Dr Kar Su‎ Tan

Saddling of the nose is due to collapse of the mid vault area, or what we sometimes call the keystone area. It does not usually happen spontaneously, unless there has been previous surgery, trauma, septal perforation, cocaine use, rare autoimmune diseases or tumour growth. A thorough nasal examination including a nasoendoscopy should be performed to identify the underlying cause. The way to treat this usually involves reconstruction of the weakened septum using rib cartilage.

There is an extremely small, theoretical risk of permanently losing your sense of smell, although I have not personally encountered such a case before. Indeed, understanding the anatomy and physiology of the sense of smell, it would more likely than not, improve it. That said, you may experience temporary congestion that can last up to 2 weeks following rhinoplasty. This will impair your ability to detect smells. May I also suggest that if preserving your sense of smell is a serious consideration, avoid using implants or any foreign material.

Septoplasty involves removal or weakening of the portion of the septum that is deviated. The septum is also the main support structure that gives our nose its shape. When the Septoplasty had been too aggressive in removing or weakening the septum, structural weakening can occur. This may sometimes take time to manifest itself. With time, not only is there a worsening saddle deformity, the breathing function can also get worse as the nose starts to collapse on itself. To fix a saddle nose requires reconstruction of the septum.

There are 3 factors which affects the appearance of the nose: skin, cartilage and bones. You were not very specific in describing the location and appearance of the dent, so I'll discuss a little on all 3: Skin - scars from previous trauma, permanent wrinkle lines due to frequent nose rubbing from allergic rhinitis, or even acne scars can cause a dent or depression on the nose. Typically these kinds of dents can be reduced with lasers, resurfacing or scar revision surgeries. Cartilage - cartilage is found in the lower 2/3 of the nose.

Thanks for the question. You are describing what we call a short nose. This is very common in Asian patients. It can also be very common (contracted nose) following infection/ rejection after an implant rhinoplasty. I won't bore you with the excessive technical details of the different techniques to achieve lengthening, but the simple answer to correct a short nose, is to lengthen it. Lengthening is most commonly achieved through open rhinoplasty. The material of choice is either the septal, ear or the rib cartilage.

The stitches done for alarplasty is usually removed after 1 week.

By far the most common indication for Septoplasty is for nasal obstruction, a condition that mostly causes discomfort and inconvenience. Occasionally, the nasal obstruction can be severe enough to cause or worsen obstructive sleep apnoea, which is a medical condition that demands attention as it can lead to health problems. Rarely, we perform Septoplasty when there is recurrent nose bleed. The curvature of the deviated septum alters the airflow and can cause excessive drying of the lining at specific areas, leading to frequent nose bleeding.

One way to approach this question is to weigh the pros vs cons: Pros - Generally, septorhinoplasty, even with a rib harvest, is considered a very safe procedure. - You get to breathe better! - Correct Obstructive Sleep Apnoea: A deviated septum can occasionally cause or worsen obstructive sleep apnoea - which is a real medical condition that needs to be treated. Untreated, you are at risk of developing heart problems, high blood pressure even diabetes, just to name a few.

Yes and No. The nasal septum is a midline structure in the nose composed of cartilage and bones. It is the main structural support of the nose. Without a good septum, breathing function is compromised. There are some parts of the septum that are visible (top and front parts), whereas the other parts of the septum are not visible (inside part). Depending on where the deviation of the septum is located , it may or may not be visible.

It depends. You can certainly do a threadlift, but it may or may not be complicated. There are a few questions that needs to be answered: what is it you are trying to correct with the threadlift that your autologous rhinoplasty did not address (bridge? tip?) what has been done during the autologous rhinoplasty? In the best case scenario, no bridge augmentation was done during the autologous rhinoplasty, and you are looking for threadlift to create more bridge augmentation to complement your autologous rhinoplasty.

If you had a previous rhinoplasty, or any nasal surgery or trauma, the crease is most likely due to a broken cartilage/graft/implant. In such cases, the correct solution is to repair it surgically. Non-surgical camouflage using fillers is a possible but tenuous option, as it can cause unsightly bulking up of the columella. In addition, it may be risky for skin necrosis as the columella skin is quite thin, and fairly high-pressure injection will probably be required. Could it be a skin scar from a previous rhinoplasty?

What results do you want to achieve for your rhinoplasty? Straightening of nose? Improvement in breathing? Or both? Unfortunately, there are no easy answers to your question. Your best bet will be to find the surgeon that 1) you are most comfortable with, so that you can communicate clearly your goals. 2) who does a lot of rhinoplasty 3) who can help you visualise your results either through simulations or results of his work, preferably both, so that you can decide whether it is the result you are looking for, and he can ascertain accurately what your requirements are.

The recovery process is rather straightforward. I usually tell my patients that the stitches are removed in a week, and by 2 weeks you will be comfortably back on your work routine (except exercise and alcohol consumption). Swelling, however, often takes 6 to 12 months to slowly settle, before revealing the final result. Not to worry though, as by 2 weeks, most people will not be able to tell you had a recent nose surgery or nose surgery for the matter.

Chlorpheniramine is a first generation antihistamine. It is actually a very effective and potent medication that had been proven to be very safe over the years. The main issue with chlorpheniramine is that it requires an 8 hourly dosing, and it can cause significant drowsiness, thus affecting work, driving and operating machinery. The newer generations have less of these side effects and require less frequent dosing.

Think of your nasal passage as a tube for air to flow through. There are many things making up the wall of this tube, such as your turbinates and your septum. If the septum is bent inwards (as in a deviated septum), it is like the tube is narrowed. Similary, if your turbinates are large, it can also reduce the flow through this "tube".