When form fouls up function

November 15, 1999

(Philadelphia, Pa.) Thousands of Americans undergo rhinoplasty - commonly referred to as a "nose job" - with the hope of improving their appearance. But an aesthetically enhanced nose sometimes comes at a price: loss of proper nasal function.

In rhinoplasty, cartilage is removed from the nose to change its shape. If too much cartilage is removed, the sides of the nose can collapse when a person inhales, thus inhibiting breathing. A procedure performed at the University of Pennsylvania Health System can correct the problem.

"We restore the over-operated areas with the patient's own cartilage," explains Daniel G. Becker, MD, of the Division of Facial Plastic and Reconstructive Surgery in Penn's Department of Otorhinolaryngology-Head and Neck Surgery.

Proper breathing is restored through an outpatient procedure performed under mild sedation. First, the surgeon obtains the cartilage that will be used to reinforce the sides of the patient's nose.

That cartilage comes from one of two locations-either from a different section of the nose or from behind the ear. A small incision is made on the inside of the nose, creating a tiny pocket well beneath the skin's surface. The cartilage graft, called a nasal batten graft, is then inserted into the pocket to strengthen the nose's structure.

The graft is not visible and does not alter the nose's shape-unless the patient requests a change. "But we can also create a more natural appearance if the patient desires," Becker notes.

Becker has performed the procedure, which takes about an hour, on some 30 patients. Following surgery, patients experience mild soreness and swelling for about a week. The procedure can also be performed on people who have not undergone rhinoplasty but were born with weakened nasal tissue. Because impaired breathing is considered a medical rather than cosmetic problem, the corrective surgery is often covered by insurance.

University of Pennsylvania School of Medicine

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