Restoring Facial Harmony With Artistry, Nasal Function, & Micro-Precision.

The Cottle maneuver is a simple diagnostic test where the cheek is gently pulled laterally (outward) next to the nostril. If this action immediately improves nasal airflow on that side, it indicates internal nasal valve collapse (narrowing of the airway passage). This indicates that standard rhinoplasty or septoplasty must incorporate structural cartilage grafts (like spreader grafts) to reinforce the valve and prevent collapse.

Scars undergo a complex maturation process that takes 6 to 12 months. Early scars often appear red, raised, and firm but may naturally soften and flatten over time. Revising a scar before it has fully matured can result in poor healing, wound dehiscence, or recurrence of thick tissue. Therefore, scar revision is typically planned only after the scar is at least 6 to 12 months old.

Cosmetic rhinoplasty focuses solely on the external appearance of the nose (e.g., removing a dorsal hump, refining the nasal tip). Septorhinoplasty addresses both the external shape and the internal septum (the partition dividing the nostrils). If the septum is deviated, it blocks the airway. A septorhinoplasty corrects the deviation to restore breathing while simultaneously refining the nose's external contour.

Hypertrophic scars remain within the boundary of the original wound, while keloids grow beyond the margins and are highly prone to recurrence. Management involves surgical excision using micro-sutures along natural skin tension lines, often combined with post-operative therapies such as localized corticosteroid injections, silicone gel sheeting, or pressure dressings to suppress collagen overproduction.