Our Summary

This research paper discusses the complexities of performing two types of nose surgeries at the same time: fixing a hole in the wall that separates the nostrils (septal perforation repair) and reshaping the nose (rhinoplasty). The paper explains that such dual surgeries can be successful if careful planning is done before the operation, the surgery is skillfully executed, and the patient receives diligent care after the surgery.

The paper emphasizes that several factors should be considered for planning such a surgery, such as the cause of the hole, the condition of the hole, and the overall health of the nose. It is important to identify where the nose is blocked, understand the patient’s aesthetic aspirations, and check if the combined surgery is feasible.

The paper also points out that the techniques used for reshaping the nose and fixing the hole can sometimes overlap, making it possible to perform both surgeries at the same time. However, the method used to fix the hole can impact the reshaping of the nose, and vice versa. Therefore, it is important to carefully consider these influences while planning the surgery.

Among the various methods of fixing the hole that can be combined with the nose reshaping surgery, the paper mentions two: inserting a graft (a piece of tissue) in between the hole and rotating the inner lining of the nose, which can affect the appearance or function of the nose. Techniques used in nose reshaping targeting any part of the nose can also impact the tension or available lining for fixing the hole.

The paper concludes that combining these two surgeries can be beneficial for both the patient and the surgeon, but it should be carefully and thoughtfully considered.

FAQs

  1. What is the preoperative workup and optimization process for simultaneous septal perforation repair and rhinoplasty?
  2. What are some techniques used to simultaneously perform septal perforation repair and rhinoplasty?
  3. How can the combination of rhinoplasty and septal perforation repair procedures impact the aesthetics and function of the nose?

Doctor’s Tip

One helpful tip a doctor might tell a patient about rhinoplasty is to carefully consider the combination of septal perforation repair and rhinoplasty. It is important to undergo thorough preoperative evaluation to determine the feasibility of performing both procedures simultaneously and to ensure that the surgical plan takes into account the location of obstruction, aesthetic goals, and overall nasal health. Additionally, it is crucial to work with a skilled surgeon who has experience in performing both procedures in order to achieve the best possible outcomes.

Suitable For

Patients who are typically recommended for rhinoplasty may include those who have:

  1. Aesthetic concerns such as a large or crooked nose, a bump on the bridge of the nose, or a drooping tip
  2. Functional issues such as difficulty breathing due to a deviated septum or enlarged turbinates
  3. Previous nasal trauma resulting in a deformity
  4. Congenital nasal abnormalities
  5. Desire for improved facial harmony and symmetry

In the case of concurrent septal perforation repair and rhinoplasty, patients with a septal perforation that is causing symptoms such as nasal obstruction, crusting, bleeding, or infection may be recommended for surgery. Additionally, patients who are seeking both functional improvement and aesthetic enhancement of their nose may benefit from the combined procedures.

It is important for patients considering concurrent septal perforation repair and rhinoplasty to undergo a thorough preoperative evaluation to assess the status of the perforation, nasal anatomy, and overall nasal health. This will help determine the feasibility of performing both procedures simultaneously and guide the surgical planning process.

Overall, patients who are in good general health, have realistic expectations, and are motivated to undergo the necessary postoperative care are typically good candidates for rhinoplasty and may also be suitable candidates for concurrent septal perforation repair.

Timeline

  • Preoperative consultation: Patient discusses goals and concerns with a plastic surgeon and undergoes a physical exam and imaging to determine the best approach for their individual needs.
  • Preoperative preparation: Patient receives instructions on how to prepare for surgery, which may include avoiding certain medications or supplements and arranging for transportation to and from the surgical facility.
  • Rhinoplasty surgery: Patient undergoes the rhinoplasty procedure, which may involve reshaping the nose, correcting breathing issues, or both.
  • Perforation repair surgery: If a septal perforation is present, the surgeon may also repair it during the rhinoplasty procedure using techniques such as interposition grafting or mucosal rotational advancement flaps.
  • Postoperative recovery: Patient experiences swelling, bruising, and discomfort in the days following surgery and must follow postoperative care instructions to promote healing and reduce the risk of complications.
  • Follow-up appointments: Patient attends follow-up appointments with the surgeon to monitor healing progress, address any concerns, and discuss long-term care and maintenance of the results achieved through rhinoplasty and perforation repair.

What to Ask Your Doctor

  1. What is the reason for my septal perforation and how will it be addressed during the rhinoplasty procedure?

  2. What are the potential risks and complications associated with performing septal perforation repair and rhinoplasty simultaneously?

  3. How will the closure of the septal perforation affect the aesthetic outcome of the rhinoplasty procedure?

  4. Will I need additional procedures or follow-up care after the surgery to ensure the success of both the septal perforation repair and the rhinoplasty?

  5. How experienced are you in performing both septal perforation repair and rhinoplasty simultaneously?

  6. Can you provide before and after photos of patients who have undergone both procedures concurrently?

  7. What is the expected recovery time and postoperative care plan for someone undergoing both procedures at the same time?

  8. Are there any specific precautions or lifestyle changes I should make before or after the surgery to optimize the results of both procedures?

  9. How will the closure of the septal perforation impact my nasal breathing and overall nasal health in the long term?

  10. Are there any alternative treatment options or considerations I should be aware of before proceeding with concurrent septal perforation repair and rhinoplasty?

Reference

Authors: Jones EA, Olson KL. Journal: Facial Plast Surg. 2023 Dec;39(6):603-608. doi: 10.1055/s-0043-1772577. Epub 2023 Aug 21. PMID: 37604185