Septorhinoplasty: Patient #898163


Patient Overview:

Patient had a deviated septum and wanted to correct breathing issues as well as cosmetic appearance with a septorhinoplasty. They found their nose too large overall, dorsal contour irregularities/bump, and a boxy tip.

Patient is 3 years post-op.

Surgical Case Study:

  • Rhinoplasty-Approach: An inverted V. incision was made in the columella and extended into the vestibular skin. This extended behind the soft triangles and along the inferior border of the lateral crura. Subperichondrial dissection continued over the lower lateral and upper lateral cartilages. Wide subperiosteal dissection was performed over the nasal bones.
  • Rhinoplasty-Caudal: A septal extension graft was fashioned and fixed to the septum using multiple 4-0 PDS. The medial crura were fixed to the graft using 4-0 PDS.
  • Rhinoplasty-Dorsum: Dorsal irregularities were smoothed with a rasp.
  • Rhinoplasty-Middle Third: A left spreader graft placed and fixed using 4-0 PDS. A right spreader graft placed and fixed using 4-0 PDS.
  • Rhinoplasty-Septum: The lower laterals were split. The mucoperichondrium and mucoperiostium were elevated off the left side of the septum. The mucoperichondrium and mucoperiostium were elevated off the right side of the septum. The bony cartilaginous junction was disarticulated. The lower two thirds of the bony septum was removed. Cartilage was harvested from the edge of the cartilaginous septum preserving a 1cm dorsal and caudal strut. The caudal septum was anchored to the maxillary spine using 4-0 PDS in a figure of 8 fashion. A large quilting suture of 4-0 gut was placed to coapt the mucosal flaps.
  • Rhinoplasty-Tip: Cephalic trim was performed preserving 8mm strips. Tip defining sutures were placed using 4-0 PDS. A spanning 4- 0 PDS was placed between the lateral crura Interdornal sutures of 4-0 PDS were placed. A shield graft was fashioned and fixed using 4-0 PDS the lower laterals were fixed to the septal angle using 4-0 PDS

Septorhinoplasty is a surgical procedure that combines two distinct techniques: septoplasty and rhinoplasty. It is performed to address both functional and aesthetic issues of the nose.

  1. Septoplasty: This aspect of the surgery focuses on correcting a deviated septum. The septum is the partition that divides the two nasal passages. If it is deviated (shifted to one side), it can obstruct airflow and cause breathing difficulties. Septoplasty involves straightening and repositioning the septum to improve nasal airflow and function.
  2. Rhinoplasty: This aspect of the surgery is concerned with reshaping and enhancing the external appearance of the nose. Rhinoplasty can address various aesthetic concerns, such as a hump on the bridge of the nose, a crooked nose, a bulbous tip, or the overall size and shape of the nose. It involves making incisions inside the nostrils or, in some cases, on the columella (the tissue between the nostrils) to access and modify the nasal structure.

Combining septoplasty and rhinoplasty in a septorhinoplasty allows the surgeon to address both functional and cosmetic aspects of the nose in a single operation. This is particularly beneficial for individuals who have breathing difficulties due to a deviated septum while also wanting to improve the appearance of their nose.

Septorhinoplasty is a complex surgical procedure that requires a skilled and experienced surgeon or an otolaryngologist (ear, nose, and throat specialist) with expertise in nasal surgery. The surgeon will carefully assess the patient’s nasal anatomy, breathing issues, and aesthetic concerns before developing a personalized treatment plan. Dr. Ferguson is both an ENT and Board-Certified Cosmetic Surgeon.

It’s important for patients to have realistic expectations and a clear understanding of the potential outcomes of the surgery. As with any surgery, there are potential risks and complications associated with septorhinoplasty, so it’s essential to discuss the procedure thoroughly with the surgeon and follow their pre and post-operative instructions for a successful outcome.