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Rhinoplasty – building up the Nose

Often rhinoplasty requires adding to the nasal structures rather than taking away explains Sydney cosmetic plastic surgeon DR DARRYL HODGKINSON

Whenever the nose needs structure added, it requires either a bone or cartilage graft or an implant. There are many reasons a person may want their nose to be “built-up”. These include congenital deformities, which may result in an uneven nose, a nose broken through trauma that may require more support to the bony structures, people from Asian descent who may want a stronger bridge all patients who have a sixties “over-operated on nose”.

Whatever the reason, nasal grafting is more popular than you may think. Sydney cosmetic plastic surgeon Dr Darryl Hodgkinson explains: “About 15% of my patients have some kind of grafting during a rhinoplasty to get the optimal shape of the nose.”

So What Does The Surgery Entail?

Dr Hodgkinson prefers to use the patient’s own tissue to make the graft. While there are options such as silicone implants he recommends using bone and cartilage. “The body will have a reaction to anything you put in that’s foreign. However, if it’s your own tissue your body won’t have a reaction. There are also long-term problems associated with implants and we want to avoid these in the nose because the tissues are so thin and everything underneath will show if the skin or lining of the nose becomes fragile with time.”

If cartilage is needed it is usually taken from the septum (cartilage dividing the nostrils) or behind the ear. This ensures the scars are well hidden. “I usually try to take the cartilage grafts from inside the nose itself, from the septum. When this is not possible, for instance if the septum is twisted or damaged and needs rebuilding, I’ll take the graft from behind the ear,” explains Dr Hodgkinson. Bone grafts may also be necessary and these are usually taken from the elbow.

Taking the grafts doesn’t require more than 15 minutes surgical time and once harvested they can be crafted into the appropriate size and shape. “This way they won’t show under the skin and they will become an accepted and living part of the face,” says Dr Hodgkinson.

BEFORE and AFTER Rhinoplasty by Dr Hodgkinson
BEFORE and AFTER Rhinoplasty by Dr Hodgkinson
BEFORE and AFTER Rhinoplasty by Dr Hodgkinson