Nasal anatomy is a very perfect structure.
It is one of the organs of our body with the most complex anatomy and the structure that contributes the most to the aesthetic appearance of the person who can be seen differently from every angle. There are pages of books and articles written on the anatomy of the nasal surface. But most of us see the arch on the back of our nose as ugly and want to get rid of it. The cartilage and bone structures that make up the arch are very specific structures and they are in a perfect anatomical relationship with each other. Only in some people it is slightly to the right or left, or slightly above the level. Patients call these position changes as my nose is crooked or I have a big arch.
So, does this perfect anatomical structure have to be removed to fix this situation?
I think no, just changing the height and location will be enough. This is exactly where the starting philosophy of preventive nose surgery begins.
Can the position of the nose be changed by protecting the dorsum?
Yes, absolutely… Moreover, the main air ducts that allow us to breathe pass just below the dorsum of the nose. If we protect this structure, these channels will also protect their structure and breathing disorders will not be observed.
And how does that work?
Of course, it is too complicated to explain here. This is a surgical technique and its name is preservation rhinoplasty. In fact, instead of just taking the height, it is to pull the nasal arch down by removing tissue from underneath, preserving the surface structure and only lowering its level without disrupting its integrity.
If we can do that, why should we take it off?
Patients whose nasal dorsum is not opened are less likely to have irregularities in the nasal dorsum after surgery and naturally have a shorter recovery period. Once the arch is removed, it is not possible to repair the nasal roof perfectly again or to expect it to heal perfectly even if it is repaired.
For this reason, the problems experienced lead to the development of new techniques. Preservation rhinoplasty is the present and future of rhinoplasty. The basic logic is that the more preservation we can do, the less problems we are likely to have. Preservation rhinoplasty can be performed with both open and closed methods. Here, of course, the closed method in which the skin is protected is the first choice. After all, the skin is also a structure and if it can be preserved, the basic logic is the possibility of preservation. Likewise, the vascular nerve packets in the tissue. In the detail of protective rhinoplasty, there is a sub-membrane operation. The thick membrane covering the nasal skeleton separates the soft tissues from the hard skeleton. If you work on the skeleton under the membrane, soft tissues, nerves and vessels are not cut, so that the much feared swelling, bleeding and bruises are very few and can pass quickly.
The basic philosophy is to preserve, to operate with minimal damage to the tissue. This philosophy is called preservation rhinoplasty. The method is performed by preserving all structures from skin to bone and only shaping them.
How can we simplify this surgery?
The simpler it is, the faster the recovery and fewer problems. That’s the whole philosophy.