Episode 19 – Podcast Show Notes

🎙️ Dr Dan Behind the Scalpel – Episode: The Roman Nose

The Roman nose is one of the classic nasal shapes that patients may seek rhinoplasty to address. Characterised by a prominent dorsal hump and a long, downward-pointing nasal tip, a Roman nose can make patients feel that their nose is too large or prominent for their face.

In this episode, Dr Dan explains what causes a Roman nose, why it often runs in families, and the structural changes that contribute to its distinctive appearance.

He also discusses the complexities involved in correcting a Roman nose, including hump reduction, nasal bone restructuring, rebuilding the middle third, managing tip position and addressing the nasal valve to ensure that both the appearance and function of the nose are considered.

🔎 What You’ll Learn in This Episode:

• What is meant by a “Roman nose”.

• The key features that characterise a Roman nose.

• Why a Roman nose can make the nose appear overly large or prominent.

• Why Roman noses often run in families.

• How overgrowth of the septal cartilage contributes to the appearance.

• How a large dorsal hump and tip ptosis develop.

• What columella show and a long alar can have to do with nasal growth.

• Why skin thickness is an important consideration when correcting a Roman nose.

• The role of hump reduction and nasal bone restructuring.

• Why rebuilding the middle third of the nose is important.

• How spreader grafts and septal grafting may be used.

• Why tip position and projection need to be carefully considered.

• Why some female patients may also require alar base reduction.

• How a Roman nose can be associated with nasal obstruction and nasal valve problems.

• Why addressing nasal function is an important part of Roman nose surgery.

• Why complex Roman nose surgery may benefit from an experienced rhinoplasty surgeon with a strong understanding of nasal valve anatomy.

🎙️ Dr Dan Behind the Scalpel – Episode: Saddle Nose Deformity After Previous Rhinoplasty

A saddle nose deformity doesn’t only occur following significant trauma. In some cases, it can develop after previous rhinoplasty surgery when too much structural support has been removed without adequate reconstruction.

In this episode, Dr Dan discusses saddle nose deformity following previous nasal surgery, including why the nose can gradually collapse months after an operation, the role of over-resection and inadequate structural support, and the less common complication of septal perforation.

Dr Dan also explains why timing can be critical when a saddle nose deformity is identified shortly after surgery, how early intervention may sometimes prevent a more complex reconstruction, and what happens when patients present months or years later with established scar tissue and skin contraction.

🔎 What You’ll Learn in This Episode:

• What causes a saddle nose deformity following previous rhinoplasty.

• How over-resection of the nasal dorsum can contribute to structural collapse.

• Why the middle third of the nose needs adequate structural support.

• Why a saddle nose deformity may not become obvious immediately after surgery.

• How septal perforation can contribute to loss of nasal support.

• Why the timing of revision surgery can be critical.

• When early intervention may be possible following a previous rhinoplasty.

• Why scar tissue and contracture can make delayed reconstruction more complex.

• How skin stretching may be used in selected patients.

• Why hydrodissection may sometimes be required in severe cases.

• When hyperbaric oxygen therapy may be considered.

• Why rib cartilage may be required for complex saddle nose reconstruction.

• How extended spreader grafts can restore support to the middle third.

• How fascia and crushed cartilage may be used for camouflage and contouring.

• Why complex revision rhinoplasty requires specialised experience.

Dr Dan Behind the Scalpel – Episode: Traumatic Saddle Nose Deformity

A saddle nose deformity is one of the more complex problems that can occur following significant trauma to the nose. In this episode, Dr Dan discusses what a traumatic saddle nose deformity is, how it develops, and the functional and cosmetic concerns it can cause.

From contact sports injuries to major accidents, severe trauma can disrupt the nasal septum and nasal bones, resulting in a loss of structural support and a characteristic collapse of the middle third of the nose.

Dr Dan explains when it may be appropriate to consider surgery, why ongoing participation in contact sports can influence the timing of reconstruction, and the complex techniques and grafting required to rebuild the structure and projection of the nose.

🔎 What You’ll Learn in This Episode:

• What a saddle nose deformity is.

• How trauma can cause collapse of the middle third of the nose.

• How severe trauma can also affect the nasal bones.

• Why traumatic saddle nose deformities can cause significant nasal obstruction.

• The cosmetic concerns patients may experience following a traumatic injury.

• How a saddle nose deformity can affect wearing glasses.

• Why participation in contact sports can influence the timing of surgery.

• The importance of risk mitigation following reconstruction.

• Why saddle nose reconstruction is a complex rhinoplasty procedure.

• Why rib cartilage grafting may be required to rebuild the nose.

• The role of fascia grafts in camouflage and reconstruction.

• How skin contraction can affect patients with previous compound fractures.

• Why patients may need to prepare the skin before surgery.

• How structural grafts are used to support and reconstruct the middle third of the nose.

• Why patients with traumatic saddle nose deformities should seek a surgeon with extensive rhinoplasty experience.