnish an otherwise aesthetically pleasing result—an event that is equally distressing to both patient and surgeon alike in around 26% of Rhinoplasties in one study. There is an anatomical structure called “dome.” that is a part of Lower lateral cartilage ( the cartilage that forms the tip of the nose ).Dome of right and left side meeting together in the midline with those who has normal well defined good looking tip.In others, with large bulbous tip, these domes are wide apart and are then reduced in size surgically and placed together. The correction of this trouble is to directly address the lower lateral cartilage under vision by open tip plasty and reduce the size of dome surgically by weakening it or excising it and realign the dome at correct height and position.There are several dissolvable stitches are used to fix these cartilages in position. The space here is not enough to describe endless surgical procedures that can be done on these cartilages to reach the goal. I hope this answers your questions
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