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RHINOPLASTY - Dr. P. THULASI DAS

Rhinoplasty or plastic reconstructive surgery of the nose, originated in India. As far back as 1500 BC, “The Ramayana” describes Lakshmana amputating Surpanakha’s nose, and Ravana getting it reconstructed by surgeons. In 600 BC, Sushrutha of Benares, one of the earliest plastic surgeons wrote his surgical text –‘Sushrutha Samhitha’, where he described the use of skin flaps from the cheek for rhinoplasty. Later, in the 4th century AD, Vagbhat proposed rhinoplasty again using cheek skin flaps in his book ‘Ashtanga Hridyans’.

The secret of the ‘Indian method’ passed between certain families for centuries, until 1793, when it finally reached Europe. Later, the ‘Italian method’ evolved, and in 1837, the first rhinoplasty in the U.S.A was performed, using the ‘Indian method’.

During the turn of the last century, Jacques Joseph, an orthopaedic surgeon in Berlin published a number of articles on the correction of various deformities of the nose. Some of his concepts hold good even today and he is generally considered as the father of modern rhinoplasty.

Subsequently, there have been many improvements in techniques, and today it has been almost perfected to an art, aesthetic rhinoplasty being an entity by itself.

The surgeon’s goal is twofold, to achieve an aesthetic result and to have a satisfied patient.

It is not possible to deal with the proportions of the nose or establish a standard of beauty without considering it within the context of the whole face. Facial beauty is an elusive concept, related to symmetry, balance and the harmonious relationship among its different segments. The square of Leonardo, shows how the artist was aware of the aesthetic interdependence of the various parts of the face and tried to codify them. (Fig.1)

A surgeon or an artist with experience in facial observation and analysis may readily detect problems.

In any case, it is necessary to follow certain rules and measurements to assess the face. These are derived from studies of physical anthropology that correspond mainly to the Indo – European race, and the currently accepted standards of beauty. Many variations occur in different races and may be considered beautiful in a particular ethnic and cultural background. A balance among the facial components is important. A beautiful large nose may be out of proportion in a very small face or vice versa. A parrot beak or a hump on the nose, may be considered a good shape generally, but surgically and aesthetically, it is not so.

Photographs of the full face view, nasal view and the profile have to be taken, studied and assessed in detail for the surgeon to arrive at a conclusion, as to the modifications and corrections needed.
Depending on the reshaping that has to be done, the size of the nose may have to reduced or augmented. Deviations of the nose may be external or internal and corrections are done accordingly. Modern rhinoplasty techniques use incisions which are not visible externally and hence no scar or marks are seen outside.

Here, we show you some photographs of patients before and after surgery to illustrate the results.

>In today’s context, there are more and more people who are becoming aware of their appearances and wanting to ‘look good’ is a very essential part of one’s make-up. Since, this can also be achieved with hardly any complications and minimum hospitalisation, the path to beauty is not as distant or as inaccessible as it was in the past.

At Sinus and Nose, we specialize in Rhinoplasty. We have the necessary plastic surgery skills as well as the ENT skills for a total correction of nasal deformities. Till date we have done over 500 Rhinoplasties, for varieties of deformities.

Click below image to enlarge view

Before

After


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Before

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