Rhinoplasty is classically thought to be a procedure for cosmetics only. But in reality Rhinoplasty should be a functional surgery as well ALWAYS.
Trained in Ear, Nose, Throat – Facial Plastic Surgery – we understand the anatomy of the nasal cavity, the tubinates, the septum and the internal nasal valves extremely well. These all play a function in the ability to “breathe better” from your nose.
There are multiple procedures we perform in CONJUNCTION with your rhinoplasty, when appropriate:
1) Septoplasty – The septum is the wall that divides the inside of the nose into a left and right side. Normally it should be completely straight or have a slight bend to one side or the other. A deviated septum will lean markedly to one side or the other, or can have a break in it which causes a “spur” which can block one or both sides of the nose. During your rhinoplasty consultation, we always diagnose if you have a deviated septum. If you do, we will always add this component to your surgery. Septoplasty repair is performed through internal cuts only (NO external cuts) and we remove obstructed portions of the septum and straighten any bending areas to give you a completely straight septum to help you breathe better.
2) Inferior Turbinate Reduction – The inferior turbinates are finger like structures on the inside of your nose. They are bone on the inside, covered with soft tissue, with an outside mucosal lining. The purpose of the turbinates is to warm, humidify and moisten the air we breathe. In dry climates, or with allergies, the tubinates can swell abnormally and cause nasal obstruction as well. We will diagnose inferior turbinate hypertrophy (enlargement of the turbinates) at your initial rhinoplasty consultation. If we determine your inferior turbinates are causing obstruction we perform an Inferior Turbinate Reduction during your surgery as well. This is performed through internal cuts only (NO external cuts) and we shrink down the size of the turbinates to give you more room for nasal breathing.
3) Spreader Grafts to repair the Internal Nasal Valve – The internal nasal valve is an area bounded by the septum, inferior turbinate and upper lateral cartilage. This area contributes to the greatest sensation of good nasal breathing when it is patent. When it is obstructed patients will feel a sense of nasal congestion or obstruction. We will routinely perform a Cottle maneuver or a modified Cottle maneuver during your rhinoplasty consultation to assess the patency of your internal nasal valve. If it is found that your internal nasal valve is weak, we will use pieces of your native cartilage from the septum (usually harvested during the septoplasty portion of the procedure) and stitch these into place with an endonasal spreader graft technique that was created by Dr. Kanodia and Dr. Jack Sheen during their time together in the 1980’s Rhinoplasty world of Beverly Hills, CA. This is performed through internal cuts only (NO external cuts) and we increase the patency of the internal nasal valve so you can breathe better from your nose without obstruction.
You will ALWAYS be counseled on all 3 of these techniques during your rhinoplasty consultation with Dr. Dugar or Dr. Kanodia in order to assess how we can, not only make your nose LOOK better, but also to determine how we can make your nose WORK/BREATHE better as well.
-Dr. Deepak Dugar