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

For Zoom video consultation  contact on what’s app 91-7470864561 consultation fee @1000 Rs.

Cleft Lip Nose deformity

Dr.Baser's Better Rhinoplasty

Patients with cleft deformity have cosmetic problems and impaired nasal airflow as a result of distorted anatomy.These patients have septal deflections, atretic nostrils, turbinate hypertrophy, and cleft lips and palates

Cleft lip nasal deformity offers a unique challenge to the reconstructive surgeon for many reasons.

1) clinical presentation of cleft lip varies widely, requiring a host of surgical techniques.

2) deformity may be quite severely asymmetric, making surgical correction difficult.

3) patients with cleft lip may have been previously subjected to numerous surgical interventions, leading to significant scar tissue in the operative site.

Unfortunately a Good cleft lip surgeon may be not be so well skilled in Nose surgery very often patient goes back to the cleft surgeon ,who tries to correct but the results may be not be most satisfactory ,a specialist Rhinoplasty surgeon can be of better help

4) Timing of rhinoplasty, whether synchronous or staged with…

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Rhinoplasty in Thick skin patients, It is difficult but Good results are possible

Dr.Baser's Better Rhinoplasty

  • Rhinoplasty patients with thick skin have a significant subcutaneous fatty layer beneath the skin and this layer can hold swelling fluids (edema) for a very long time.
  • Pre opreative skin preparation about 2 to 4 weeks before my exfoliants like salcylic acid face wash and topical retinoic acid may be useful
  • Use of Oral Isotretion to improve the acne prone skin and reduce thickness ,though useful but Isotretion may have several side effects and need to be taken under strict medical supervision .The liver functions need to be monitored by regular blood tests.Pregnancy need to be avoided for up to 6 months after stopping Isotretion to avoid possible teratogenic side effects. We use a very low dose Isotretion 10 to 20 mg per day to reduce the incidence of side effects this need to be continued for 6 to 8 months
  • Patients must be warned that it may take long…

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Low cost Rhinoplasty

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You may think that this is a far stretch from choosing your rhinoplasty surgeon, but in all reality – it’s not. Nasal surgery is often complex, with a perfect balance between structure and function, each procedure carefully planned and executed to achieve the best result.

Therefore, who would you choose to do it? A well qualified and experienced Rhinoplasty specialist who has performed countless rhinoplasties before yours, who has the “before and after photos” to back up this skill and experience? Or would you trust your face to the lowest bidder, a “chop shop” that employs surgeons with limited experience doing every cosmetic procedure on earth from breast to liposuction and occasionally Rhinoplasty ,certainly lacking the vision, or most certainly, the skill required to achieve the result you’re hoping for?Many have started practice , invested a lot in fancy clinic, want to increase the number of foot falls by charging less & less making it look much more affordable , sounds great but in fact they may be learning by practising Rhinoplasty on you at your cost

Rhinoplasty surgery is not something to trifle with…as the rule behind this procedure, is that you only want to do it once!

In a market economy ,the first thing patient ask how much a Rhinoplasty cost ?that’s natural but one need to understand Rhinoplasty is different from online shopping ,you want to have it done once only to get the best aesthetic and functional results ,the lowest cost may help you saving some money but soon you will realise a sub optimal result is not what you expected.Its better not to undergo Rhinoplasty than taking Risks with your nose


एक बाजार अर्थव्यवस्था में, पहली बात रोगी पूछते हैं कि राइनोप्लास्टी की लागत कितनी है? यह स्वाभाविक है लेकिन राइनोप्लास्टी को समझने की आवश्यकता ऑनलाइन खरीदारी से अलग है, आप इसे केवल एक बार सबसे अच्छा सौंदर्य और कार्यात्मक परिणाम प्राप्त करना चाहते हैं, सबसे कम लागत। आपको कुछ पैसे बचाने में मदद मिल सकती है, लेकिन जल्द ही आपको एहसास होगा कि एक उप इष्टतम परिणाम वह नहीं है जिसकी आपको उम्मीद थी। बेहतर होगा कि आप अपनी नाक से रिस्क लेने की तुलना में राइनोप्लास्टी न करें।

Teenage girl ridiculed’ because of her nose Nasal Tip plasty changed her life

Though we get many patients who wants their noses to be like Film star have fancy ideas about Nose Job ,but a majority of patients want to live a normal life .They want to look like all others .These are the patients who are benefitted greatly from Rhinoplasty .Story of a young Teenage girl in her own words

Rhinoplasty in Thick skin patients, It is difficult but Good results are possible

  • Rhinoplasty patients with thick skin have a significant subcutaneous fatty layer beneath the skin and this layer can hold swelling fluids (edema) for a very long time.
  • Pre opreative skin preparation about 2 to 4 weeks before my exfoliants like salcylic acid face wash and topical retinoic acid may be useful
  • Use of Oral Isotretion to improve the acne prone skin and reduce thickness ,though useful but Isotretion may have several side effects and need to be taken under strict medical supervision .The liver functions need to be monitored by regular blood tests.Pregnancy need to be avoided for up to 6 months after stopping Isotretion to avoid possible teratogenic side effects. We use a very low dose Isotretion 10 to 20 mg per day to reduce the incidence of side effects this need to be continued for 6 to 8 months
  • Patients must be warned that it may take long time may be a year or more for the micro-edma to settle and final results to be apparent
  • Rhinoplasty patients with thick skin can develop post-op scar tissue beneath the skin as the post-op edema lifts and creates a “potential space” under the skin and above the cartilages and bone.
  • This “space” can fill with scar tissue. Post-operative steroid injections are usually indicated in Rhinoplasty patients with thick skin to prevent soft tissue polly beaks.
  • An experienced Rhinoplasty Specialist may very gently thin this subcutaneous layer out to slightly think the skin in a thick sebaceous skinned patient.
  • extreme caution must be used to avoid compromising the blood flow to the skin in order to prevent skin necrosis. This is a very advanced technique that must be used conservatively.

In Rhinoplasty patients with thick skin, additional cartilage in the form of grafts are often used to create the definition and narrowing desired at the tip and along the bridge.( a strong tent pole must be used to create a nice defined tent.)

This may be a different concept at first for patients (and unfortunately for many inexperienced Plastic Surgeons).

We believe with proper selection of cases peri-operative skin care and use of proper surgical techniques good results can be achieved in majority of thick skin patients

Failed Rhinoplasty & Revision Surgery

Dr.Baser's Better Rhinoplasty

Failed Rhinoplasty can be devastating and can have sever emotional impact Rather than gaining a long-awaited nasal enhancement, the patient is left with a disappointing and unfamiliar facial appearance. The resulting impact upon self-confidence can vary, but for some, embarrassment, lack of self esteem and depression can affect nearly every facet of life.

Although the causes of a failed Rhinoplasty are many
On part of surgeon
1)occasional Rhinoplasty surgeon ,general plastic/General ENT with limited Rhinoplasty experience
2)Using old outdated technique
3)Inability to project long term results
4)Over ambition -Trying to achieve unrealistic results

non-compliance on behalf of the patient, not following post operative instruction or do not come for follow up appointment ..

Use of artificial material like Silicone – the initial operation is simple as it requires just insertion of a implant results can be done in half an hour’s time as day surgery ,Immediate results are very good…

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