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anesthesia : Various anesthetic
techniques can be used for rhinoplasty, ranging
from only local anesthesia to local with IV sedation
to general anesthesia. The choice of anesthesia is made
by the surgeon and the anesthesiologist, with the input
of the patient.
duration of rhinoplasty: The surgery can take
anywhere form 45 minutes to 4 hours, depending on the
complexity of the operation.
open
vs. closed rhinoplasty : There are two approaches
to working on the inside of the nose, referred to as
"open" and "closed". In the external
or "open" rhinoplasty, most of the incisions
are inside the nose with the exception of an incision
across the columella (the skin between the nostrils).
With endonasal or "closed" rhinoplasty, all
the incisions are hidden inside the nose.
There is no "right way"
when it comes to deciding between an open or closed
approach. It really depends on which way the surgeon
feels will give you the best result, which technique
your surgeon prefers, and what you are comfortable with.
Excellent results can be obtained with either method.
grafts & implants: Often
times, primary rhinoplasty (the first time your nose
is operated on) involves removal of tissue to create
the desired effect. In secondary,
or revision, nose surgery, the procedure frequently
requires replacing or adding tissue or grafts to compensate
for the unwanted results of the prior surgery.
Grafts are used to rebuild the nose
and fill in the areas that lack enough tissue in the
bridge of the nose (known as the dorsum) as well as
in the base. In cosmetic nose surgery, a graft is often
times placed on the dorsum or spine of the nose in asian
or african american rhinoplasty. They can be made
from the body's own tissue, such as cartilage or from
a synthetic material.
Cartilage Grafts: Cartilage
grafts can be taken from the septum deep within the
nose, from the ear, or from a rib. It is easiest for
the patient if it is taken from the nose; however, if
not enough tissue is present, the ear cartilage is a
good alternative. Cartilage grafts tend to look and
feel more natural than synthetic grafts, but in rare
instances, they can deteriorate or be absorbed by the
body.
Synthetic Implants: Types
of synthetic implants include silicone (Implantech and
Inamed Aesthetics are two popular manufacturers), expanded
polytetrafluoroethylene (ePTFE) implants (SoftForm®
and Gore-Tex® are the two most popular) and Polyethylene
Implants (MEDPOR®) and Hydroxyapatite Implants.
There are many different types and materials to choose
from which offers some flexibility and options for the
surgeon, but synthetic implants are sometimes more easily
felt and seen than cartilage grafts if they are not
placed correctly.
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