Rhinoplasty or septorhinoplasty: surgical correction of the external and internal nose

The remarkable evolutions in endonasal surgery today provide rhinoplasty with increasingly precise and minimally invasive techniques. Modern endonasal rhinoplasty may minimize side effects and complications as it uses specific anatomical corridors to reach and correct well-defined anatomical targets.

Rhinoplasty and septorhinoplasty both concern the nose but differ in technical terms. Strictly speaking, septorhinoplasty combines the correction both of the outer and inner nose, while rhinoplasty concerns the external nose only. However, since nasal cavities are closely related to the external appearance of the nose, no nasal surgery finalized to alter the shape can be planned and executed regardless of the function. The very old idea of an independent treatment of aesthetics and function is quite absurd in rhinoplasty.

In high demand by men and women of different ages, septorhinoplasty still remains one of the most complex operations in facial plastic surgery due to the numerous patient-specific anatomical variables and the millimetric anatomy of the nasal structures. Rhinoplasty is an unforgiving operation. The rhinoplasty specialist is aware of the exclusive attention to be given to each individual patient since the first contact. A thorough functional and anatomical diagnosis, an advanced aesthetic analysis, and even a deep understanding of the psychological and emotional state of the patient are prerequisites to this life-changing surgery, whether it has a cosmetic or functional purpose.

Scrupulousness, precision, empathy, and versatility are the primary components of Dr. Palma’s formula YOUnique Rhinoplasty™.

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Rhinoplasty, septorhinoplasty, and septoplasty: differences, objectives and results

Nasal surgery terminology is often used improperly. The terms rhinoplasty, septoplasty, or septorhinoplasty, and septo-rhino-turbinoplasty all indicate operation involving the nose, but they are not interchangeable. Each of these words pinpoints a different kind of surgery whose goal is the surgical correction of structural alterations that cause defects in the shape and/or function of the nose.

  • The term septorhinoplasty (also, rhinoseptoplasty) refers to the combined correction of the external and internal nose.
  • The compound word septo-rhino-turbinoplasty adds further surgical targets. The turbinates are valves of the internal nose that heat, purify, humidify, and regulate the airflow. An increase in the volume of the inferior turbinates provokes the so-called turbinate hypertrophy, the most frequent cause of obstruction in the upper respiratory tract.
  • Last but not least, the term rhinoplasty indicates the correction of the external nose only. However, even when the patient asks for a “nose job” to beautify the nasal appearance, every maneuver on the external nose (dorsum, tip, and nasal wings) does inevitably determine a functional impact on the internal nose. An exclusively “cosmetic” approach to rhinoplasty is not only inadequate and unrealistic but entails a high risk of being counterproductive on both aspects, functional and aesthetic.

Septorhinoplasty and patient expectations

When a patient requires a rhinoplasty, he or she tends to expect a pure cosmetic correction, or rather a surgery limited to the external of the nose and its appearance.

Conversely, the patient with breathing problems (deviation of the septum or the nasal pyramid, hypertrophy of the turbinates, etc.) will instead turn to the surgeon for a septoplasty, septorhinoplasty (or rhinoseptoplasty) or turbinoplasty (rhino-septo-turbinoplasty).

Is it possible to correct the aesthetic aspect of the nose disregarding its functions? The answer is NO: the modification of structural components of the nose, such as dorsum height, wings shape, tip size and position, almost inevitably entails an impact on the function. Specularly, the alignment of the external nose (nasal pyramid) frequently requires modifications of the nasal septum and its internal osteocartilaginous structure.

Rhinoplasty, septoplasty, and turbinoplasty are often performed simultaneously because they involve inter-related anatomical structures.

Moreover, the cartilage harvested from the septum is the most precious material for grafting procedures. Grafts are a powerful tool to provide structural support in revision cases and in selected primary cases. Different kind of grafts can be judiciously used to enhance the appearance of different nasal areas (radix, dorsum, tip, columella and wings).

Septorhinoplasty with Dr. Pietro Palma in Milan

Septorhinoplasty is one of the most requested procedures in facial plastic surgery. Such a delicate and complicated surgery is performed at its best by expert surgeons possessing a wide range of operative skills, advanced manual dexterity, and specific competences in facial analysis. The specialist rhinoplasty surgeon is the professional who has developed special expertise through years of studies, implementation and continuing improvement of safe and reliable techniques. With over 25 years of surgical practice exclusively dedicated to nasal surgery, Dr. Pietro Palma is acknowledged as one of the leading experts in rhinoplasty in Europe and internationally.

Functional and/or cosmetic nasal surgery can be performed via different approach, traditionally distinguished in external (or open rhinoplasty) and endonasal (or closed rhinoplasty). Dr. Palma has developed a third pathway, known as Hybrid Rhinoplasty™. His personal approach combines the benefits of the two conventional pathways. It is minimally invasive as it does not need any external columellar incision and limits the dissection only to the areas to be corrected. The unsurpassed advantage of Hybrid Rhinoplasty™ lies in its versatility as it allows to extend surgery according to the specific needs. Any nasal anatomical area can be accessed via custom-made incisions, hence surgery is performed on specific anatomical target without disturbing adjacent anatomical areas. Such a highly personalized surgery diminishes the risks of untoward results and complications that may require a revision rhinoplasty.

Needless to say, only a rhinoplasty specialist is qualified to design and execute a made-to-measure operation after a meticulous, specialist preoperative work-up. For more information on septorhinoplasty, you are welcome to schedule an interview with Dr. Palma at the Clinica del Viso (Piazza Repubblica, 21 – Milan – Tel +39 0263611932) or Casa di Cura “LA MADONNINA” (Via Quadronno, 29 / 31 – Milan – Tel +39 0258395555).