Post-traumatic rhinoplasty requires a structural, anatomical mindset

NEW ORLEANS — Performing rhinoplasty to correct the results of a traumatic injury to the nose is more than just a cosmetic procedure, requiring the surgeon to take a different approach to the surgery, according to a speaker here.

During the American Academy of Cosmetic Surgery Annual Scientific Meeting, Amit B. Patel, MD, said he prefers to address the trauma from a structural and anatomical mindset rather than a cosmetic one, determining how many architectural “insults” are present and the degree of damage to be repaired.

Using the example of tablecloths draped over a series of tables, Patel explained the nature of the architecture of the nose, stating that the structure underneath is what determines the outer shape of the nose.

“The nose, in so many ways, is just like a house,” he explained further. “You have a structure that is projected off of the foundation, which is the face in this case.”

The septal framework is the most important component to fracture patterns, according to Patel. He said the surgeon must determine several key factors in cases of trauma, such as whether there is a primary or secondary shift, as well as whether a bend or fracture is present.

At the University of Kentucky, Patel is often faced with cases of childhood injuries and trauma. When a childhood injury is given years to develop before a patient has surgery, however, the case becomes much more complicated for the surgeon, he said.

Although rhinoplasty is often considered cosmetic to the patient, Patel said the architectural, structural and anatomical components of the nose are the most important to address and research to yield the most appealing and appropriate results. – by Abigail Sutton

Reference:

Patel A. Surgical considerations in the post-traumatic nose. Presented at: American Academy of Cosmetic Surgery Annual Scientific Meeting. Jan. 13-17, 2015; New Orleans.

Disclosure: Patel has no relevant financial disclosures.