Septorhinoplasty Endonasal Approach
In Berlin

Rhinoplasty is a series of operative methods adopted to alter the nose’s aesthetic and functional properties. Incisions can be placed inside the nose to gain surgical access. This is referred to as endonasal approach. Alternatively, the surgical access can be gained by placing the incisions outside the nostrils, namely the external approach. Before the external (open) approach became popular, the terms rhinoplasty and endonasal rhinoplasty were used interchangeably. There wasn’t a clear distinction between the two. But this field has rapidly evolved over time to create an explicit distinction between open (external) and closed (endonasal) rhinoplasty. Besides the differences, the two approaches have several similarities in the incisions as well as the guiding principles behind each technique.

ABOUT SEPTORHINOPLASTY

Patients can undergo nose surgery either for functional or cosmetic reasons. Septorhinoplasty combines the two reasons, that is, reshape the nose to ensure it cosmetically synchronizes with the rest of the face while meeting the functional obligation of efficient breathing. To meet the functionality, the surgeon corrects a deviated septum due to disease, injury, previous surgery or trauma.

Research shows that over 1 million people on a yearly basis undergo nose surgery and their reasons for doing so are plenty. Our health center is well fitted with the right equipment to perfectly carry out this surgery.

Septorhinoplasty is normally conducted as an out-patient operation. We have topnotch surgeons who safely carry out the procedure for a pleasing outcome. It takes about 2 ½ hours to be through and is done under general anesthesia. It is normal to experience swellings or bruising after the surgery but these do disappear after a given period of time.

The etiologies for nasal deformity are plenty, including hereditary such as large dorsal hump, traumatic experiences like a motor vehicle accident, congenital issues such as cleft palate nasal deformity, and iatrogenic e.g. a past operation gone wrong.

Candidates for Septorhinoplasty

The key issue that is looked at even before any other considerations is whether you are physically healthy or not. Once that is established, your surgeon will assess other factors such as having breathing difficulties or in need of a cosmetically appealing nose.

Age is also an important factor since the teen girls are preferably aged 16 years and above while the teen boys 18 years+. All these will be determined as you undergo a one-on-one consultation with the surgeon.

There are a number of benefits associated with Septorhinoplasty. These include:

• Improved appearance that had been distorted by a crooked nose

• Better breathing by relieving nasal blockages

• Correction of a bent septum which in turn improves shape

• Likely to sleep apnea and snoring

Can realize both cosmetic and functional improvements, hence the customary say hit two birds with a single stone

• Adjust the nose’s shape and balance facial features

Quite a number of patients, and surgeons alike, are normally faced with the daunting task of picking either open or closed rhinoplasty.

THE ENDONASAL APPROACH

The closed rhinoplasty approach entails making all the surgical incisions from within the nostrils. The idea is to ensure that a visible scar is kept off despite parallel incisions encircling close to half of nostril lining.

But this approach never lacks its fair share of challenges, especially when it comes to reposition of the nasal skin since the right and left nostril incisions are disconnected. That makes it a necessity to carry out the whole operation through narrow surgical openings while visibility is minimized.

There are chances that the nasal cartilage may be distorted considering gaining access to the nasal framework may involve tremendous stretching of the nasal skin. This approach is praised for its ability to prevent a visible scar but is at times limited by technical matters. Unlike most medical centers, we have advanced our skills in conducting Septorhinoplasty using the endonasal approach even as the open rhinoplasty technology continues to advance.

The endonasal rhinoplasty technique insists on the following benefits:

• Lowers the need for surgical dissection
• Reduces postoperative edema
• Targets improvements can be made without having to take the nose apart
• The recovery period is fast
• Minimizes (or eliminates) the risks of developing a visible external scar

The External Rhinoplasty

As opposed to closed rhinoplasty, external rhinoplasty is limited by the fact that visible scars are inevitable. This approach involves making small bridging incisions that connect incisions made on the right and left nostrils. About 4 to 5 mm visible segments are realized but the approach ensures possible distortion of the nasal cartilage is minimized. Each component in the nose is naturally evaluated without disturbing the alignment.


Choosing between either of the techniques is determined by the patients’ needs and surgeon’s assessment. If the patient needs to the scars concealed at the end of the surgery, then endonasal approach is the best option to take. This has also proven to solve many aspects of an undesired nose. Open approach on the other hand is backed by the fact that it has improved effectiveness, accuracy and versatility. Our center remains adept about the closed technique, especially for patients who have a comparatively straightforward nasal anatomy and many other types of patients.

SWELLING AFTER SEPTORHINOPLASTY

As already pointed out above, it is normal to experience a swelling after this surgery. However, the likelihood of experiencing the swell is determined by the technique that was used. If an inside incision was made (endonasal approach), chances are no swelling will result. Alternatively, if the open approach was adopted, patients should expect some degree of swellings.

A significant reduction of the swelling should be felt in the first month and then go down slowly some few months later on. If this is the approach that has been used on you, you can do some few things to help ease the swelling. For instance, you may ice your nose in the 24 hours after the surgery. You may also use more pillows to elevate your head as you sleep and also rely on a diet with very small amount of salt since too much of it causes more fluid to be retained.

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