Structure rhinoplasty refers to building a bone/cartilage structure under the nasal skin.

After any sub-structure of nasal anatomy (nasal hump, nasal tip, nasal wing, etc.) is surgically modified, the structure rhinoplasty approach restructures the remaining structure in line with the original anatomy.

This construction often "recycles" the intranasal cartilages and bones for use.

In some cases, additional cartilaginous structures (rib cartilage, cartilage of the ear, etc.) are needed as construction materials.

So Why Do I Prefer This Approach?

The answer is stability.

In rhinoplasty, all the surgical techniques described so far produce "good" results. What matters is the rate at which these results are accomplished.

The maneuvers applied in rhinoplasty to open and shape the nose weaken the nasal structure and make it vulnerable.

Such weak structures can bend, twist, shift, shrink or lose height and angle.

The structure rhinoplasty approach is based on eliminating intraoperative weaknesses and taking measures against potential postoperative resistance problems.

We use beams and columns made of cartilage to support the nasal structure.

These are called “grafts”.

We often obtain such beams and columns from the septal cartilage at the center of the nose. The anterosuperior portion of the septal cartilage that support the nose are preserved. The posteroinferior portion that does not contribute to supporting the nose is removed. If such cartilage is insufficient, we can obtain the cartilage grafts we need from the ribs or ears.

For instance, removing the hump of an aquiline nose is like opening the dome of a building. In structure rhinoplasty, we close this open roof with long separator beams (spreader grafts) that are attached to the nasal ridge (dorsum) and close the roof.

For instance, when the tip of the nose is opened, the suspensory ligaments that support the tip of the nose weaken. The tip of the nose always tends to drop down after surgery. The tip of the nose drops down during the aging process, even in patients who have never had surgery. In structure rhinoplasty, the height and position of the nose tip are not left to chance. Nasal tip cartilages are fixed via solid cartilage columns added to the midline nasal septum. The tip of the nose becomes rigid and may lose its natural movement but still maintains its position.

 

 

For instance, when you reduce nasal tip cartilages in width, the remaining cartilage may weaken, bend and twist postoperatively. We put a long support beam on this cartilage and prevent it from bending.

For instance, when the nasal base is narrowed, the angulation of nasal wings may change. We reinforce the wing structure by placing a long cartilage beam along the wing so that the wing does not assume a notched and asymmetrical appearance postoperatively.

Other examples are also available.

Structure rhinoplasty includes various surgical techniques including but not limited to controlled bone incisions, bone surface shaping techniques, bone fixation sutures, wedge grafts controlling the bending angles of cartilages, splint grafts correcting nasal curvature, spreader/spacer grafts restricting bone movements, camouflage grafts and ligament reconstruction.

Structure rhinoplasty is almost always performed using the open rhinoplasty approach.

We check and observe the problems in the nose, and we do our work after we make sure we made our measurements and saw everything we needed to see.

Then we reconstruct the nasal skeleton as we see, feel and evaluate it again.

As a procedure, structure rhinoplasty takes long due to the excessive number of details.

It is not a one-hour surgery.

It's like building up a microscale model.

Even structure tip rhinoplasty can sometimes take 2 to 3 hours.

It goes without saying that structure rhinoplasty is the approach with the greatest global accumulation of know-how and experience as well as extensive literature, making it the most stable approach in the long run.

Since structure rhinoplasty does not follow a conventional procedure, it can be performed in and tailored for different noses and different individuals, thus making it possible to perform it even in complicated situations.

Structure rhinoplasty may cause more postoperative edema compared to dynamic rhinoplasty with closed approach or dorsum preservation approaches such as let down and push down. However, the resistance of this surgery to long-term postoperative changes is relatively higher.

Every technique creates great value in the hands of the practitioner, and every technique has successful practitioners.

The results of a doctor who performs Technique A highly successfully will of course be better than the results of a practitioner who has just started applying Technique B.

Therefore, patients should prioritize their selection of the physician rather than the technique.

However, it will be useful for you to have some knowledge about the technique to be applied during your surgery. Because some techniques have handicaps irrespective of the practitioner's experience, ability or success.

During preoperative examination, we discuss with our patients the advantages and disadvantages of the rhinoplasty technique to be employed.

Please feel free to contact us for more detailed information on rhinoplasty techniques.

Take good care...

... of yourself and your beauty.

OB