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Ultrasonic nose surgery uses piezoelectric instruments (scrapers wears, saws) that impact just the bones and the stiff cartilages through ultrasonic vibrations, as the instruments used in dental surgical treatment. The use of piezoelectric instruments requires a more prolonged technique than the isial one, allowing to imagine the whole bony vault, to improve it with rhinosculpture or to set in motion and stabilize bones after regulated osteotomies.


Usually, the plastic cosmetic surgeon first separates the nasal skin and the soft tissues from the osseo-cartilagenous nasal framework, and after that improves them, sutures the cuts, and uses either an external or an internal stent, and tape, to immobilize the freshly reconstructed nose, and so assist in the recovery of the surgical cuts.


The autologous grafts usually are gathered from the nasal septum, however, if it has insufficient cartilage (as can occur in a revision nose surgery), then either a costal cartilage graft (from the chest) or an auricular cartilage graft (concha from the ear) is collected from the patient's body - rhinoplasty austin. When the nose job requires a bone graft, it is gathered from either the cranium, the hips, or the chest; furthermore, when neither kind of autologous graft is available, a synthetic graft (nasal implant) is used to enhance the nasal bridge.


To tape-record the "before-and-after" physiognomies of the nose and the face of the patient, the specific visual point of views needed are photographs of the nose seen from the anteroposterior (front-to-back) point of view; the lateral view (profiles), the worm's- eye view (from listed below), the bird's- eye view (overhead), and three-quarter-profile views. Picture A. Open rhinoplasty: At nose job's end, after the plastic cosmetic surgeon has sutured (closed) the cuts, the fixed (brand-new) nose will be dressed, taped, and splinted stable to permit the undisturbed recovery of the surgical incisions.


Photo B. Open rhinoplasty: The brand-new nose is prepared with paper tape in order to get the metal nasal-splint that will debilitate it to preserve its appropriate shape as a brand-new nose. Picture A. Open nose job: Pre-operative, the standards (purple) ensured the surgeon's precise cuts in cutting the nasal defect correction strategy.

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Open nose job: Post-operative, the taped nose, prepared to get the metal nasal splint that debilitates and secures the recently corrected nose. Picture C. Open nose job: The metal nasal splint help wound healing by protecting the tender tissues of the new nose. Picture D. Open nose job: The taped, splinted, and dressed nose completes the nose job.






Open nose job: After the initial taping of the nose, a personalized, metal nasal-splint, designed, cut, and formed by the cosmetic surgeon, is emplaced to immobilize and secure the tender tissues of the new nose throughout convalescence. Photograph D. Open rhinoplasty: The taping, emplacement of the metal splint, and dressing of the new nose finish the nose surgery procedure - rhinoplasty austin.


Photograph 2. Open nose surgery: The right lower lateral cartilage (blue) is exposed for correction. Picture 1. Open nose job: The columellar cut marked as a red-dot guideline, will assist the surgeon in the exact suturing of the nose. Picture 4. Rhinoplastic correction: A nasal-hump excision strategy; the black line delineates the dorsal airplane of the new nose.


Open rhinoplasty: the nasal tip is sutured to narrow the nose. Picture 1. Open rhinoplasty: The incisions are endonasal (in the nose), over here and thus are hidden. The skin-incision to the columella aids the cosmetic surgeon in precisely suturing to conceal the scarexcept for the columellar cut (red-dot standard) across the nasal base.


Picture 2. Open nose surgery: The nasal interior. The scissors show the lower lateral cartilage (blue), which is among the wing-shaped cartilages that conform the tip of the nose. The rugged red original site delineation suggests the area of the columellar cut. When the skin has actually been raised from the bone-and-cartilage structure, the cosmetic surgeon carries out the nasal correction jobs.

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Open rhinoplasty: To narrow the pointer of a too-wide nose, the cosmetic surgeon initially identifies the cause of the excess nasal width. The stitch being emplaced will narrow the tip of the nose. The red delineation suggests the edge of the nose-tip cartilage, which is narrowed when the surgeon tightens up the folded cartilage apex.




Photograph 4. Nasal bulge excision: The black delineation indicates the desired nose-reduction result: a straight nose. The nasal hump is bone (red) above the scalloped grey line, and cartilage (blue) listed below the scalloped grey line. The cosmetic surgeon cuts the cartilage part of the bulge with a scalpel, and chisels the bone portion with an osteotome (bone chisel).


Rhinoplastic instruments: Bone-scraping rasps, of various grades and types, that the cosmetic surgeon utilizes to improve the corrections needed to produce a new nose. In plastic surgical praxis, the term primary rhinoplasty denotes an initial (novice) reconstructive, practical, or aesthetic corrective treatment. The term secondary nose surgery denotes the modification of a stopped working nose surgery, an event in 520 per cent of rhinoplasty operations, thus a revision nose surgery.


Although many modification nose surgery treatments are "open technique", such a correction is more technically complicated, typically because the nasal support structures either were deformed or destroyed in the main rhinoplasty; thus the look at here surgeon must re-create the nasal assistance with cartilage grafts gathered either from the ear (auricular cartilage graft) or from the rib cage (costal cartilage graft).


In reconstructive rhinoplasty, the defects and defects that the plastic surgeon encounters, and must bring back to regular function, kind, and appearance include broken and displaced nasal bones; interfered with and displaced nasal cartilages; a collapsed bridge of the nose; congenital flaw, injury (blunt, permeating, blast), autoimmune condition, cancer, intranasal drug-abuse damages, and failed primary nose job outcomes.

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When cartilage is disrupted, suturing for re-suspension (structural support), or the usage of cartilage grafts to camouflage a depression allow the re-establishment of the typical nasal contour of the nose for the patient. When the bridge of the nose is collapsed, rib-cartilage, ear-cartilage, or cranial-bone grafts can be utilized to restore its anatomic stability, and thus the aesthetic continuity of the nose.