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University of Maryland Medical Center
Baltimore, Maryland -- On February 1, 2006, we step inside the operating rooms at the University of Maryland Medical Center (UMMC) in Baltimore and watched as Director of Facial Plastic Surgery, Thomas Le, M.D., an assistant professor of Otorhinolaryngology-Head and Neck Surgery at the University of Maryland School of Medicine, and Scott Strome, M.D., chair of the Department of Otorhinolaryngology -Head and Neck Surgery at the University of Maryland School of Medicine and Chief of Otorhinolaryngology at the UMMC perform a rhinoplasty, the surgical method of reshaping the nose.
According to Dr. Le, the reasons for rhinoplasty are one of the following: cosmetic, traumatic, congenital or functional. Rhinoplasty can be used to change the size of a nose, reshape the tip or bridge, narrow or enlarge portions of a nose, correct a birth defect, repair an injury or help alleviate a breathing problem.
The nose is an organ where form follows function and vice versa. If you have a straight, well proportioned nose, you will likely breathe well. If you have a crooked, twisted or pinched nose, you might not breathe clearly.
During a rhinoplasty, surgeons enter the nose one of two ways: endonasal or external. In the endonasal approach, all the incisions are internal and access is gained by going through the nostrils. In the external approach, Dr. Le makes a small cut in the columella, the small space between the two nostrils. He is then able to lift the soft skin of the nose and access the bone and cartilage.
Every rhinoplasty is unique. While the surgeon meticulously plans what he or she is trying to achieve before the surgery begins (for instance, a hump reduction or a nasal tip reconstruction), he or she is not always certain how this will be accomplished until accessing the inside of the nose and confirming the anatomy.
During the webcast, you were able to watch as Dr. Le performs an external rhinoplasty on a patient with nasal valve collapse that had resulted in breathing difficulties. In very simple terms, Dr. Le reconstructed the internal anatomy to spread out the nose