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3D High-Definition Nose Surgery
NOTE: The 3D High Definition Technology mentioned on this site is used for 3D High Definition SURGERY and should not be confused with 3D Virtual Computer Imaging that is used before surgery.
3D Hi-Def Technology or in its full name “Three Dimensional High Definition Technology” has been used for years in many different types of surgery and nowadays it is also being used in advanced rhinoplasty procedures.
As one of the world’s top nose surgeons, Dr. Samieh (Sam) Rizk is accredited to be one of the first few surgeons who use this technology in their practice. Dr. Rizk was selected as a Top Rhinoplasty Doctor by Tatler and Castle Connolly (A Peer Review Doctor Rating Organization which selects top doctors in each field). According to Dr. Rizk, using the 3D technology helps the patient to speed up the healing process compared to the traditional rhinoplasty procedure that other plastic surgeons still perform. With facial plastic surgeons that use traditional, older techniques, the only hope that patients have not to get any bleeding and swelling is based on the surgeon’s experience and expertise.
A traditional rhinoplasty is often performed by the surgeon working within the inner nose structures by using a regular headlight to get an interior view of patient’s nose and then using other types of tools/instruments to perform the actual surgery. The risk of this “old style” nose surgery is that some tiny blood vessels and muscles which are invisible to the doctor and the surgeon can easily damage them and create a chance of greater nose bleeding and swelling, and therefore it might take up to two weeks in order to fully recover.
A large advantage of 3D technology is PRECISION, where the high definition telescope shows structures in detailed accuracy to within millimeters. Millimeters make a big difference between an excellent and an unsatisfactory outcome by increasing visualization and precision. 3D technology helps the surgeon to have a precise view of the interior nasal area by inserting a high definition telescope that connects with a 3D high definition imaging system which projects the picture on a large screen in real time.
This technology also helps the surgeon in trauma preventing by not hitting the patient’s blood vessels, muscles and sensitive tissues, which otherwise can create bruising and swelling later on. By decreasing swelling, you get an improved overall outcome because swelling which is prolonged can lead to scar tissue.
The surgeon that is using 3D technology can save the patient time by allowing a faster recovery (in about five days after surgery). Using 3D technology increases visualization and precision, therefore the advantage is not just a rapid recovery. Patients usually have less pain than in the traditional surgery style. Some surgeons like Dr. Rizk may combine the use of different tissue glues types that are naturally absorbed into the skin layer and that also helps to diminish the possibility of swelling and bruising after the surgery.
What is high definition rhinoplasty?
It is a type of endonasal rhinoplasty where the use of the telescope (high definition) is used to better visualize the bridge of the nose to get a better view during the surgery on a high definition 3d screen. It is a technique that Dr. Rizk believes helps achieve a better outcome through better precision of removal of the nasal bump and allowing for a more natural result with a more minimal recovery. Dr. Rizk believes surgical swelling during the procedure and anesthetics injected in the nose can make the external appearance of the bridge appear falsely higher during the surgery and so the surgeon may remove more bone and cartilage. This initially will appear normal but as the swelling dissipates after surgery the nose will appear scooped. So Dr. Rizk's use of this high definition telescope is to get a better internal view of the nose and cancel the effect of the swelling of the skin and soft tissues during the surgery. See published article above in Plastic Surgery Practice Magazine.
How long has Dr. Rizk been using this approach?
Dr. Rizk has been using endonasal telescopes for over 15 years in delicate sinus surgery and orbital decompressions for Graves' disease (published in Otolaryngology-Head and Neck surgery Journal) and has adapted the use of more advanced high definition telescopes with high definition TV monitors in endonasal rhinoplasty for the last 4 years.
What are some advantages to using this approach?
1. Better ability to visualize the nasal bridge.
2. Better ability to visualize the osteotomy sites and tracks to narrow the nose.
3. Better ability to enter the sub-Smas plane in the nose which is a blood free plane therefore, preserving the overlying soft tissue envelope which results in less bleeding during the surgery.
Minor irregularities in the bridge or bump of the nose which may be missed with an external look by the surgeon of interior of the nose and bridge are picked up in high magnification with the high definition telescope camera system. This may decrease the need for revision rhinoplasty which may result if these minor missed irregularities later manifest as a bump or irregular nasal bridge once the swelling resolves.
What are some of the disadvantages to using this approach with high definition telescopes?
1. Cost-Equipment-both high definition telescopes and camera systems/tv screens are expensive.
2. It requires a learning curve to use this equipment-Dr. Rizk has been using this equipment for many years with sinus surgery and endoscopic orbital decompression (see published articles on this in Otolaryngology-Head and Neck Surgery Journal in the media section of Dr. Rizk's main website www.drsamrizk.com).
Is the equipment new?
No this equipment is currently being used in many other surgical procedures all over the face and body but its application to rhinoplasty is new.
Why are more surgeons not using this technique?
Some traditional rhinoplasty surgeons prefer the older approaches. This is relatively new and the equipment is also costly and requires a learning curve to use it. Surgeons who have used endoscopes in other types of surgeries would me more adaptable to using it in rhinoplasty. Dr. Sam Rizk has published it in Plastic Surgery Practice above. As with any new technique, it takes time for more people to adapt to using it and some surgeons will adapt quickly and others will not like to use it-surgeons have their own personal approach to rhinoplasty which works for them. This System helps Dr. Rizk achieve a more accurate and natural result with a more rapid recovery.
Does Dr. Rizk use the high defintion rhinoplasty approach in every rhinoplasty?
No, Dr. Rizk uses it when there is a large nasal bump and in most endonasal cases but not all. Realize Dr. Rizk performs both open and closed (endonasal rhinoplasty) and customizes the approach and techniques to the particular patient and situation, whether its a revision or primary rhinoplasty also affects his approach.
Where has Dr. Rizk presented or published this information in Plastic Surgery Conferences?
Dr. Rizk has presented this technology at conferences in the US, London (Face Conference-2010,2011, and Brazil-2009) and has published it in Plastic Surgery Practice Journal and the article is currently pending publication in a peer-reviewed plastic surgery journal. See articles above and video demonstration of a portion of technique.