What to Expect During Preservation Rhinoplasty

Preservation rhinoplasty is usually performed under general anesthesia. The procedure involves injecting hemostatic fluid to help reduce bleeding, followed by access through a rim incision or an inverted V incision at the columella.

Once the nasal structures are visualized after subperichondrial and subperiosteal dissection, the surgeon proceeds according to the planned correction.

If dorsal preservation is being performed for hump removal, a piece of cartilage is removed from beneath the bony cap. The nasal bones are then osteotomized and moved downward as much as required. Cartilage may be removed from the upper area just beneath the bone or near the base over the maxillary crest.

This creates space to lower the dorsal tissues while maintaining the cartilage and bone. The top of the septal cartilage and nasal bones remain intact and untouched.

If a bulbous or bifid nasal tip is being corrected, Dr. Gambhir may use advanced suture techniques and strategically placed cartilage grafts to refine the tip. This allows the surgeon to alter the shape of the nasal tip while preserving the important alar cartilage in that area.

The length of the surgical procedure varies depending on the techniques used and the number of areas that need correction.

What to Expect After Preservation Nasal Surgery

Since preservation rhinoplasty is generally less traumatic than structural rhinoplasty, recovery may be faster. Patients may experience less swelling, bruising, and discomfort, which can help them return to office or desk work earlier.

A nasal splint is applied to protect the surgical correction and is usually removed approximately 7 to 10 days after surgery.

Patients may return to desk work in about 7 to 10 days. Strenuous activity should be avoided for 6 weeks to help prevent bleeding. Nose blowing is not allowed for 3 weeks.

Complications After Preservation Rhinoplasty

As with any rhinoplasty procedure, preservation rhinoplasty also carries possible risks. The chances may be lower in suitable cases, but patients should understand the possible complications before making an informed decision.

Possible risks include:

• Bleeding
• Bruising
• Infection
• Residual deformity
• Deviation
• Minor irregularities
• Septal collapse
• Anesthesia-related complications

Post-Operative Rhinoplasty Essentials

Begin walking on the evening of surgery to support circulation and healing. Continue walking as much as possible during the recovery period.

Avoid bumping the nose and avoid strenuous activity for 6 weeks. Do not blow your nose, and sneeze only with your mouth open. Avoid housework for 2 weeks and avoid swimming or contact sports for 4 weeks.

Preservation Rhinoplasty Recovery and Healing

Preservation rhinoplasty recovery is usually faster compared to other methods because the surgery causes minimal tissue injury. Bruising and swelling are generally minimal.

A splint is applied after the procedure and is removed in about 7 to 10 days. In the early post-operative phase, patients usually have less discomfort. Medication is provided to support healing and recovery.

Preservation Rhinoplasty Cost in New Delhi

Preservation rhinoplasty cost in New Delhi can range from Rs. 1,50,000 to Rs. 5,00,000 on average, depending on the surgeon’s experience and expertise, the geographic location, and the extent of correction required.

As the complexity of the procedure increases, the duration of surgery and the overall cost may also increase due to higher surgical facility and anesthesiologist fees.

Preservation Rhinoplasty Techniques

There are different techniques used in preservation rhinoplasty. The most suitable technique depends on the patient’s nasal anatomy, dorsal hump, septal deviation, and desired correction.

Push-Down Preservation Rhinoplasty Technique

The push-down technique is mainly used for hump removal. In structural rhinoplasty, the bony cap is removed from the top and the nasal bones are infractured. In the push-down technique, cartilage is removed from beneath the bony cap, and the bones are not touched dorsally.

Dr. Gambhir routinely performs this technique for patients who are ideal candidates.

Upper Lateral Cartilage Preservation

In this approach, the septum and upper lateral cartilage framework that forms the dorsum is not disturbed. The whole complex is moved downward as one unit, and cartilage is removed from beneath this complex.

Ligament Preservation

Important ligaments that provide structural support, such as Pitanguy and scroll ligaments, are preserved during the procedure.

Nasal Bone Management

The nasal bone is osteotomized laterally and transversely so that the whole dorsum, including the osteocartilaginous framework, can be pushed down into the nasal cavity.

Let Down Technique

The let-down technique was initially used in patients with a very high dorsal hump, especially when more than 3 mm of reduction was required. When space is limited, a residual hump may remain. To compensate for the reduction, a piece of bone may be excised from the lateral side. This is known as the let-down procedure.

The basic principle of preservation rhinoplasty remains the same: the complete osteocartilaginous framework is lowered while preserving the natural dorsum.

Dr. Gambhir understands these complexities and decides when to use push-down or let-down preservation rhinoplasty based on the patient’s nasal structure.

Instrumentation Used in Rhinoplasty

Rhinoplasty requires a basic rhinoplasty set, but finer corrections may require piezotomes or piezo instruments. Dr. Gambhir uses advanced instrumentation for precise correction during preservation rhinoplasty.

Spare Roof Preservation Rhinoplasty

In cases where there is a severely deviated septum requiring near-total correction, and the aim is to preserve the dorsum, a spare-roof technique may be used. This allows the surgeon to perform the required septal correction, including extracorporeal septoplasty when needed, while preserving the dorsal framework.