The Nose Inside and Out

Program Description This unique seminar will bring together leaders from both the American Rhinologic Society (ARS) and American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS). We will be examining both functional and aesthetic considerations in nasal surgery from workup to revision surgery. When it comes to nasal surgery, all aspects of anatomy and physiology should be considered, especially when functional and aesthetic surgery is combined. A thorough evaluation is important prior to cosmetic rhinoplasty, with or without septoplasty, including an evaluation of the septum, ostiomeatal complex and inferior turbinates, often using fiber optic endoscopy. The indications for CT scanning will be discussed in patients with sinus disease prior to rhinoplasty. Functional endoscopic sinus surgery can be performed at the same time as rhinoplasty precluding the need for a second surgical procedure. Benefits and contraindications for a combined approach will be presented. Prevention and surgical treatment of nasal septal perforations will be presented since nasal septal perforations most commonly occur following nasal surgery or cocaine abuse. Preventative measures to reduce iatrogenic occurrences will be discussed as well as surgical techniques to repair septal perforations of various sizes. “Functionally safe cosmetic rhinoplasty” will address potential functional pitfalls from cosmetic rhinoplasty. The speaker will target reduced cross‐sectional area of the internal nasal valve following many standard rhinoplasty techniques. Methods for cosmetic rhinoplasty that preserve and/or enhance nasal valve function will be presented. Revision rhinoplasty is reported in 5% to 15% of patients. Based on a recent study, “Functional and aesthetic concerns of patients seeking revision rhinoplasty,” the most common complaints that patients present with, from the patients’ point of view, will be presented. This will be accompanied by a summary of these problems with tips on how to prevent them from occurring in the first place. Case presentations will highlight the above. Educational Objectives 1) Understand the importance of a detailed workup prior to nasal surgery and rhinoplasty. 2) Understand that functional endoscopic sinus surgery can be performed concurrently with cosmetic rhinoplasty. 3) Perform safe septorhinoplasty while maintaining function; prevent sepal perforations; learn why patients seek revision surgery.