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What Makes a Rhinoplasty too Difficult

Rhinoplasty is one of the most complex and intricate cosmetic procedures with the highest rate of revision among them. Even the slightest alteration to the nasal tip or the desire to remove a hump from the bridge requires a keen artistic eye and surgical expertise. It is not surprising that many surgeons will turn a patient away because the circumstances pose too great a challenge.

Although some of the following circumstances may make a rhinoplasty case too difficult (to the point where surgery is denied), successful rhinoplasty results are possible in all these situations. A skilled and experienced rhinoplasty specialist like board-certified plastic surgeon Dr. Bivik Shah will best determine if this procedure can meet your needs.

A Bulbous Nasal Tip

Rhinoplasty has often been referred to as the “procedure of millimeters” because an alteration of just one millimeter can significantly impact the overall appearance of the nose. When reducing a bulbous nose, which is the second most common request among rhinoplasty patients, the surgeon must avoid over-thinning the cartilage and over-elevating the nasal tip. Advanced, less invasive techniques that bend and shape the cartilage should be used to minimally debulk the skin.

A Perforated Septum

A small hole in the nasal septum can cause a variety of minor symptoms such as a whistling noise when breathing. A large hole in the septum can cause more severe symptoms such as difficulty breathing, blood discharge, crusting, and pressure. The larger a hole in the septum, the more difficult it is to correct. The soft tissue in and around the septum must be stretched across the hole for closure, and large perforations cannot easily be corrected because the soft tissue can only stretch so much. A silicone “button” can be inserted into the hole as a temporary solution. Perforations smaller than 2 centimeters can usually be corrected permanently with surgery.

African American Rhinoplasty

African American rhinoplasty can pose a challenge for surgeons who primarily operate on those with non-ethnic backgrounds. The skin is usually thicker and the bone and cartilage structure is often very different than a Caucasian nose. In addition, changes to the underlying nasal structure do not show through as well on thick and dark skin. Since scarring is also more apparent on darker skin, the closed rhinoplasty approach is often recommended, which can make the procedure more challenging.

Revision Rhinoplasty

Revision rhinoplasty is always a more complex procedure than primary rhinoplasty. This is because natural nasal structures may be missing, and scar tissue may be present as a result of the first procedure. It is often recommended that a patient choose the same surgeon to perform the revision surgery because only that surgeon will know what exactly was done during the first procedure. However, many seek a more skilled and experienced surgeon to perform their revision rhinoplasty if they suspect that their first surgeon was not an expert.

Board-certified plastic surgeon Dr. Bivik Shah has performed countless rhinoplasty and revision rhinoplasty procedures and is one of the top rhinoplasty specialists in the area of Columbus, OH. If you are interested in this procedure, please schedule a consultation by calling the Columbus Institute of Plastic Surgery at (614) 482-2123. For your convenience, you may also fill out our online contact form.