Overview
Rhinoplasty, or aesthetic nose surgery, is a procedure designed to harmonize facial proportions and improve the overall balance of the facial profile. Beyond its cosmetic purpose, it can also correct functional breathing difficulties caused by structural abnormalities within the nasal framework.
At our practice, the procedure is performed by Dr. Marc-David Benjoar, who has specialized in rhinoplasty for more than ten years. His approach is based on personalized analysis, precision, and natural outcomes that respect each patient’s individual anatomy. Dr. Benjoar has developed an advanced and original technique known as Hybrid Preservation Ultrasonic Rhinoplasty Assisted by Computer, or ORTHONOSE Rhinoplasty. This method integrates ultrasonic instrumentation, preservation principles, and computer-assisted planning to achieve accurate and stable results.
Advantages of ORTHONOSE Rhinoplasty
• Outpatient Surgery: Most rhinoplasties are performed on an outpatient basis, allowing patients to return home the same day following a brief observation period.
• Optimized Recovery: The procedure is generally not painful. Postoperative discomfort is mild and well-controlled. Most patients resume activities within 3 to 5 days.
• Natural and Customized Results: The aim is to sculpt a nose that fits harmoniously with the rest of the face, avoiding artificial appearances. Minimal adjustments are favored to preserve the patient’s identity.
What Is ORTHONOSE Rhinoplasty?
The ORTHONOSE concept is the result of over ten years of research and refinement of existing rhinoplasty techniques. Below is an overview of the principal surgical approaches used in modern nasal surgery, followed by an explanation of the method preferred in our practice.
Available Surgical Techniques
Closed Rhinoplasty
Principle: All incisions are made inside the nostrils, leaving no visible external scars.
Indications: Ideal for correcting the osteocartilaginous dorsal hump, tip elevation, or minor septal deviations.
Advantages: Less invasive, less postoperative swelling, and faster recovery (around 3 months for final results).
Open Rhinoplasty
Principle: A small incision is made on the columella, providing direct access to the nasal framework.
Indications: Suitable for complex tip modifications, secondary (revision) rhinoplasty, or major structural corrections.
Advantages: Increased precision for complex remodeling. The columellar scar is discreet and fades over time.
Recovery: Tip swelling may persist for about two months; the final result appears within six months to one year.
Structural Rhinoplasty
Principle: Performed exclusively through an open approach, this method reconstructs the junction between cartilage and bone after dorsal reduction.
Indications: Used in secondary or complex primary rhinoplasty (e.g., deviations).
Advantages: Excellent stabilization of the nasal dorsum using grafts.
Disadvantages: Removing the hump creates an ‘open roof’ that must be reconstructed—challenging for thin skin and may require camouflage grafts.
Preservation Rhinoplasty
Principle: Conducted via a closed or open approach. Instead of removing the hump, the surgeon repositions it downward (Push-Down technique).
Indications: Preferred for less complex primary rhinoplasty cases.
Advantages: Maintains natural nasal dorsum continuity, reducing risk of irregularities.
Disadvantages: Cartilage memory may lead to mild hump recurrence. The middle third may flatten slightly, broadening nasal width.
Ultrasonic Rhinoplasty: Innovation and Precision
Ultrasonic rhinoplasty represents a significant advancement in nasal surgery. Using ultrasound via piezotomes, it sculpts and smooths nasal bones and cartilage with precision. Unlike traditional instruments, the piezotome targets only bone tissue, sparing vessels, nerves, and mucosa.
Advantages: reduced trauma, improved precision, faster recovery, and adaptability across various nasal anatomies, including Asian, African, and Caribbean features.
Computer assisted Hybrid Preservation Ultrasonic Rhinoplasty (ORTHONOSE)
ORTHONOSE combines preservation and structural rhinoplasty with ultrasonic precision and computer guidance. It merges preservation for bone, structural methods for cartilage, ultrasonic tools, and digital 3D planning for consistent results.
Surgical Sequence
1. Open surgical access under magnification for precise control.
2. Ultrasonic weakening and repositioning of the bony hump using Push-Down preservation technique.
3. Cartilage reshaping with sutures on a remodeled and reinforced septum to prevent widening of the middle part of the nose (frequent drawback of standard preservation technique).
4. Integration of preservation and structural approaches for stability and natural contour.
5. Computer-assisted planning for reproducible accuracy.
Computer-Assisted Planning and Surgical Guidance
Using the Vectra H2 Canfield system, a 3D facial scan is obtained. Three simulations are designed by a graphic engineer under Dr. Benjoar’s direction, reviewed with the patient that select his/her final choice, and used to produce two sterile, patient-specific surgical guides. 7 days after surgery, a custom night splint is worn for one month to maintain results.
The Rhinoplasty Journey: From Consultation to Recovery
1. Preoperative Consultation: Evaluation, rhinomanometry or CT scan, and 3D simulation planning.
2. Anesthesia: Usually general, with neuroleptanalgesia possible for simple tip procedures.
3. Procedure: Outpatient surgery with same-day discharge after observation.
4. Postoperative Care: Resin splint for 5–7 days, replaced by custom ORTHONOSE splint; mild swelling and minimal pain; recovery in about 5 days.
Rhinoplasty Pricing in Paris
Aesthetic Rhinoplasty: €7,500–€12,000 (includes surgeon, anesthesiologist, and clinic fees). Secondary rhinoplasty averages €10,000. Not covered by insurance.
Functional Rhinoplasty: €5,000–€8,500 for medically justified procedures (e.g., post-traumatic deviations). Partial coverage by private or public insurance possible with prior authorization.
Frequently Asked Questions
Is Rhinoplasty Painful?
Mild nasal congestion and slight swelling are common; pain is minimal and controlled with medication.
Will I Recognize Myself?
Yes. The surgery enhances harmony without changing identity.
Main Surgical Steps: Tip refinement, projection adjustment, and dorsal hump reduction for facial balance.
Possible Complications: Rare; mainly minor aesthetic irregularities. Proper planning and conservative technique minimize risks.
Insurance Coverage: Possible only in functional or post-traumatic cases; cosmetic corrections not reimbursed.
Why Choose Dr. Marc-David Benjoar?
- Over a decade of specialized rhinoplasty experience.
- Developer of the Hybrid Preservation Ultrasonic ORTHONOSE technique.
- Computer-assisted 3D planning for accuracy.
- Emphasis on function, aesthetics, and patient safety.
- Outpatient procedures with minimal downtime.
Conclusion
Rhinoplasty requires both technical precision and aesthetic sensitivity. Combining ultrasonic instruments, preservation principles, and digital planning, Dr. Benjoar offers a modern, minimally invasive approach ensuring natural, stable, and individualized outcomes for every patient.