Oh God what happened to my Nose-Post Traumatic nasal deformity can be devastating

Picture1Out of all the facial features the nose out stand and so as Nasal deformities.Some people are born with bad nose some have a deformed nose after a trivial trauma in Childhood  but those who had a good looking face and nose ,when they get a unexpected nasal disfigurement it is sever Psychological Shock.

At the time of initial trauma bleeding, head injury and other life threatening conditions have priority ,Nose is not very important at that time usually managed by Junior on call doctors or not so experienced doctors, after the initial period these otherwise normal persons when they see themselves in mirror they have severe psychological disturbances.When all the wounds heal the Nasal disfigurement remains and affects the over all personality,many times functional problems such as Nasal blockage and sinusitis which the patient never experienced can appear.This man with a post traumatic nasal deformity covers his face whenever goes out of house.

Case 1-One soft ware engineer had a accident head injury facial trauma was hospitalized for several days recovered from head injury ,the nasal fracture was reduced ,after the healing completed ,he had a sever saddle nose deformity hated himself for the disfigured face , left job and confined himself inside house,

Case -2 A house wife survived in a major Car accident lost a closed family member  ,primary care was given at the site and moved to a large hospital several days of hospitalization ,attempted Fracture nasal bone reduction  but left with a ugly depressed nose. She adopted a deep silence and stopped talking to any one except the bare minimum .Otherwise a beautiful  lady disfigured nose after accident seeing a psychiatrist and taking anti depressant

Case 3-A factory worker injured his nose on work deep cut and multiple fracture ,sever bleeding ,fracture reduction with repair of lacerated wound done but left with a sever depressed crooked nose with nasal obstruction

Case 4- A young man had a sever facial trauma with scared forehead and totally collapsed nose-He was ridiculed by his friends and family even his wife used to pass nasty comments ,He was considered as unlucky man by the villagers so much that he considered committing suicide but stopped short because of young children.A  gave him his life back

Nasal reconstruction

Secondary Rhinoplasty in these cases have limitation ,a thorough counselling is required and they should understand they may not achieve the pre injury nose, the scars may be less visible but they cannot disappear

Steps of surgery-

1)Exposure-Even if there is a scar on dorsum try to expose the nasal frame work through a External Rhinoplasty Exposure

2)Open up the septum and assess the abity of the septum to support the nose,partly damaged septum can be restrenthen  if there are multiple fractures it is important to  build a nasal frame work which is strong and stable,the pieces of septal cartilage/Ethmoid/vomer are very useful graft material and can be used to built up the entire nose,a rib cartilage provides a strong and stable foundation and is used a invisible graft for making the nasal frame work

3)Septal perforation can be repaired at this stage

4)A floating columellar strut gives mobility to tip as well improves tip projection

5)Dorsum Augmentation-can be done by cartilage/diced cartilage/facia-A scarred skin can be expanded only up to a limit resit the temptation to achieve the perfect nose.You can augment only as much the skin permit avoid using dorsal rib cartilage grafts they very often curls and give a crooked appearance to the dorsum

6)Facial blanket below the skin-Temporalis fascia/Fascia Lata used underlying a severely scarred and damaged skin helps in giving a smooth contour ,masks graft outline which might be visible several months after the initial surgery

7)Scar Revision -If required should be done in the end

see the VDO on You tube

Picture31sadd24trauma

 

 

Most of these patients are very grateful if we can bring them even close to their appearance before the accident.One of the most exciting moment of my life when the Husband of one of my patient called me in late evenning ,saying doc thanks After many months I saw a smile on my wifes face.Thanks for giving back her real life

Our website-www.cosmeticrhinoplastyindia.com

Akash Nose clinic Bicholi Mardana ,Indore,India Tel-91-731-2496038,4064080,09926564989

Crooked Nose Correction – Externally deformed nose with breathing problem

Better Rhinoplasty

Be  watchful  before you  select your surgeon

Crooked nose functional Crooked nose requires both internal and external correction

A two team approach is the perfect recipe for disaster

In India it is a very common practice for one surgeon to perform the external correction and another to do the septum work. In many cases the 2nd surgeon is a ‘ghost surgeon’, he comes in to the operating theatre at the time of surgery and never sees the patient after that, patients are made to believe that since two doctors are involved they will get best of both worlds when in fact the reality is just the opposite.

When I met world famous Rhinoplasty surgeon Prof Gubisch from Germany in Iran he said

“Only a surgeon who can do complete septal correction should be allowed to do Rhinoplasty”

Correction of a crooked nose is one of the more difficult and challenging aspects of Rhinoplasty…

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Rhinoplasty workshop at Akash Hospital Indore

This was the 20th Workshop for training of Doctors in art and  science of Rhinoplasty  or commonly called as Nose plastic surgery .ENT/Plastic/Maxillofacial surgeons from all over India and abroad cam to Indore for this unique experience. The delegates were trained by lectures/video presentation and Live surgery demonstration of  Rhinoplasty opreations.The faculty for the workshop were prof Ignazio  Taska from Italy .Prof.Migul from Portugal,prof.Brajendra Baser,Dev Roy &Dr.Prahalad from India.

The 3 day academic feast was enjoyed by all Doctors. It was a good time for patients as well as they got their treatment at nominal cost

 

Rhinoplasty at Discounted rates -Rhinoplasty workshop April 7-9th 2017

Good opportunity for those who want Rhinoplasty at discounted rates -Our Annual Rhinoplasty workshop will be held from 7th  to 9th April at Akash Hospital ,Indore

,8 selected cases will be operated in the workshop ,No surgeons fee only Hospital charges .Send your photos for consideration to Dr.Pragati Shubha at akashhosp@gmail.com or consult personally between 5 to 7 P.M on working days at Akash Hospital ,Rajendra Dharkar Marg ,Bicholi Mardana Opposite Agrawal public school