Rhinoplasty for beginners – article review

Rhinoplasty is a surgical procedure that mainly has a cosmetic role but also implies a functional one for the improvement of nasal obstruction. The wide variation in the patient’s nasal anatomy and aesthetic desires make this surgery a difficult one. Throughout time, variable techniques have been described, like closed ones and opened ones. The last trends in rhinoplasty are the hybrid rhinoplasty and the preservation rhinoplasty techniques. Taking into account all this, it is necessary to guide a beginner in rhinoplasty to some easier techniques and some cases with low difficulty. Material and methods: We used the literature available in English by consulting the main medical databases (NCBI®, EMBASE®, Cochrane®), using as keywords for search: ‘easy rhinoplasty techniques’, ‘first steps in rhinoplasty’. We analyzed the studies published in the last 15 years. Several reference books for rhinoplasty were also used. Results: The first stage of rhinoplasty is represented by the preoperative analysis and discussion with the patient. Various questionnaires should be submitted prior to surgery to analyze the mental health status and patient expectations. The aesthetic principles of the face will be analyzed. Open rhinoplasty techniques are perceived as easier due to the increased visibility and seem to be used more by beginners. A big hump, along with a skin of moderate thickness, without the need to correct the nose or the nasal pyramid is the most suitable case for the first steps in rhinoplasty. A combination of open and closed techniques that can be used for beginners is the open approach by transcolumellar incision. Conclusions: Very important for a beginner in rhinoplasty is the correct selection of patients. This should include a careful psychological evaluation, and then the identification of low-difficulty surgical cases that can guarantee success at first. Open rhinoplasty with transcolumellar incision is a more accessible technique that can be used in selected cases until the surgeon has obtain sufficient experience.