Yesterday I gave a talk in Mumbai which was telecasted to 45 centres live to hundreds of ENT surgeons across India.The point I was highlighting that in Nose surgery form and function are inseparable ,and the correct way to tackle these problem is to correct both septal deformity and external deviation in one sitting by the same surgeon
1)Patient says he just want to breath well not interested in any aesthetic procedure
2)Most ENT surgeons can do good septal surgery but are not so well trained in Rhinoplasty ,do not want to loose a patient and goes ahead and do a septoplasty operation
3) The lower part of the Nasal dorsum is actually the upper part of nasal septum and without correcting the dorsal deviation ,any septal surgery the results are suboptimal
4)Though initially there may be improvement but later on symptoms recur and many times the nasal shape gets deformed because of the surgery itself .The problems starts now
5)The revision operation in these cases is very complex and may not give a perfect results .A opportunity to correct a good looking breathing well nose has been lost
6)Two Team approach -Many times the ENT surgeon says I will call aplastic surgeon or vice versa to help in the operation ,the lay mind thinks the more the marries ,this is a perfect recipe for disaster. One nose one surgeon ,one philosophy .Very often the surgeons blame each other .This approach is condemned worldwide but unfortunately still widely prevalent in India .