- Incisions
- Hump removal
- Nasal septum
- Tip narrowing
- The nasal bones
- Splint
- Tip support
- Shorten the nose
- The nasal spine
- Revision surgery
- The nasion
- Odd cartilages
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This is a different
person, but it is a similar view taken during surgery to show the base of the
septum (pink) off center to the patient's left, and sticking into the nostril. The
cartilages in the columella are colored green.
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| Click on any image in this tutorial to see a greatly-enlarged version |
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This septum (pink) has
been approached through an incision along the dorsum (green). You can see the fracture in the
cartilage of the septum (fracture line traced in blue). This crooked
septum is supposed to be a smooth flat wall in its uninjured
state.
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Above we see two views
of a crooked piece of septal cartilage that was removed from a nose whose airway
was obstructed by the deviated septum. It's easier to see the deflection
in the image on the right, which shows the cartilage edge on. The fracture
lines and angles in this cartilage would not be present in a normal, uninjured
septum
Note how white and shiny the cartilage is when it's taken from the body. The deflected portion can be safely removed, and usually it's not necessary to put cartilage back into the septum. The removal of cartilage doesn't result in a hole in the wall between the two sides of the nose because the fibrous membrane and soft tissue that line each side of the septal cartilage is still intact. That soft tissue maintains the separation wall between the right nasal cavity and the left nasal cavity. |
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Sometimes we
remove part of the septum even if it's straight. If the nose's appearance
is unsatisfactory, the septal cartilage can be harvested, trimmed and shaped,
and used elsewhere in the nose to give the nose a better appearance.
Septal cartilage is strong and easy to work with, and it's a very good material
to use in reconstructing a nose.
The two views above show a straight piece of cartilaginous septum that I removed from a nose, not because the cartilage was crooked and blocking the airway, but because the tip of the nose needed work, and I used the septal cartilage to rebuild the tip. You will see this piece of cartilage again in the chapter on tip support. See how this piece of cartilage is flatter than the previous one we saw on this page. In blue, I've marked where I will carve off a strip of the cartilage to use in the nose. This cartilage is also quite large compared to the size of the entire nose. Won't removing this much cartilage harm the appearance of her nose? In a future chapter, we'll discuss how to know what portions of the septal cartilage it is safe to remove for use in another part of the nose. |
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Clear all red checks in the Rhinoplasty Tutorial |
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