Rhinoplasty with rib harvesting

This type of procedure is dedicated to patients with post-traumatic changes i.e., after ENT or plastic surgery, and congenital defects causing deformation of the cartilage and / or bone part of the nose. The inner parts of the nose, such as the septum and turbinates, are often distorted, making breathing difficult. Then, along with the correction of the nasal septum and turbinates, and thus with the improvement of the nose function, the shape of the outer parts of the nose can be changed. Sometimes it happens that the septum, which is the most important scaffold, and at the same time the source of cartilage for adequate support for the nose, is so bent or completely broken after an injury or emitted by another doctor that it is impossible to build a good scaffold on it. Then the rib cartilage is the best source for the reconstruction of both the septal cartilage and the entire nose. By taking the rib at the same time, we can pick the peritoneum and fragment of the rectus fascia as well. All of this is used to make a good scaffold of the nose that has been damaged by other surgery or trauma. Sometimes we have no choice but to use only the rib!

Depending on the type of deformity, the nose can be made smaller by reducing parts of the nose and enlarged by adding cartilage structures. The procedure is performed under general anesthesia.

• Before starting the nose surgery, we prepare the costal cartilage.
• We make a cut in the sub-nipple fold in the medial part from the midline of the breast, both in men and women. The scar after collection remains about 2-3 cm long.
• Then we proceed to the basic nose surgery. In the current state of knowledge, the nose cut for this procedure is performed leaving a scar on the post, which is almost invisible with time.
• We dissect the entire nose, remove the existing scars.
• From the rib cartilage, we reconstruct the septum and other structures that have been lost either because of surgical procedures or because of an injury.

After the procedure, each patient has a plaster and plaster or thermoplastic dressing on their nose and nasal tampons. After the surgery, the patient experiences discomfort consisting in difficult breathing due to tamponade of the nose and later swelling and pain in rib extraction. These ailments are relieved with painkillers. After the treatment, the eyelids are swollen and blue, which disappear after 1-2 weeks.

Patients after such procedures should not consume alcohol, avoid physical exertion, eat spicy foods, drink hot liquids, bend down and situations that may cause blood pressure to rise. Return to work is possible after 2 weeks, provided that the work does not require physical effort causing an increase in blood pressure and is not in a dusty and dusty environment. Patients should avoid any extreme and contact sports for 6 months.

Consequences and possible complications after open method nasal surgery:

1. Swelling and bruising - this is a consequence, not a complication.
2. Asymmetry, we are not symmetrical although it seems to the layman that our body is symmetrical. Therefore, it is impossible to achieve perfect symmetry despite all efforts.
3. Hematoma under the skin causing prolonged extreme swelling, thick scarring, and a poorer aesthetic effect.
4. Hematoma in the septum causing abscess and, consequently, perforation of the septum and the formation of a hole in it.
5. Bleeding from the nose, sometimes quite profuse. In most cases it stops on its own and sometimes requires another tamponade.
6. Infection, from minor to extreme, which can cause damage to cartilage structures and collapse of the godmother of the nose, scarring and distortion of the nose.
7. Post wound dehiscence with prolonged healing leaving a wide, uneven, hypertrophic or keloid scar.
8. Necrosis of the skin on the tip of the nose which destroys the aesthetic effect of the treatment.
9. Pneumothorax after rib retrieval, requiring pleural drainage.
10. Hematoma at the collection site.
11. Infection and abscess at the site of collection.
12. Purulent pleurisy and pneumonia.