Showing posts with label Reverse V Deformity. Show all posts
Showing posts with label Reverse V Deformity. Show all posts

Monday, August 31, 2020

Common Mistakes and Problems in Rhinoplasty Operations

Some Problems That Can Be Seen After Aesthetic Nose Surgeries


Although the face is the most visible area of a person at first glance, correction of deformities found in this area is very important from an aesthetic and psychological point of view. Thanks to the development of techniques applied in the field of Medicine and the application of innovative methods, nose surgery related to nasal aesthetics can be performed in today's conditions in the form of much simpler operations than in the past. Rhinoplasty, called rhinoplasty, can be an important requirement both with aesthetic expectations and in terms of Health. As a result of eliminating the disorder in the area with aesthetic surgery, the person can breathe in a healthier way and have the nose that they want.

Common Mistakes and Problems in Rhinoplasty Operations


Recently, everything from fashion to beauty to aesthetics turns to nature. Aesthetic concepts also change with the return to naturalness. For example, the upturned, nostrils that we used to like are now found far from naturalness, while the noses that seem to be corrected with small touches are preferred. Among the reasons why patients have rhinoplasty is to repair deformities in an injury or to change the physical appearance of the nose to correct a birth defect, or to facilitate breathing by improving some breathing difficulties.

Rhinoplasty is one of the most common in aesthetic operations. It is done in order to eliminate deformities that exist naturally in the nose, occur later or occur due to trauma. Disfigurement should be corrected in some cases only because it causes visual discomfort, while in most people it also causes problems such as respiratory disorders. No matter what reason aesthetic surgery will be applied, the primary goal in nasal aesthetics is to make the respiratory tract in the nose work best at the end of the operation. During the operation, one or more of the procedures for reshaping the nose, removing disfigurements, or changing the shape of a part are applied.

Pinch Deformity


Rhinoplasty is a procedure performed in the nose aesthetics (rhinoplasty) to reshape the nose by changing the structure of cartilage and bones. In order to create a more aesthetic nose shape, sometimes it is necessary to cut the bones and cartilage, sometimes on the contrary, complete their missing places and change their shape. 

The fact that the tip of the nose looks like it is squeezed with a latch is called a pinch deformity. In fact, many people who have had nose surgery can experience this problem with the tip of the nose. Because in aesthetic nose surgeries, the tip of the nose is usually politely and clearly desired. There are 2 reasons why this problem occurs. In previous techniques, the tip of the nose and wing cartilage are narrowed as much as possible, and the tip of the nose was tapered by stitches thrown at the angles of the cartilage that make up the tip of the nose. Although it looked beautiful in the early period, in the late period when the payments passed, the tip of the nose formed an image of being squeezed with a latch. Internal collapses in the wings could also narrow the airway and disrupt a person's breathing. But in newly applied aesthetic operations, less is taken from cartilage to make the tip of the nose obvious and elegant. Three vertices of cartilage and the cartilage become an entirely different anatomical point thanks to the stitches and the cartilage is getting into a more open airway position, and this position squeezed from tip of nose to suppress the image of the collapse with the latch is to run. Pinch nose rhinoplasty is a complication of the tip of the nose. The tip of the nose looks extremely narrow, as if it is tight with the latch. Excessive removal of nasal cartilage and close and tight removal of nasal tip forming sutures form pinch deformity. In rhinoplasty, the support tissue and roof are one of the most important elements. A bad shape and a decrease in breathing occurs when there is also weakness in this supporting tissue at the tip of the nose. This deformity can be corrected with adding missing cartilage tissues to the tip of the nose, reshaping it. Here, nasal tip techniques such as batten graft, lateral krural strut, and lateral krural reconstruction can be used. Extra cartilage tissue can be taken from the cartilage of the septum or auricle. The skin at the tip of the nose can also be thickened with chopped cartilage or a thin fascia.

Inverted V deformity


Inverted-V Deformity


Especially in photos taken with flash, the formation of an inverted V-shaped shadow on the back of the nose is called an inverted V-deformity. It can often be seen on surgical noses. This problem arises for 2 reasons. In our nose, where the bone ends and the cartilage begins, the lack of cartilage tissue can cause this. This problem can be caused by excessive cartilage removal or lack of necessary support. The second reason is that the bone roof, which opens after the nasal arch is removed, cannot be adequately closed. In order to prevent reverse V deformity, it is necessary to make sure that the nasal bones are shaped to close the roof. In addition, long cartilage supports in the form of beams are placed on both sides of the septum cartilage in the back of the nose. In this way, both the natural width of the back of the nose is formed, and the bone – cartilage transition line softens, preventing the formation of Shadows. These supporting cartilage also contribute to the opening of the airway by increasing the angle called the internal nasal valve.

Saddle Nose Deformity


Saddle Nose Deformity
Image source: Saddle Nose Rhinoplasty - 
https://emedicine.medscape.com/article/840910-overview

From the side, the collapse of the back of the nose is called the saddle nose. The reason for this is due to 2 applications. First, trying to make an overly curved nose can cause this nose. Already now the overly curved nose is desired by very few people. In recent years we have been making more natural, balanced height and flatter noses. The second reason is that during the treatment of curvature of the septum (the basic support structure of the nose, consisting of bone and cartilage in the middle of the nose), very aggressive surgery on the septum or removal of close to the entire septum also causes the appearance of a saddle nose. We know that the septum is the basic support of the nose. Minimalist approaches are now exhibited during surgical procedures applied to the septum. Only the curved part of the septum is corrected without disturbing the support function. But it is necessary to correct the curvature of the septum. Because a septum that is not in the middle both prevents breathing and causes the nose to appear curved from the outside. 

Dorsum Irregularities


Indentations and protrusions on the back of the nose, especially seen from the side, are called dorsum irregularities. It can occur especially in late periods when payments pass. In order for this not to happen, it is necessary to shape the back of the nose with rasps, chisels, scalpels and scissors with very thin and precise techniques. It's been checked over and over. Op. In addition, a paste made from bone and cartilage powders, a series of six tissues or a temporal novelization fascia can be used to remove these pummels.

Pollybeak Deformity


The nasal tip region is called the" nasal type region "and the region immediately above the nasal tip is also called the" supratip region". After rhinoplasty operations, when the natural ratio of these two regions is disrupted, an image of the tip of the nose similar to the appearance of a parrot's beak (parrot's beak) may appear. This deformity, which occurs because the Supratip region is ahead of the type region, is called "beak nasal deformity" or "Pollybeak deformity". This deformity can occur due to more than one cause.

Causes Of Pollybeak Deformity


The most commonly known cause is insufficient resection from the supratip region. In other words, beak nasal deformity is a complication of rhinoplasty. In addition to insufficient removal during surgery, excessive wound healing that can occur in the supratip area can also occur due to proper growth in the front due to tissues. In this case, re-surgical reduction of this area may be sufficient for treatment. Especially in patients with thick skin, after rhinoplasty surgery, excessive healing tissue (scar tissue) may occur in the supratip area, and in this case this appearance in the form of a parrot's beak may occur.

Another cause of beak nasal deformity may be a collapse at the tip of the nose. Nasal deformity can occur again when the tip of the nose is further behind the supratip area.

Excess in the Supratip region pushes the tip of the nose down, causing a downward rotation of the "type" region. This deformity is also known as" Parrot beak deformity "or" supratip fullness".

According to their cause, beak nasal deformity can be classified as follows: in general, pollybeak deformity can be classified in two main ways:

1. Cartilaginous beak nasal deformity (cartilaginous polly beak)

- Supratip region remains ahead due to excessive resection of the nasal bone
- Supratip region remains ahead due to incomplete resection of Supratip region
- Lag of the type area due to excessive resection of the lower lateral cartilage (loss of nasal tip support)


- Lack of proper bandaging of the skin in the Supratip area or the appearance of overly soft tissue in the supratip area during recovery, depending on skin characteristics
- Excessive thick skin on the tip of the nose and supratip
- Improper resection of the vestibular mucosa 
- Excessive scar tissue in supratip area of the nose deformitesin the emergence of Gaga, in fact, something that's misleading physicians who have a nose job during the surgery paid for this supratip deformity after surgery and the edema in the region, conceal, is to reveal this deformity is replaced by scar tissue.

Patients with a beak nasal deformity often complain the most because of the "beak look". If the support of the tip of the nose is also weak; this appearance may appear exaggerated when laughing.

In patients with a deformity classified as" cartilaginous beak nasal deformity (cartilaginous polly beak deformity)", treatment can be provided by planning revision rhinoplasty (secondary rhinoplasty). Tissue resection and other interventions can be performed according to the amount and cause of the deformity. As can be seen from the side, the low downward appearance of the tip of the nose caused by this deformity disappears by reducing the height of the supratip section, which is excessive, and removing some of the tip of the nose.

In patients with deformities classified as" soft tissue beak nasal deformity (soft-tissue polly beak)", steroid injection and bandaging may be recommended to the supratip area.

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