Dynamic Rhinoplasty and Longtime  Aesthetic Results

Since 1992 thousands of aesthetic nasal surgery procedures have been performed by him which have been appreciated for their long term stability and the best natural aesthetic results. Dr. Naraghi is a member of multiple international professional societies including European Academy of Facial Plastic Surgery (EAFPS), American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS), American Rhinologic Society (ARS), and European Rhinologic Society (ERS). More than thirty international scientific papers and over one hundred journal articles and chapters in Rhinology were authorized and published by Dr. Naraghi. He has presented numerous scientific papers in many international congresses in Europe, US and Australia, introducing several new methods in nasal surgery. Dr. Naraghi is the author of six books, most of them are in the field of Rhinology.A two-volume Rhinology  book has been appreciated by the President of ISO-HNS as the first comprehensive Rhinology textbook in his native language. Dr. Mohsen Naraghi have earned three national first rank awards for the best surgeon in research, the highest rank in speciality board and the first rank in the comprehensive national medical examinations. Mohsen Naraghi MD has had extened experience and appreciated innovations in the field of Rhinology. He was recognized by the president of ISO-HNS as an innovator of minimally invasive surgical techniques in the field of Rhinology. He has been the pioneer of the Endonasal Endoscopic Laser Surgery in Iran.Recently, he was the presenter of the article in Los Angeles which won the 2005 International Award of the American Rhinologic Society. He presented his lecture in Rhinoplasty Course at the American Academy of Facial Plastic and Reconstructive Surgery Annual Meeting in Los Angeles.Hereby you can read a published interview with him about his new work.

Can you explain the problem in the aesthetic nasal surgery which led you to innovation of your new technique?

As you know, many people have long noses with a long skin covering, making them difficult cases for the aesthetic nose surgery. The problem with these noses is maintaining the stability of the results in the long term, because the long skin covering and the functions of the muscles that pull the nose downward makes a propensity for the nose to hang down. The expert surgeon must be familiar with the best techniques to solve this problem and to ensure good long term results.

Could you explain simply your technique which you have presented in the  Congress?

I have named my technique “Dynamic Rhinoplasty Spring” because it is based on dynamic correction of the nose based on a spring model in contrast to the traditional static techniques. I presented a method of dynamic technique using the elastic forces of the cartilage as a spring to compensate forces of the muscles of the nose which tend to pull down the nose (Fig.1).
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I prepare a piece of cartilage from the septum inside the nose and in a special method I insert it in a narrow canal which I had made it in the base of the nose. I perform special procedures to make this piece of cartilage acting as a dynamic rather than static piece. Here is embedded the mystery of dynamism and long term durability of this technique. As you could observe in the before and after surgery photographs, the nose is stable even with the strongest facial movement during a vigorous laugh, and no falling down is observed during laugher (fig.2).
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The nose also is stable with age, it is a younger nose with a younger face appearance and more stable to the aging changes (fig.3).
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How could you acheive the best results in your rhinoplasty surgeries?

The goal of aesthetic Rhinoplasty is reconstruction of the nose in harmony with other features of the face. Every correction in the nose should be made with consideration of all aesthetic components of the face. The nose would seem natural if the surgeon has a perfect cosmetic facial analysis.
Fig.3

What is the best age for Rhinoplasty?

Rhinoplasty could be done at any age after 15 in the girls and 17 in the boys. Some reconstructive nasal surgeries could be performed earlier.

Would there be any scar after Rhinoplasty?

No trace of surgery would appear on the nose in expert surgeon hand. People would not find any clue of surgery. This nose is just the same as a natural nose.

Is there any pain in rhinoplasty?

My patients do not often complain of any pain after surgery.

Do you perform surgery on old patients?

With advances in surgical techniques, there is no age limit in the elderly. In older patients, Rhinoplasty could create a younger appearance and better breathing.

How do you evaluate the application of laser and endoscope in your Rhinoplastic surgeries?

I use both of them in most of my surgeries. Many patients have different endonasal problems which cause difficult breathing and other problems such as nasal discharge and facial pain. A Rhinologist must be familiar with the precious knowledge of internal structure and internal pathology of the nose. I have presented the important role of endoscopic evaluation in Rhinoplasty in the 13th International Congress of the International Confederation for Plastic, Reconstructive and Aesthetic Surgery in Australia. I could obtain the best functional results with these adjunctive procedures. Every patient must have better breathing after Rhinoplasty.