Many experienced surgeons feel that rhinoplasty is the most difficult facial plastic operation. This is because the nose is a complicated three dimensional structure that not only is central to the face and a focus point during conversation, but also supports the essential function of breathing. When improving the appearance, it is vital to maintain or enhance the function of breathing. It is also necessary to anticipate the long term changes of the nose as the healing process continues into the future. Dr. Vipond has been fortunate to have trained with a number of facial plastic surgeons, each with different techniques. He is a strong believer in Structural Rhinoplasty whereby improvements made in the strength of the nose not only can lead to an improved appearance but also to improved breathing.
Dr. Vipond not only performs purely cosmetic rhinoplasty, but more commonly, sees patients with both concerns regarding the appearance of their nose and difficulty breathing. While this may be the result of an earlier accident, it is also frequently an inherited problem. Rhinoplasty may be performed through incisions made inside one or both nostrils, called an Endonasal or closed approach, or through a small skin incision, called External or open approach. The type of incision as well as the planned techniques are carefully planned based on the individual appearance and function of your nose. During your consultation, Dr. Vipond will spend time looking at your nose with you, discussing your concerns, and carefully evaluating the structure of your nose in order to reach an individualized treatment plan that will help improve the symmetry and balance of your nose with your face. If desired, computer simulation of possible post-operative appearances can be used as a tool to help visualize your new nose.
Because rhinoplasty is a difficult procedure with often uncertain changes with healing, even the best performed procedures can result in unsatisfactory results. Approximately 40 percent of Dr. Vipond’s rhinoplasties are performed to improve either the appearance or function or both after a previous rhinoplasty. It is even more important during revision rhinoplasty to carefully plan and execute the surgery in order to restore balance and function to a nose weakened from an earlier operation. Often it is necessary to use cartilage grafts to reinforce or replace damaged cartilage. While cartilage within the nose is preferred, there is frequently not enough in secondary procedures to adequately strengthen the nose. Occasionally cartilage from behind the ear or rib may be used. Alternatively, cartilage from tissue banks or artificial materials are other options. Dr. Vipond will discuss these choices with you during your consultation.
Sometimes patients have concerns with small contour irregularities with their nose. In these circumstances, a non-surgical rhinoplasty may be appropriate. This relatively new technique utilizes an injectable filler in order to smooth out dimples, even out depressions. Depending on the location of the injection, the filler can also improve nasal breathing by stiffening weaknesses in the nostrils. There are several different types of fillers that may be used. Dr. Vipond will discuss the different options with you during your consultation.
Rhinoplasty is typically performed through one or both nostrils, using incisions made on the inside of the nose. There is usually no external scar. Dr. Vipond will discuss specific information about incisions at the time of your rhinoplasty consultation. Just as there are many types of noses, there also exist many different rhinoplasty techniques. Rhinoplasty is an operation where just a few millimeters can make a significant difference in the appearance of the nose and your appearance as a whole. Dr. Vipond tries to achieve a straight, strong profile that improves the symmetry and balance of the individual's face.