AUGMENTATION RHINOPLASTY. Anon ‘Asians. the nose is often flat at the bridge and ‘oad and bulbous atthe ep. Asa result, che main deste isco have the nasal contour higher, the nose tip smaller and more prominent in appearance and projection. The low nasal bridge can be The NOSE is one of the most prominent facial features, and is often readily injured. It is also a ‘common site of congenital deformity and tumour formation. Rhinoplasty Is plastic surgery performed on the ose, and is also one of the most ‘frequent plastic surgery operations. ‘The surgeries often involve the shaping or restructuring of the bony or cartilaginous deformities or an associated correction of a deviated nasal septum which can bea functional disability, For cosmetic surgeries, the common ones are Corrective Rhinoplasty, © Augmentation Rhinoplasty, Reduction Rhinoplasty or a combination of one or more af these. enhanced by bons, carlage or synthetic material like silicone For the own bone and carlage ie can be harvested fom sites ike the patient ile eestor eib, I has becarefullycarved to fit the desined contour. This isthe best implant ast isthe patients own tase, but there ae some disadvancages. The desired shape cannot be achieved Sometimes because the cartilage for bone may bend, and hence cause distortion, Anatomically, the nose can be divided into an upper ewovthids boay fixed portion, and lower ‘one-third soft carlaginous or mobile segment. If we use the bone or even a rigid cartlge grfi Ie is often too stil forthe whole nose and hence may appese rather unnaturl In adltion the patient will have to undergo an addiconal operation harvest the graft, and this may leave varying degree of seattng at che donor sce. ‘The nexe option isco ute synthetic material, andthe most widely used one in thinoplasy, i che silicon prosthesis. These prostheses are often soft and pliable, and are avallabe in various shapes and sizes, ‘They canbe further shaped ro conform tothe desiced proiles. As itis lo soft, the nose will not look sti, unless che patiene decides to havea very prominent nose like the Westerners do Ie is crucial to postion the prosthesis co rest securely on the nasal bone to that ic will not stick out and become mobile. Ie must be placed in straight position, so that there is no observable deviation. Absolute steility during the operation mast be ensured to prevent potential infections. If there isan infection, it ie almose always Aifcule to eradicate, and the prosthesis may have co be removed, Many other materiale ae also avilable like coral extracts, Teflon and others. But, hese must be carefilly selected to aut the individual patient REDUCTION RHINOPLASTY. For Westerners, the nose can be over prominent in both ehe bony and carlaginous portion. There may also bean obvious naal hump, unusually high asl bridge or very large deviated of curved nail tip which does not conform to the surrounding anatomical seeuctures. These will have to be reduced proportionately, so thatthe nose will blend with the surrounding facial fearures. ‘Asians differ by having broad norrils and bulbous nasal tips and it also can appeat too prominent and unflattering. The broad norsils can be natrowed and the bullous natal tip reduced by removing the excest. Abrofatey tues, The low nostril concours can also be enhanced by rearranging the carlages. CORRECTIVE RHINOPLASTY, Somme: the nose can be deformed due 0 ether congenital smal developments or acquired through acidenes ot traumas, Ie can involve the nasal bone or cattlage or booth. Correction of these deformities wil depend on theexisting conditions. Forpatients with flips, the natal deformities can be corected by tearangements of the deformed cartilages and reinforced by ‘atilage grafts taken from the nasal seprum of the 1G ue primary and ideal objective is to correct the damaged nose 10 a state acceptable by both the patient and public. patients, For busn or tumour deformities, proper reconstructive procedures wil have to be tllored t0 restore the soft ristues, as well asthe framework of the note Inavery severely deformed nose, sometimes eaternal prosthesis may haye ta be considered ifthe reconstructive surgeries cannot eestore the damaged. nose co reasonably acepuable condition CONCLUSION. Rhinoplasties can be comples surpieal procedures which involve a good knowledge of che anatomy and functions of the note. Good and versatile surgical sil, understanding of the soft tissues and appreciation of che aesthetics of she note ae ako important. Complex surgical restorations after severe traumas or-burn injuries may be time consuming,.mult-staged and often may involve a team approach. The primary and ideal objective is te corzect the damaged nose roa state acceptable by both the pasient and public In aesthetic shinoplasty, itis vial for us to ensure ‘that he patient i saisied with che Sal resus ofthe surgery. Theteore it is outine forthe plastic eurgeons rostudy the note carefully analyse the deficiencies and plan for che mose appropriate surgery to enhance the note, Any serious mistake may leave complications which may squire much challenging efoto recy and often over a prolonged period. So please consult {qualified plastic surgeons who are abe o perform the bert chinoplary procedure fr you