One of the rhinoplasty applications, Letdown rhinoplasty technique is a technique which is applied to restore a slight-humped nose structure into a normal appearance. During the operation, a bone is dislocated from the side walls of the nasal bone, and nasal dorsal bone is let down in layers without damaging natural structure of the nasal dorsal bone. In this application, since naturalness of the nasal dorsum is not damaged, there is no change in the light and shadows reflecting from the nose, and thereby naturalness is maintained.
In fact, the pushdown rhinoplasty technique applied in 1970s and then abandoned for a while is today used by revising with little differences. With this technique, naturalness of the nasal structure is maintained and an aesthetic appearance is achieved.
In normal rhinoplasty surgeries, nasal dorsal bone and/or cartilage are removed; humped part is separated from the upper part of the bone by breaking or rasping it. This application naturally results in destroying anatomic structure of the nasal dorsum.
In case of the letdown rhinoplasty surgery, nasal dorsal bone or cartilage is not removed, a piece is taken out from the bottom side, generally side walls of the nasal dorsal bone, thus the hump on the upper part is moved downward and eliminated. After the surplus is removed, the nasal dorsal bone which maintains its naturalness is let down and placed into nasal cavity. Thus, the nose is shaped without damaging natural nasal roof, aesthetic line of eyebrows-nose is preserved, and appearance deformities likely to form after re-shaping nasal roof by surgeon are prevented. After the surplus in the bone or cartilage is removed and the roof is moved inside the cavity, normal relation between dorsal bone, cartilage and tissues is maintained without any damage, airway don’t become narrow and it provides the surgeon with freedom of operation.
Another rhinoplasty application is pushdown rhinoplasty technique. As in the Letdown rhinoplasty technique, this is a technique which is applied to restore a slight-humped nose structure into a normal appearance. During the operation, nasal dorsal bone is pushed down in the nasal cavity of the nasal dorsal bone without removing bone from the nasal bone and without damaging natural structure of the nasal dorsal bone. In this application, since naturalness of the nasal dorsum is not damaged, there is also no change in the light and shadows reflecting from the nose, and thereby naturalness is maintained.
Its first applications were seen in 1970s. It is now re-used as a Letdown rhinoplasty technique after revising with little differences. This is because the pushdown rhinoplasty technique has limitations. The limit for pushing dorsal bone down is determined with the size of the nasal cavity. Furthermore, dislocation without any reduction in bone structure may cause airway to become narrow. Therefore, the Letdown rhinoplasty technique which is carried out by removing bone or cartilage provides advantage for surgeon in terms of freedom of movement and shaping. With this technique, naturalness of the nasal structure is also maintained and an aesthetic appearance is achieved.
In the pushdown rhinoplasty surgery, nasal dorsal bone or cartilage is not removed, bottom side of the nasal dorsal bone is cut through the nose, and then it is pushed down and placed into the nasal cavity without removing bone or cartilage. Thus, the nose is shaped without damaging natural nasal roof, aesthetic line of eyebrows-nose is preserved, and appearance deformities likely to form after re-shaping nasal roof by surgeon are prevented.
The need for tampon after surgery in both Letdown rhinoplasty and Pushdown rhinoplasty technique has decreased day by day thanks to the advanced technology and medical equipment. Silicone splints with air holes allowing the patient to breathe are widely used.
During operation, blood penetrating from soft tissues inside and around the bone intervened can accumulate in orbits. Thus, post-surgical bruising and swelling may occur on upper and lower eyelids. Bruising and swelling do not mean that patient has pain. With the usage of modern surgical instruments (piezosurgery, drill, and motor), bruising and swelling are reduced to a minimum level and disappear in about a week. Another reason of bruising is that patient has a skin prone to bruise. A more severe post-surgical bruising may occur especially in light-skinned persons.
Silicone splints are removed two or three days after discharge on the same day or the following day. After the removal of silicone splints, patients may take a shower by washing their body without wetting their head. Splints placed inside the nose are removed in a week and nasal bands are applied. In this period, patients may take shower as normal. Nasal bands are removed on the tenth day. Stitches inside the nose will disappear on their own within about 15-20 days. Patient may go swimming in a pool or sea 15 days after surgery. Then, the control period by surgeon begins.
There is no limitation for eating or drinking after two days. Patients may return to their daily life upon the removal of nasal bands and splints on the tenth day. Patients should not be exposed to sun unless the bruises on their upper and lower eyelids disappear. If it is a must, patients should wear a hat. However, patients should not wear glasses for at least 2 months. This period may continue up to 6 months.
If you are not satisfied with the humped structure of your nose, you can reach us via our contact information for our Letdown rhinoplasty and Pushdown rhinoplasty applications.