Saturday, April 16, 2016

Should I use cadaver rib for revision rhinoplasty?

Revision rhinoplasty is a complex surgery that frequently requires additional cartilage for grafting purposes. If septal cartilage has already been utilized from the original rhinoplasty surgery to correct a deviated septum there may be insufficient cartilage for grafts during revision rhinoplasty.

Other options for additional cartilage are ear and rib cartilage. Ear cartilage is a weaker cartilage that is thin and curved. It makes for excellent grafts to shape around the nostrils and tip of the nose. However, it is not ideal for spreader grafts or for dorsal onlay grafts that need to be more stiff, thicker, and straighter.

Rib cartilage is an ideal cartilage to build the bridge of the nose, straighten the nose with spreader grafts, or reconstruct the septum. Autologous rib or your own rib can be used in men under 45 and women under 50 as it has typically not calcified at this stage. It does require an extra incision just under the breast about 2-3 inches long.

The other option for rib is cadaver, irradiated, and purified rib. This is provided from organ tissue labs and is taken from young cadaver donor rib. Obviously the donor has been extensively screened and the rib has been purified and irradiated. Cadaver rib for revision rhinoplasty has the same warping and infection rate as autologous rib. However, some studies have shown that it may have about 20% higher resorption or absorption rate.

If you are opposed to a second site surgery and want to the avoid the risks involved with using your own rib, cadaver rib is an excellent option for revision rhinoplasty.

Dr. Funk is a revision rhinoplasty expert in Houston.

Tuesday, April 12, 2016

Rhinoplasty for a bulbous tip

Many people who are seeking rhinoplasty are interested in addressing their bulbous tip or boxy nasal tip. The open rhinoplasty approach is the best way to refine the tip and create a more triangular appearance as opposed to a rhomboid shaped tip.

The open rhinoplasty approach involves making an external incision in a hidden area between the two nostrils and elevating the skin off the cartilage that forms the tip of the nose. This provides excellent exposure of the cartilage in order to shape it to form a refined nasal tip.

Correcting a bulbous tip can be done with sutures or stitches reshaping the tip, cartilage grafts, trimming certain aspects of the cartilage, and thinning the nasal tip skin.

Dr. Funk is a top rhinoplasty surgeon in Houston, TX.

Monday, April 4, 2016

What is a non-surgical nose job?

Rhinoplasty or a nose job is typically a nose surgery performed to reshape the appearance of the nose. With the rise of fillers such as Restylane, Juvederm, and Radiesse, more physicians have been trying to shape the nose with these fillers. This is what we describe as a non-surgical nose job.

What a rhinoplasty patient has to understand is that adding volume or filler to the nose will actually make the nose bigger. You cannot make the nose smaller without surgery. The area most commonly injected with filler is over the bridge of the nose to build it up and create a stronger straighter profile. It is essential to seek a well trained injector with much experience as the nose is quite vascular and injection into a blood vessel could lead to skin loss and severe scarring.

I personally do not favor filler injection to the nose unless it is for a minor tweak after rhinoplasty such as a graft loss or cartilage resorption leading to a small depressed area.

Dr. Funk is a top rhinoplasty surgeon in Houston, TX