Thank you for your question. This is a rather technical question and it depends on what the initial problem is and what is done during the surgery. Nonetheless, this is a good question and I’m glad more patients are now able to appreciate the different techniques and the implications it will have on the nose in the long term.
Generally speaking, surgeries that are limited to the nasal dorsum e.g. implant insertion and alarplasty would not affect the movement of the nose in the long term. During the recovery period, the nose will be swollen and there will be some stiffness but that will subside over time and your nose should regain most of its mobility. (See below for rhinoplasty recovery timeline).
Procedures that involve the nasal tip, such as elongation of the nose and increase projection of nose may involve steps that can restrict nasal tip movement. The use of extended spreader grafts in combination with a columellar strut graft is a very strong technique that is useful for reconstruction of traumatic noses. In some patients with weak cartilages or very thick skin (common in Asian patients), this technique may be used but the trade off is that the nasal tip will remain stiff and relatively less mobile.
Newer techniques such as use of septal extension grafts without extended spreaders grafts but use of tip sutures to control the tip enable the same results but with a less stiff nose. Other manoeuvres that release the nasal skin and thin out the tip of the nose also enable the surgeon to extend the nose without such strong grafts. The choice on the technique will depend on the patient’s expectation and anatomy.
Preservation of the membranous septum is important to maintain the mobility of the nasal tip. I have seen patients who came for a revision rhinoplasty because they find their nasal too stiff. The rigid construct of the septal extension graft was removed and a septal extension graft with tip suture technique was used to revise the nose to restore the mobility. Speak with your surgeon today to see what is most suitable for your nose.
I hope this answers your question. Have a great weekend!
