Rhinoplasty, Facial Plastics & Reconstructive Surgery in Singapore

Dr Dennis Chua invited to share his experience in the "International Consensus on Functional and Aesthetic Rhinoplasty".

FUNCTIONAL SEPTORHINOPLASTY

A complex septal deviation with narrow nasal valves will be the most common reason that patients require a functional rhinoplasty to treat the condition. The nasal cavity will have to be assessed thoroughly and the nasal valves in particular will have to be checked for both static and dynamic obstruction. A deviated septum combined with enlarged inferior turbinates is the most common reason for nasal obstruction.

Functional septorhinoplasty can be performed via an open (external) or closed (endonasal) – “scarless” approach. Either technique is possible depending on the patient’s wishes and surgical condition.

Functional rhinoplasty in Singapore can help improve the function and appearance of the patient’s nose at the same time. Strengthening the nasal tip support will help improve the patency of the nasal valves and subsequent airflow.

Scarless (Endonasal) Rhinoplasty

Nasal Valve Reconstruction: Alar Batten Grafts

An experienced ENT doctor in Singapore, Dr Dennis Chua is a Board Certified ENT & Facial Plastic Surgeon, and has published a book chapter describing the use of Alar Batten Grafts in improving airflow in patients with a blocked nose.

The alar batten graft is a commonly used technique that can be placed by open or closed rhinoplasty to improve nasal obstruction with documented nasal valve obstruction. The cartilage graft can be obtained from the nasal septum or from the ear (conchal cartilage graft). This cartilage graft is then used to strengthen the lateral nasal sidewall where the maximal site of nasal valve collapse is. It is a simple yet powerful technique for correction of nasal valve obstruction resulting in nasal obstruction. Click here for Dr Dennis Chua book chapter on Surgical Pearls: Alar Batten Grafts.

Alloplasts (Silicone implant)

Silicone, Goretex or Medpor are implants commonly used for nasal dorsum augmentation in Singapore. If performed with the correct surgical techniques, they can result in a natural yet dramatic difference in the patient’s appearance safely. Whilst using implants, it is important to avoid L-shaped implants for the nose to minimize the risk of implant extrusion. There are some tips to minimize extrusion of implants. These include avoiding pressure on implants, putting the implant in a subperiosteal plane (deeper plane) and using the softer implant to minimize tissue trauma. Rib Cartilage in Rhinoplasty.

Autologous cartilage (rib, septal or ear cartilage)

The rib graft is a fantastic source of autologous cartilage for augmentation rhinoplasty in asian noses. It is safe and has the lowest complication rate compared with alloplasts (eg silicone). The 7th rib is also the straightest and longest available for dorsal augmentation. This helps to achieve a long-lasting natural look after a cosmetic rhinoplasty. Rib cartilage can be harvested safely with minimal morbidity if performed correctly. A straight piece of rib can be obtained from a small 2.5cm incision that is hidden in the skin crease and can heal nicely without much scarring. This rib cartilage can be used as a single piece or it can be diced into smaller pieces (wrapped in fascia) for dorsum augmentation. It is important to achieve a natural look in nasal dorsum augmentation and avoid the “overdone” appearance after a rhinoplasty. Rhinoplasty should achieve a natural and harmonious look with the individual’s face for optimal results.