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Innovations in Rhinoplasty

Before and after rhinoplasty with olecranon bone graft by Dr Hodgkinson
Before and after rhinoplasty with olecranon bone graft by Dr Hodgkinson
Before and after secondary rhinoplasty with olecranon bone graft by Dr Hodgkinson
Before and after secondary rhinoplasty with olecranon bone graft by Dr Hodgkinson

Sydney plastic surgeon Dr Darryl Hodgkinson says a successful rhinoplasty requires surgical finesse. Tara Casey reports.

According to plastic surgeon Dr Darryl Hodgkinson, nose reshaping surgery, or rhinoplasty, is technically very difficult. He says creating a nose that is in proportion with the patient’s face and features requires the experience of hundreds of cases to know whether to build up or reduce the nasal structure.

‘No two noses are alike, just as no two faces are the same, and therefore the surgeon must sculpt the nose using the tissues and techniques available,’ he says. ‘This individualisation of the rhinoplasty procedure as opposed to using just one technique is referred to as “finesse rhinoplasty”.’

The use of digital imaging before the operation allows for precise planning of the procedure, taking into account the patient’s aesthetic desires. The patient is not only able to communicate what they want and get an idea of the final result but the surgeon is also able to communicate to the patient what he or she can achieve.

Dr Hodgkinson, an expert in rhinoplasty, has over 30 years of experience with all kinds of nose reshaping surgery to reduce humps, reconstruct tips, reduce the flare of nostrils, correct breathing problems and more. He lectures worldwide at plastic surgical conferences on nose surgery and is noted in plastic surgical literature more than 20 years ago as the innovator of the operation which augments the dorsum, or bridge, of the nose using the olecranon bone graft (a small graft of the patient’s ulna bone from the crease of their elbow to avoid visible scarring).

‘Unlike silicone, Gortex and many cartilage grafts or injections used in nasal surgery, this graft has long-term stability, creates a smooth contour and stays in place,’ he says. ‘The graft is also made from the patient’s own bony tissues so it will not be rejected by the body.’

At the same time the bridge is augmented, other areas of the nose can be corrected as well, including the nostrils, the tip and the interior structures of the nose to improve breathing and function.

Patients who seek to have the bridge of their nose built up by grafting are generally those who have what is commonly known as a ‘ski jump’ or a ‘scooped out’ nose. This is common in Asian patients and also in some patients who have previously undergone rhinoplasty surgery.

‘Rhinoplasty, if performed correctly, only needs to be carried out once in a patient’s lifetime,’ says Dr Hodgkinson. ‘Therefore, the most important choice the patient makes is who will be their surgeon.’