Board Certified
Plastic Surgeon
Since 1989

Dr. Widder performs a nose job

Dr. Widder performs a nose job

Description of the nose job pr

Dr. Widder: The pledget that I am putting inside the cavity is soaked with Heparin, which is a vasoconstrictor. It stops the bleeding, allows the procedure to be done without a disturbing view. The concern is the appearance of his nose. He didn't like the hump and he had a problem with breathing so he wanted me to improve on nasal breathing. He requested specifically not to change the width of the alars and the tip of the nose, he wanted it to stay the same. We will comply with his request.

I'm starting the procedure with a cleaning of the hair in nostrils. So we're starting the procedure with the septoplasty turbinectomy. That also will allow me to harvest the cartilage and then later on for the columella to create a nicer show at the time. So what I'm doing now I'm exposing the septum and then we'll remove the part of the septum that is obstructing the airway.  And now I pass the cartilage spot and I'm exposing the bone cartilage septum. And now I'm going to remove the obstructing bone part. So this was the part of the septoplasty, which I removed the obstructing cartilage and bone. Now I'm injecting the turbinate with local anesthesia to prevent the turbinate from bleeding when I remove it; Partially remove it. So we're done with the septoplasty and turbinectomy and we gonna start with the rhino.

This technique of the rhinoplasty is called the open technique, which means I make an incision in the columella and lift of the skin and everything is exposed. The harder technique of closed rhinoplasty doesn't give you as much exposure so I prefer the open technique. It is nowadays the most popular. The incision is made with the so-called Seagull Wing Technique. And that allows the scar to be almost invisible because it brakes the line of incision. So it's not a straight line, it's a broken line in a seagull type incision. So the rhinoplasty procedure is based on the life-sized photograph, which I believe you can see it over there, the life-sized photograph, which I draw before surgery. And it allows me to measure how much tissue I'm going to remove. I review the drawing with the patient before surgery and if he likes the surgical planning, we proceed with the surgery. So I'm lifting now the skin from the so-called lower lateral cartilage, which are the cartilages that creating the dome of the tip of the nose. So, after exposing the lower lateral cartilage, I'm exposing now the dorsum of the nose, which is made of cartilage and bone. But we left the bridge of cartilage, which I had to reduce in order to give him a nice slope and get rid of the hump. Now I'm lifting the skin from the bone. The rasp, that's the smoothing out that bony part. If there's any part that is not smooth, using the rasp will even it out and bring it to the desired level.