I am honoured to have been chosen to give a talk on Septoplasty / Rhinoplasty in Children at the International Conference ESPO 2014. (European Society of Paediatric Otolaryngology )
Having worked with European Surgeons with a long history of research in this area, I operate on the noses of young patients where waiting for mid-facial growth and development would be the poorer option.
When to offer surgery and how to fashion a conservative surgical roadmap will be the objective of this section of decision making workshop.
The picture on the left is pre-operative view
The picture in the middle depicts digital morphing
The picture on the Right is post-operative result at Seven Weeks after surgery.
Pictures have been cropped to protect patient Identity and are published with written consent
Beyond the straightening of a crooked nose, reduction of nasal dorsal humps and gross tip asymmetries is the world of Finesse Rhinoplasty where an otherwise symmetrical and otherwise well proportioned nose may be considered for what is called the Finesse Rhinoplasty
Double break of columella: In the profile view the columella is seen to have a double break.
The first break … as one follows down the nasal dorsum and nasal tip … is defined as the point at which the tip of the nose turns inferiorly and posteriorly onto the infra-tip lobule.
The second break occurs at the midcolumella, where the columella takes a more horizontal course and extends posteriorly to the subnasale. This latter point usually corresponds to the junction of the medial and intermediate crura.
This is also the point which is my choice for a trans-columellar incision if using an external approach for Rhinoplasty