Sinuplasty vs. Rhinoplasty: Which is Right For You?

A surprising number of patients who come to our offices for rhinoplasty are told that they have something a little wrong with their sinuses or some other structure inside the nose. This defect affects their breathing and makes it less efficient.

A deviated septum is sometimes a shock to a patient who has lived their whole life thinking their breathing was perfectly fine and just wanted to change the shape of their nose, according to New Jersey rhinoplasty expert, Daniel G. Becker.

People who wonder if they have to choose between sinuplasty, or sinuplasty and rhinoplasty should know that they don’t have to choose one over the other. Indeed, they are often performed at the same time. This is true of other nose surgeries such as septoplasty and turbinoplasty.

Doctors recommend that the sinuplasty or any other surgery to correct a medical issue be done before the cosmetic rhinoplasty but during the same session.

About the Nose

Besides being the most prominent part of the face, the nose is a complex structure, which makes rhinoplasty a challenging skill to master. There are four pairs of sinuses among many other parts of the nose that need to be taken into consideration during nose surgery.

Sinuses are spaces around the nasal cavity that are filled with air and take up a surprising amount of space. 

The frontal sinuses are above the person’s eyes. The ethmoid sinuses are between the eyes, and the sphenoid sinuses lie behind a person’s eyes.

Finally, the maxillary sinuses are found beneath the eyes. These sinuses appear at various stages in a child’s development.

People are born with the ethmoid and maxillary sinuses, though there’s no air in them at first. The other sinuses arrive later and keep developing throughout the person’s life.

Because they’re hollow, the sinuses make a person’s skull lighter, but they also keep the inside of the nose moist by producing mucus. The mucus traps pollutants and pathogens.

Why Do People Choose Sinuplasty?

The most common reason people get sinuplasty is that they have chronic inflammation of their sinuses, or sinusitis that doesn’t respond to more conservative treatments.

Though traditional sinuplasty involves cutting through tissue and bone to enlarge the sinuses, a new technique called balloon sinuplasty does not require this type of trauma.

During balloon sinuplasty, the surgeon threads a balloon catheter into the sinus then inflates it to force the opening to expand.

When this is done, the enlarged sinus is flushed with saline solution to remove debris such as pus. Then, the balloon is withdrawn, leaving the sinus open and cleared.

Rhinoplasty

There are two basic rhinoplasty techniques: open or closed. In an open rhinoplasty, the surgeon makes an incision through the columella  (the strip of cartilage between the nostrils) and opens the nose up to operate.

According to studies, surgeons prefer the transcolumellar gull wing, where an upside-down V incision is made in the tissue.

In a closed procedure, the surgeon operates from inside the nose. Most surgeons use open rhinoplasty, though surgeons whose patients want them to improve the look of the tip of their nose or the top of their nose used closed rhinoplasty.

Most patients seek rhinoplasty because they have a bump in their nose that they find unattractive.

Other reasons include a nose that’s crooked, either because it’s been injured or the patient was simply born with it, a saddle nose that has a dip in the middle then turns upward at the tip, or a nose tip that’s too bulbous or has some other aspect about it that the patient finds unsightly. 

Many plastic surgeons find fixing the tip of the nose to be the most challenging type of rhinoplasty.

In some cases, the tip of the patient’s nose can’t be fixed because the skin there is too thick and the cartilage beneath it is too thin. The plastic surgeon should let the patient know this during the consultation after they’ve examined the nose.

Other people find their nose too large or too small in proportion to the rest of their face, their nose is too wide, or their nostrils are too narrow or too flared.

Who’s a Good Candidate for Nose Surgery?

A candidate for rhinoplasty is in good overall health both physically and mentally and has specific and realistic goals when it comes to their nose surgery. Their facial growth should also be completed.

Since this happens when people are about 13, plastic surgeons sometimes have consultations with teenagers who hate their nose but aren’t completely sure about what they want to be done with it. This can also make rhinoplasty more daunting than other types of cosmetic surgery.

A candidate should come to the consultation with a list of questions and be able to answer the questions that the plastic surgeon puts to them. The doctor will also tell them the best options for their nose surgery or if the surgery can be performed at all.

Though a sinuplasty can be performed at the same time as rhinoplasty, the patient must not have any infections in their upper respiratory system such as a cold or flu.

They’ll need to quit smoking at least two weeks before the surgery, and they’ll need to fast the night before their surgery. This is because most nose surgeries are done under general anesthesia.

The patient also needs to discontinue anti-inflammatory or anticoagulant medicines before their surgery, and they’ll need someone to drive them home and stay with them at least overnight.

It’s also a good idea to prepare the home for the patient’s convalescence. Needful things should be in reach of the bed, and meals should be cooked beforehand.

Since the patient will need to sleep with their head elevated for a few nights, a husband pillow and a neck pillow are good to have.

Rhinoplasty takes about one to two hours and may take more time if sinuplasty is performed at the same time.

The improvements brought by sinuplasty or septoplasty can be felt quickly, and the nose will heal into its new shape after about a year. The great majority of patients are very pleased with their rhinoplasty surgery.

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