Robotic surgery has changed many types of surgery and the way it is being performed. It has lead to smaller incisions, less downtime and quicker recovery. So is there a role for robotics in facial plastic surgery?
Currently, the answer is no. Robotic surgery is best used in hard to reach areas where access typically requires a larger incision and can now be reached with a smaller incision. In facial plastic surgery, rhinoplasty is performed already with either a small incision or incisionless approach. In facelift surgery, the incisions are concealed around the hairline and are necessary to remove the excess skin. Some facelifts can be performed with an endoscope. Even with forehead bumps (osteomas), Dr. Shah uses an endoscope to remove the lesion rather than a large incision. More importantly, in aesthetic surgery there is a feel to the procedure which may be lost with a robot.
While robotic surgery has changed abdominal and thoracic surgery, its role appears to be limited in aesthetic surgery of the face currently.
Clint Dempsey recently broke his nose while playing soccer in the World Cup game against Ghana. During the soccer match, John Boyeaccidently smashed his shin against his nose. The nose was confirmed to be broken by the United States training facility. Soccer, a sport where the foot and legs takes precedence of the hands, often leaves the face unprotected from injuries.
Nasal fractures can occur readily in contact sports and is one of the most common injuries. Nasal fractures can be detected by several methods. First of all, one of the best ways of detecting a nasal fracture is be being seen by a qualified physician. Mobility of the nasal bones is the sign that the nasal bones are fractured. Although plain x-rays are often ordered in the acute care setting, they are suprisingly inaccurate at detecting nasal fractures. The reason for this is that normal lines seen on the face (called sutures) often overlap the nose making interpretation of the xray difficult. CT scans of the face can isolate the nasal bones from the bones in the background and help in diagnosing nasal bone fractures.
The septum of the nose is cartilage and is often displaced or misaligned after nasal injury. A deviated septum is again detected by a qualified physician with a nasal speculum and headlight. An xray is not helpful in detecting a deviated septum. CT scans are very accurate in detecting deviated boney portions of the septum, but do not detect cartilaginous deviations flawlessly. Often times cartilaginous deviations seen in the nose readily, are not as easily seen on CT scan.
So, while contact sports are fun to watch… when playing them, protect your face as injury is quite common.
A massage has many known health benefits including tending to sore muscles, improving lymphatics, and overall relaxation. One unintended effect of massage is nasal stuffiness. So how do we avoid this and what is responsible for this phenomenon. When our face is placed in a dependent position, such as face down the blood tends to pool here. Part of this is the dynamic nature of the nasal turbinates. The turbinates regulate our breathing by swelling and deswelling. When we lie down on one side, the turbinate on that side will swell, making breathing easier on the opposite nasal passageway. Similarily, when receiving a massage, since the face is down, both turbinates will swell creating potential for diffuclty breathing.
What are some solutions to "massage induced nasal obstruction"? Some natural oils such as peppermint, menthol, or eucalptus can act as a natural decongestant. Other conventional medical techniques, may be using a nasal spray either over the counter or prescription to help constrict the nasal turbinate. Be cautious using Afrin too much or if medically contraindicated as it isnot safe to use on a continual and daily basis.
Hopefully, this allows patients to enjoy their massages a little more.
Nasal hair is something we are supposed to have. Vibrassae, the medical term for nose hair, serves to help filter particles and air. However, overly long nasal hair is probably not high on our list of attractive. So what are you supposed to do prior to a rhinoplasty? Pluck, clip, or leave it alone.
The answer depends on the timing of the procedure. If you are having a procedure within a week, the best answer would be to do nothing, but if you must do something, trim your hairs don't pluck them. The reason for this is that manipulation of nasal hair can cause an ingrown hair or infection of the follicule termed a folliculitis. In some patients, this can lead to an abscess. Pulling nasal hairs is definitely more likely to cause a folliculitis than trimming hairs with either a scissors or a nasal hair trimming device.