page_title: Rhinoplasty
section_title: Photographic records
hierarchical_section_title: Rhinoplasty / Surgical procedure / Photographic records
caption_attribution_description: English: Rhinoplasty. Showing a technique used to narrow the tip of the nose. The red line is on the edge of the tip cartilage, which is being narrowed by placing a suture to tighten the fold at the tip. The suture is in blue, ending in the needle, which appears white. The cartilage is being held in place with a tweezers, shaded green.
context_page_description: Rhinoplasty, commonly known as a nose job, is a plastic surgery procedure for altering and reconstructing the nose. There are two types of plastic surgery used – reconstructive surgery that restores the form and functions of the nose and cosmetic surgery that changes the appearance of the nose. Reconstructive surgery seeks to resolve nasal injuries caused by various traumas including blunt, and penetrating trauma and trauma caused by blast injury. Reconstructive surgery also treats birth defects, breathing problems, and failed primary rhinoplasties. Rhinoplasty may remove a bump, narrow nostril width, change the angle between the nose and the mouth, or address injuries, birth defects, or other problems that affect breathing, such as a deviated nasal septum or a sinus condition.
context_section_description: For the benefit of the patient and the physician–surgeon, a photographic history of the entire rhinoplastic procedure is established; beginning at the pre-operative consultation, continuing during the surgical operation procedures, and concluding with the post-operative outcome. To record the "before-and-after" physiognomies of the nose and the face of the patient, the specific visual perspectives required are photographs of the nose viewed from the anteroposterior (front-to-back) perspective; the lateral view (profiles), the worm's-eye view (from below), the bird's-eye view (overhead), and three-quarter-profile views.
  Photograph A. – Open rhinoplasty: At rhinoplasty's end, after the plastic surgeon has sutured (closed) the incisions, the corrected (new) nose will be dressed, taped, and splinted immobile to permit the uninterrupted healing of the surgical incisions. The purple-ink guidelines ensured the surgeon's accurate cutting of the defect correction plan.
  Photograph B. – Open rhinoplasty: The new nose is prepared with paper tape in order to receive the metal nasal-splint that will immobilize it to maintain its correct shape as a new nose.
  Photograph C. – Open rhinoplasty: After the preliminary taping of the nose, a custom-made, metal nasal-splint, designed, cut, and formed by the surgeon, is emplaced to immobilize and protect the tender tissues of the new nose during convalescence.
  Photograph D. – Open rhinoplasty: The taping, emplacement of the metal splint, and dressing of the new nose complete the rhinoplasty procedure. The patient then convalesces, and the wound dressing will be removed at 1-week post-procedure.
  Photograph 1. – Open rhinoplasty: The incisions are endonasal (in the nose), and thus are hidden. The skin-incision to the columella aids the plastic surgeon in precisely suturing to hide the scar—except for the columellar incision (red-dot guideline) across the nasal base. The columellar incision allows the surgeon to view the size, shape, and condition of the nasal cartilages and bones to be corrected.
  Photograph 2. – Open rhinoplasty: The nasal interior. The scissors indicate the lower lateral cartilage (blue), which is one of the wing-shaped cartilages that conform the tip of the nose. The jagged red delineation indicates the locale of the columellar incision. Once the skin has been lifted from the bone-and-cartilage framework, the surgeon performs the nasal correction tasks.
  Photograph 3. – Open rhinoplasty: To narrow the tip of a too-wide nose, the surgeon first determines the cause of the excess nasal width. The suture being emplaced will narrow the tip of the nose. The red delineation indicates the edge of the nose-tip cartilage, which is narrowed when the surgeon tightens the folded cartilage apex. The suture (light blue) ends in the needle (white); tweezers (green) hold the nasal cartilage in place for the suturing.
  Photograph 4. – Nasal hump excision: The black delineation indicates the desired nose-reduction outcome: a straight nose. The nasal hump is bone (red) above the scalloped grey line, and cartilage (blue) below the scalloped grey line. The surgeon cuts the cartilage portion of the hump with a scalpel, and chisels the bone portion with an osteotome (bone chisel). After chiselling away the main mass of the nasal hump with an osteotome, the surgeon then sculpts, refines, and smoothens the cut nasal bones with rasps (files).
caption: Photograph 3. Open rhinoplasty: the nasal tip is sutured to narrow the nose.
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