Deviated septum?

Written by Escobar MD     

People have asked me this question with relative frequency. To avoid complications, I will give you the following example: the nose will be like two conducts through where air flows, and the wall that separates these conducts is the septum.

In some cases this wall interrupts the flowing of air through one of the conducts, due to prior trauma or a birth defect. When the flow is interrupted it is logical that the breathing will not be good, and it will be necessary to set this wall in a position that allows good breathing. This is what is known as a septoplasty.

Nasal Tip Surgery in Colombia.

Written by Escobar MD    

In my opinion, the most important factor to obtain a beautiful, natural nose that works to breathe is the nasal tip.

The tip is made up of cartilage and the skin that covers it. Due to its location in the central part of the face, any slight defect can be very notorious.

Besides, if an adequate technique is not used, the changes that are performed on the nasal tip will not be stable long-term; this means that they will worsen in time, both aesthetically and functionally. An ugly tip has many possibilities of causing a nose that does not breathe well.

This technical difficulty is what has popularized the open technique (with external incisions), although, to my understanding, better results are obtained with a closed technique (without external incisions), obviously, with the adequate training.

Difficult rhinoplasty

Written by Escobar MD     

There are highly difficult rhinoplasty cases. They tend to be cases with several prior surgeries. A nose that is in a bad condition, with previous surgeries, will normally show that the reconstruction needs an expert surgeon and a technique that is capable of solving what was not possible previously.

There are many techniques to solve these cases nowadays. In many of these cases, given that there has been an important damage in the structure of the nose in prior surgeries, it is necessary to reconstruct what was lost or damaged.

Some surgeons use the patients' own tissues, or synthetic tissues, or a combination of both. If the patient's own tissues are used, they can be rib cartilage, septum cartilage or ear cartilage.

Personally, and due to the technique that I perform, I prefer (in a case needs a reconstruction of the support and structure of the nose) to use ear cartilage. It is strong, flexible and malleable enough to recreate most of the cartilaginous nasal structures (which are the ones that are most damaged by prior surgeries).

Nasal Base Surgery

Written by Escobar MD   

  

In some people the width of the base of the nose is somewhat greater that desired. The ideal value varies according to the patient's race, but we can say that the ideal value is equal to the distance between the eyes or up to 4 mm greater than this.

The treatment of the nasal base during a rhinoplasty is a complementary point of the surgery, but it is of great importance. If an adequate technique is not performed, there can be consequences such as asymmetries, breathing problems or visible scars.

"Mestizo" nose

Written by Escobar MD  

   

The racially mixed nose is defined as the nose that results from the combination of races that has happened mainly in Latin America. The racially mixed nose will therefore have the characteristics of the african-american, native, and white nose in greater or lesser degree, according to the degree of crossbreeding.

This type of nose needs a completely different treatment than that of a Caucasian or white nose. The racially mixed nose can have a wide spine and nasal base, weak cartilages and thick skin; these factors result in the lack of support and definition, which is characteristic of this type of nose.

Open or closed rhinoplasty?

Written by Escobar MD     

At the moment performing a rhinoplasty, there are two main types of techniques: the open and the closed rhinoplasty.

The open technique consists of making an incision on the skin of the area that separates the nostrils (columella), combined with other incisions on the inside of the nose. This way we can easily access the internal structures of the nose. 

The surgeon is the one who most benefits from this technique, because they can easily perform the necessary changes on the nose. Although the patient suffers more swelling, more recovery time, and can be left with a visible scar; without forgetting that the technique has less precision at the time of evaluating the changes that are being performed during the surgery.

On the other hand, the closed or endonasal technique avoids this external incision on the skin and only uses internal incisions to gain access to the structures susceptible to change. The one who most benefits from this technique is the patient, who avoids a scar that can be noticeable on occasions, and who will also have a faster recovery with less swelling.

This last technique, in expert hands, is the one that offers the best global results, and is the one that I recommend and perform.

Deviated nose

Written by Escobar MD     

In the case of the deviated or crooked nose, if look at yourself in the mirror and observe your nose from the font, you can divide it into 3 parts. The first one is bone, next is the cartilaginous part (it is the part after the bone that is softer and, as opposed to the previous part, can be moved).

Finally there is the nasal tip, which is the lowest part and is also made up of cartilage. Normally, if all this is well, these 3 parts or portions are perfectly aligned on the central axis of the face, in such a way that the nose will have a straight appearance.

WHAT IS IT ABOUT? Every alteration in the position, whether traumatic or congenital, of any of the portions that make up the nose in regards to the central axis of the face. Therefore, if this happens your nose will be deviated or crooked.