THE NOSE CLINIC
RHINOPLASTY.IE
MUNISH SHANDILYA
OUR FOUR CLINICS
DUBLIN SOUTH COUNTY BLACKROCK
DUBLIN SOUTH, BEACON HOSPITAL SANDYFORD
DUBLIN NORTH, BON SECOURS HOSPITAL, GLASNEVIN
WATERFORD, WHITFIELD CLINIC, MAIN OFFICE
Category: Uncategorized
ADVANCES IN RHINOPLASTY: LESSONS FROM CHICAGO
LESSONS FROM CHICAGO
Conchal cartilage as Alar support grafts … too weak …makes sense
Turkish Delight makes way for Sausages & Swiss rolls ! Abel-Jan Tasman’s trick … the best presentation of a new technique … will it work sans fascia … or perhaps lay some fascia over the graft …
The elephant in the room … Injectables were not mentioned over four days ! hmmm …
Microdermabraision for columellar & Alar base scars … quiet again …
Rib cartilage grafts … indications and refined use … Dean Toriyumi’s masterclass
Did I notice a wee step back towards the “close”approach ? …Pastorek, Bobby Simon & Pietro Palma beckon …
Gilbert Nolst Trenite demonstrated the deprojection techniques beautifully … I have had the priviledge of observing and assisting him on several occasions during my fellowship with him …
Pre and Post pictures still lacking standardization … even at this level !!!
Nasal Fracture Clinic in Dublin, Kilkenny & Waterford 1850 85 50 85
NASAL VALVE SURGERY. EXTERNAL VALVE STENOSIS.
Right External Nasal Valve Stenosis
Treated with an External Approach Nasal Tip Plasty.
Nasal blockage caused by an unsightly variation of the medial crus of the right lower lateral cartilage.
The foot of the medial crus was found to be excessively enlarged and calcified. This had to be excised conservatively in this example of a Functional/Cosmetic Nasal Tip Plasty.
The foot of the medial crus was found to be excessively enlarged and calcified. This had to be excised conservatively in this example of a Functional/Cosmetic Nasal Tip Plasty.
Functional Rhinoplasty & its Cosmetic implications
LEFT : Pre-operative Frontal view
Complaints of severe nasal blockage & Snoring
DISTRESS VOR SCORE 2/10 where 10 is perfect breathing.
No help with decongestants
No Cosmetic Concerns
Attractive 35 year old lady with a very thin skin over the nose.
Investigations : Rhinomanometry and Acoustic Rhinometry with Waterford Splint Protocol.
Diagnosis : Left>Right Internal Nasal Valve Compromise. Dorsal Septal Deviation.
Management plan External Approach Septoplasty & Spreader grafts
Digital morphing technology used to explain the possible cosmetic implications of a Functional Rhinoplasty.
RIGHT: Post-operative Frontal view after 3 months
Columellar incision for External approach
Pleasant Tip and Dorsal appearance. No Tip bifidity.
Degree of swelling around the nasal tip expected to go down over 12 months.
DISTRESS VOR SCORE 9.5/10 ! Excellent breathing and reduced snoring. The effect on snoring is at times a short-term benefit.
Not concerned with the cosmesis but still happier with the appearance after surgery.
The appearance at 12 months will be interesting as the slight swelling dissipates.
