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Additionally, the septum of the nose and the nasal bones provide the foundation of structure and support. There are two main approaches to rhinoplasty: Closed rhinoplasty – which involves operating through the nostrils. Have you heard of this being done for cosmetic purposes and can you give me information on the pros and cons of this procedure? Rib Removal Surgery is commonly performed on men and women that want to achieve an hourglass look. On the contrary, it is the use of the rib in the proper locations, with the proper techniques, which greatly reduce the possibility that any changes within the shape of the rib cartilage will create changes in the outward appearance of the nose. If the surgeon feels that the patient’s goals are not realistic, he will address this during the consultation. The septum is composed of both cartilage towards the front of the nose and bone in the deeper aspects. Disclaimer: The information contained on this website should not be construed as medical advice. Ageing rhinoplasty – The nose will age along with the face and tends to grow in size and elongate. The surgical goal is always to produce a nose that looks natural, functions properly, and in harmony with the patient’s other facial features. Q: Dr. Eppley, I was reading an article by a male to female transgender woman who mentioned having a procedure in Mexico where the doctor broke her lower ribs and wrapped them tightly so that they would fuse together in a more narrow position. Chin augmentation is a common procedure performed in combination with rhinoplasty to improve the balance of the facial profile and correct a receding chin due to congenital deficiency, age-related bone resorption or facial trauma. As a facial plastic surgeon who performs both cosmetic and reconstructive surgery, Dr. Greco often performs rib graft rhinoplasty at his practice, where he is able to enhance both the form and the function of each patient's nose, and tailor every procedure to obtain the best possible results. Our rhinoplasty surgeons have extensive experience working with a diverse range of patients. When used properly, rib cartilage provides a great material from one’s own body, without the need to implant synthetic materials, to give a nice aesthetic, long-term outcome to the shape of the revised nose. For example, in operations requiring reconstruction of the lower lateral cartilages, flat pieces of rib grafts can be reshaped using EMR to create an acute angle and then possibly further stabilized with sutures. Also, is there a chance of uncontrolled bleeding from the operation? 4. A: Rib removal surgery can be done to be used for grafts in various facial reconstuctions (usually rhinoplasty) or for cosmetic contouring of various ribcage protrusions. Primary rhinoplasty is performed by removing excess bone and cartilage from beneath the skin covering the nose. Given the great deal of attention which plays into the harvesting (removal) of the rib cartilage, it is actually what to do next with the rib cartilage which is most intimidating to revision rhinoplasty surgeons. Macquarie University Clinic - Suite 401, Level 4, 2 Technology Place, Macquarie University, NSW 2109, Sydney, Australia, ENT Clinic Randwick - Suite 70B, Royal Randwick Shopping Centre, 73 Belmore Road, Randwick, NSW 2031, Sydney, Australia, ENT Clinic Sydney West - Level 2, 39 Queen Street, Auburn, NSW 2144, Sydney, Australia, What to Expect from Your Rhinoplasty Recovery, Grant before and after rhinoplasty pictures, What to Expect From a Rhinoplasty Procedure, Teens and Rhinoplasty: Issues to Consider with Teenage Rhinoplasty. I have not seen a rib removal patient who has permanent pain and this most likely relates to rib removal for chest surgery which is done differently. See additional information. Many individuals look younger by just improving the appearance of the nose. The degree and the manner of their alteration are not known by the revision rhinoplasty surgeon beforehand. How many ribs and what areas can be removed vs. what is the source of the problem, and how well these match up, determines how successful the procedure can be. This is an alternative to surgical rhinoplasty. Cartilage grafts whether taken from the septum, ear, or rib are used to provide shape to the nose. Q: Dr. Eppley, I have a rib reshaping surgery question. In cosmetic rib removal or any rib graft harvest great effort is made to preserve the neurovascular bundle which runs along the bottom of each rib. Any ribs that lie below the apices of the lungs can be  reduced for a body contouring effect. Chin Augmentation – Whilst not a rhinoplasty procedure, the nose and chin are inseparable when looking at one’s profile. I was just wondering if its possible to alter the total size of the ribcage, like to make it narrower or wider at the bust point? I do have a few questions about the surgery. Disclaimer: The information contained on this website should not be construed as medical advice. Patients opting for revision nose surgery especially tend to have issues that require correction best accomplished with their own rib cartilage graft. Rib removal surgery is done for either horizontal waistline reduction or vertical waistline elongation. Keywords: Costal Cartilage, Reconstructive Surgery, Tissue Reshaping, Otolaryngology, Rhinoplasty, Shape Change. What are the reasonable cosmetic expectations? You can schedule a consultation with Dr. Bared by calling 800-943-7295. After the harvest, the incision is closed with buried sutures and covered with tape, so minimal wound care may be required on the patient's part. The disadvantages is that it is not really clear if it would really work and could be a source of chronic pain if the separated rib area do not heal. She had her bottom ribs broken and pushed in by a Mexican surgeon. The complications from this type of surgery are essentially aesthetic….how does the scar look and how effectively has the ribcage protrusion been eliminated. According to her, it help her to look even more slimmer than before. Open rhinoplasty – which involves making a small incision underneath the tip of the nose. Given the missing septal cartilage, the only available cartilage grafting material left available to the surgeon is either from the ear or the rib. 2. The risk of using rib cartilage in the hands of surgeons inexperienced with its use is that rib cartilage has a tendency to warp or change shape. To request a consultation with Dr. Greco regarding a rib graft or other strategies for nose surgery, please contact his Philadelphia-area practice online or call (610) 664-8830. © Copyright 2020. A crooked nose – results in the loss of the dorsal aesthetic lines that can be recreated by the careful use of dermal fillers. First, the patient will be placed under general anesthesia. Cleft lip rhinoplasty focuses on improving the breathing passages together with the overall look of the nose and face. Want to speak directly with Dr. Eppley? It would not work for any higher ribs because they have a complete arc around the body with a fixed point to the sternum. The Pros and Cons of Rib Cartilage Rhinoplasty. The majority of Fillers last up to 12 months but there are fillers that last longer. This would only apply to the free floating ribs which do not have an attached end. Disclaimer: The information contained on this website should not be construed as medical advice. (and at a higher rib level since they are interested in entering the chest cavity….a goal that is the exact opposite of aesthetic ribcage reshaping)  This usually involves rib bone removal not rib cartilage removal in lower ribcage reshaping. Discomfort is minimized by limiting removal of the rib to this site specifically while keeping the surrounding tissue intact. A: I have been asked that question may times over the years about ribcage modification or rib reshaping surgery and the answer is no. In this same manner, risk is minimized to the surrounding chest and underlying lungs through this preservation of the tissues underlying and surrounding the rib. The combined expertise of both an ENT and Plastic Surgeon provide complementary skills. Dermal fillers can be used for touch-ups after nose surgery – minor irregularities can be felt following a surgical rhinoplasty can be smoothened out by using dermal fillers. The commonest reasons why rhinoplasty surgery is requested include: For a nose that is out of proportion to the face – to improve cosmetic appearance, For a blocked nose – to open the nasal passages. 3. A detailed description and pictures of your concerns allows for the most informed response. An additional benefit of removing cartilage from the 6th rib is that the 6th rib is not a ‘free-floating’ rib—it has firm bony attachments to the surrounding rib cage and the sternum (chest plate bone at the center of our chests). It may come as a surprise to most that our ribs are composed of cartilage as they approach the middle of our chest or the sternum. All Rights Reserved. The nasal bridge, the nose area between the eyes, can be reinforced with patients’ tissue such as rib cartilage, but also with other non-organic materials like silicone implant or Goretex implant. I am a slim young woman who would like a more narrow rib cage to give me a longer more narrow waist, but would like to keep my ribs if at all possible. In these cases, Dr. Greco chooses to harvest cartilage from other parts of the body. The normal anatomy of the nose—cartilages and bones—have been altered by the initial surgery. I do many more rib removals for rhinoplasty and jaw reconstructive procedures. Harvesting of rib cartilage does not necessarily weaken our strong rib cages. Out of town? Rhinoplasty surgery is better known as nose plastic surgery, nose cosmetic surgery, nose reshaping or nose job surgery. The risk of using rib cartilage in the hands of surgeons inexperienced with its use is that rib cartilage has a tendency to warp or change shape. Dr. Anthony Bared, MD, FACS is a double board certified facial plastic surgeon who specializes in rhinoplasty, revision rhinoplasty, and hair restoration. Nerve injury or neuromas can be a source of chronic pain.The lack of permanent pain in aesthetic rib removal should not  be confused, however, with the fact that there is some significant pain after the procedure. The success of rib removal for improved ribcage shape depends on the exact ribcage anamoly. In order to revise a rhinoplasty, grafting material is nearly always needed to correct the underlying deformities. Dr. Timothy Greco is a board-certified facial plastic surgeon serving the entire Philadelphia Tri-State area, including patients from the Main Line Area, Philadelphia, New Jersey, and Delaware. A detailed description and pictures of your concerns allows for the most informed response. A bump on the nose can be camouflaged by careful placement of dermal fillers. The 6th rib lies approximately directly below the breast crease in women and below the larger chest muscles in men, allowing for a camouflaging of the incision within this crease. 12188-A North Meridian St. Suite 325 Carmel, IN 46032, Phone: (317) 706-4444 Fax: (317) 982-5510 Text Us: (317) 279-6154. The careful use of injectable dermal fillers patient have the same expectations ‘ ideal ’ to..., shape change thick, it may be subtle or dramatic, depending on the nose larger... Manipulation ” since it is not that surgeons with more experience with rib cartilage from the center this... 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