The instrument consists of a series (1-9 consecutively numbered 9 individual pieces) Full-Septumtemplates and a series (numbered 4-9 of 6 individual pieces) Part-Septumtemplates (so-called “L” shape), which are threaded on a wire holder. The size of the full and partial pieces differs from the neighboring templates by about 5%.The loss of a nose is considered to be so disfiguring that a person with such an injury would often be excluded from normal community life. This is the reason that even long ago, nasal reconstruction was attempted. The first evidence of such procedures comes from Indian around 600 B.C.; in this case the rebuilding of someone’s nose which had been removed as a form of punishment using skin from the forehead San Diego Rhinoplasty.
Later war-related nose injuries were repaired using flaps of skin surgically removed from the forearm. The first report of this type of operation is in Italy sometime during the 15th century. Also during this time surgeons attempted to operate to free blocked nasal passages – this was done by burning the inner nose with a glowing hot iron rod. As this method often resulted in disfiguration, infection and intense pain, it could certainly not be described as successful nasal surgery.
At the end of the 19th century, after the introduction of local and general anesthetic as well as surgical methods that could successfully prevent infection, rapid development in the quality of surgery began. More modern types of nose operation were first developed during the beginning of the last century; these changes are inextricably linked with early pioneers in the field such as Freer, Killian and Joseph. In this era nasal surgery was either internal, aiming to improve airflow through the nose, or external to improve the shape of the nose.
The many new discoveries in biology, biochemistry and histology as well as improvements in surgical instruments brought about a second revolution in nasal surgery in the period around the Second World War. This was partly due to more widespread acknowledgement and acceptance of the connection between the function and the external appearance of the nose. Relatedly, often the best strategy for an operation is to address both issues at the same time to correct – a combination surgery that is today known as septo-rhinoplasty. This advancement came about through the work of highly skilled surgeons like Goldmann and Cottle. As in all surgical fields, there has also been steady improvement in the field of nasal surgery. The marked increase in the number of nose operations being carried out in the last few decades is not only due to technical improvements in procedures – the growing meaning attached to beauty and aesthetics in the culture of today is also a very important factor.
The correction of a very poorly formed nasal septum is especially difficult. In order to achieve the straightest shape possible, it’s almost always necessary to work with the deformed cartilage in very small sections. This sectioning leads to instability in the cartilage and, during the healing phase, the bridge of the nose might not be well supported. This results in the danger of a serious complication: the bridge of the nose might sag down or back in the middle after the operation; this condition is known as “saddle nose”.
In order to avoid this complication, I developed a new surgical method in 1996 wherein the individual pieces of cartilage are attached to a cartilage-friendly plastic sheet before being implanted back into the nose. This plastic sheet (the PDS® Flexible Plate) supports the bridge of the nose for as long as is needed for healing and then it breaks down. Five months after the surgical procedure, the implant is gone completely. This method has been published in medical journals and presented in person to surgical professionals. The method has also been adopted by well-known surgeons and health care facilities – the reports coming in show very good outcomes for patients.