- 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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Another genre of lower
lateral cartilage errors is the one I call the "lost surgeon
syndrome." In green we see some pieces of the lower lateral
cartilages, and in red a portion of the septum along the dorsum of the nose.
What can you say? It looks as though the surgeon was lost inside the nose, and was just
cutting and removing pieces at random. Think this stuff doesn't
happen?
A legitimate question might be, How could someone get this lost? Can't you just open the nose and see the cartilages and decide what you want to do and cut or sew them according to your plan? Not necessarily. Just getting inside the nose to see the cartilages, even if the nose has never been operated on before, can be beyond the capabilities of some plastic surgeons. And if that is a problem, how about having the judgment to pick the correct techniques and execute them with finesse? Forget it. (Does this count as ranting yet?) |
| Click on any image in this tutorial to see a greatly-enlarged version |
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Above and below we see
noses for which our working diagnosis is lost surgeon syndrome. The lower
lateral cartilages were modified haphazardly.
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Now that we've seen
some of the worst, let me point out that no rhinoplasty operation goes
perfectly, even in the very best of hands. None of 'em. Every nose
has a surprise inside that makes the operation difficult, that requires some
form of compromise. Every nose has some
aspect of the result with which the surgeon isn't
completely happy. The world's best rhinoplasty surgeons have to revise
noses they operated on.
The difference is that a good rhinoplasty surgeon won't make a mistake as in the photos above. Complications and unexpected results happen to great surgeons and awful surgeons, but great surgeons will have far fewer complications, and when they do occur they will be much milder. Poor surgeons will rarely have even an acceptable result. Generally, if a competent surgeon and his patient aren't happy with the results of surgery, it's because the patient received less improvement than she and the surgeon were hoping for. Often a revision operation can be performed to make things better, but not always. Some noses just won't let you get all of the improvement you wanted. |
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Clear all red checks in the Rhinoplasty Tutorial |
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