Correction d'un nez dévié par rhinoplastie - Commentaires dessinés par le Dr Niforos à Lyon

Informational video: Rhinoplasty (published in 2023). Today I'm going to talk to you about a recurring issue in rhinoplasty: a deviated tip and linear symmetry. As you can see on the nose in this video, we're dealing with an asymmetry of the tip, which is higher on one side than the other, with one nostril being elongated and the other more vertical. All of this is actually related to a deviated septum. This nostril asymmetry should be a cause for concern because, as you can see here, we also have what's called a foreign body in the right nostril—that is, a point, an angle of the septum. This is called a deviated septum. So what do we do when we have a deviated septum? First, we'll look at breathing. It's important to know if there's an obstruction, as in this case. For the pre-operative assessment, even more so than for a standard rhinoplasty, a CT scan is necessary to determine the extent of the nasal obstruction. This deviation can also manifest as a deviated nose, a nose that isn't straight, and sometimes with bones that extend to the opposite side, forming an angle with the bottom of the nose. What will need to be done? This deviated columella is indicative of the nasal septum's shape. The septum will, of course, need to be straightened. A straight septum will give you a more outward-facing nose, extending from the forehead down to the tip, much straighter. This is also the most common, though not always, cause of nasal obstruction. By clearing the passage, you'll also see, as you can see in the diagram, that your nostrils will become roughly symmetrical again. Absolute symmetry never exists in nature, but it's roughly symmetrical, meaning that someone looking at this nose from below wouldn't think, "It's crooked." And finally, we worked on the tip cartilages because they also needed to be reshaped. These tip cartilages formed asymmetrically, slightly tilted during puberty, when a child's nose transforms into an adult's. They form asymmetrically, deviated, and therefore the cartilages aren't the same on both sides. The surgeon's entire job is to reposition them in the middle, to correct this asymmetry, just as you would need to perform osteopathic surgery on the bones, as you can see in the video, to realign them with the midline of the face. As you can see here, between the before and after, the goal has been achieved. We now have a nice equilateral triangle at the base of the nose. that we previously had a completely deviated triangle. These cases of a deviated nose are complex, and you may experience a slight recurrence within the following year. While the result is still good, even better than before, in 15 to 20% of cases, a minor touch-up may be necessary. One explanation is that the skin, as we can see here, also formed during puberty, when the nose transitioned from a child's shape to an adult's. It formed over the cartilaginous structure, and because the cartilaginous structure was asymmetrical, the skin formed asymmetrically. After a year, we can perform a small resection here from inside the nostril to correct this detail, or sometimes a small piece of cartilage has recurred and twisted, and we will remove it or reshape it slightly. An asymmetrical tip, a twisted tip, is very often a sign... The symptom of a deviated septum, even if the patient feels they are breathing well. To learn more about rhinoplasty at Clinique Niforos, click here: https://www.niforos.fr/chirurgie-esth... Note: This before/after illustration is an example of a potential result and does not guarantee its reproducibility from one patient to another. All medical and surgical procedures have variations and potential complications.