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After rhinoplasty and septoplasty surgery, many surgeons use a nasal stent to stabilize the nose and help with healing. Traditional nasal stents often require sutures, which then have to be removed by your doctor.
The Bstent, developed and brought to market by Dr. Bahman Guyuron, eliminates the need for sutures and enables patients to remove the stent themselves, saving time and avoiding unnecessary hassle.
The Bstent’s thoughtful design also helps prevent many of the common complications that can happen after nasal surgery.
Dr. Bahman Guyuron shares how he developed the Bstent through extensive research and collaboration with engineers. The device was designed to simplify post-op care and improve outcomes.
Now available for surgeons to purchas, the Bstent receives overwhelmingly positive feedback from surgeons all over the world.
Always thinking ahead, Dr. Guyuron is passionate about advancing the field of nasal surgery, with continuous improvement at the heart of his work.
Learn about the inspiration behind the Bstent, its standout features, what patients are saying, and why so many surgeons are on board.
Read more about Cleveland plastic surgeon Dr. Bahman Guyuron
Learn more about the Bstent Conjoint Nasal Stent
Learn more about rhinoplasty
Request a consultation with Cleveland plastic surgeon Dr. Bahman Guyuron
Transcript
Announcer (00:03):
You are listening to Head On with your host, board certified plastic surgeon, Dr. Bahman Guyuron, the pioneer of a life-changing surgery for permanently eliminating migraines and a specialist in plastic surgery of the face, head and neck.
Dr. Guyuron (00:19):
Whenever we do rhinoplasty, that includes surgery on the septum, we need to eliminate the space between the layers of the septum. There are available stents that the serve that purpose and we’ve been using them for decades. But the problem is that those stents have to be sutured in place, otherwise they can migrate, the patient can swallow it, and also obviously the purpose will be lost. A majority of my patients are from out of town, out of country. When I operate on those patients, I don’t keep them in Cleveland for seven, eight days, which is the period minimum period that we need to keep those stents in place. What I used to do is have to call a physician, a plastic surgeon, close by the area where patient resided to remove this stitch to remove the stent because again, it was sutured internally and it got to a point that I kept thinking about what is that I can do differently to prevent that?
(01:49):
So I came up with this idea of Bstent, which the number one advantage of it is that it doesn’t need to be sutured in place. It really in a way has revolutionized my postoperative care of the rhinoplasty patients that needs septum surgery, which is overwhelming majority of patients who undergo rhinoplasty because we do septoplasty to improve the breathing. We also even on patients who do not have deviated septum need some cartilage. That cartilage comes from the septum and if we don’t eliminate the space between the layers of the septum, the patient is going to accumulate blood and that will convert to the scar tissue. It can actually cause breathing problems or if it can get infected, it can cause perforated septum. So we need to eliminate the dead space by some means. And this is the best way. This is the device. So there is something like in the market that we have been using it for decades, but this device has this, it has also this component.
(03:26):
Then the two sides are joined in the center with this bar that doesn’t let the, it sits on the right over the base of the nose and doesn’t let the stent to migrate deeper. And because of this connection, we don’t need to suture in place. And the reason that I added this segment to it is to be able to take away any dead space or unused space between the skin and deeper layers in the tip area. While this part takes away the dead space, the septum, it doesn’t take away the dead space in the nostril area or the tip area. When the blood accumulates in the tip area under the skin, it can be problematic. It can turn into scar tissues and cause what we call super tip deformity, fullness, cause excessive swelling, delayed healing, and delayed absorption of the swelling. This part serves to eliminate any dead space between the skin and underlying layers underlying frame.
(05:06):
We have just finished this study looking into any adverse effects or any problems, any issues, and none of our patients had any problems. Out of 112 patients that we included in this study, four patients had it removed by somebody else and that somebody else happened to be the family member who was plastic surgeon brother, their spouse or something like that, close family member. And since they were together, they just removed it. The rest for out of town patients, they removed it. That’s over 60 patients that were from out of town, out of country. They remove this without any problems. So as you can imagine, it saves a lot for the patients. also. They have to make an appointment, go to see another doctor to remove. It just, it takes literally 10 seconds to remove. All they do is just catch this end and slide it out.
(06:23):
And because of the silicone nature and moisture inside the nose, there’s no resistance that’s going to keep it from coming out. But on the other hand, there are enough connection between this device and the internal structures, there’s enough contact that doesn’t get dislodged by sneezing, coughing, and if it does, it can just gently be pushed back, which is extremely unlikely. The patients feel some just pressure inside as this travels across the internal nose and it is not usually very uncomfortable. The patients, don’t complain about pain. I’ve never had a patient say, stop, I need to take a deep breath or wait until the pain goes away. They just go along with it. I have them take a couple of deep breaths and just put it out and usually my nurses do this. They used to remove the stitch and this structure similar to this structure from internal nose and they love it actually. The patients also, but obviously the patients don’t know the difference because the patient did not have this device before, so they can’t compare it.
(07:48):
They appreciate that actually we save them time. They don’t have to make an appointment. Even the patients who are close to Cleveland but not exactly in Cleveland, an hour away, an hour and a half away, they just remove it themselves and we watch them to do it virtually. But we stress to them that they have to remove this part first before they remove the bandages on the outside. So inadvertently this, the removal of this would not displace anything, any cartilages, any bones, which is unlikely even if they remove the bandages first. But we instruct them that you remove this first, then the outside bandage. And even on majority of those patients that I need to do just some minor refinements, I actually use this part to control the nostrils, keep the nostrils open, it helps the nostrils so the valves do not collapse, the cartilages heal nicely because I have designed the end of these, the shape of the nostrils.
(09:06):
So they actually emulate the shape of the nostril very closely and they control the shape of the nostril while it is healing. The biggest issue that this device can prevent are actually two main ones. One is the collapse of the valve. The other one which is more important, is collection of blood within the layers of the skin. That this device can actually prevent that. And it has also in terms of design, I have designed in such a way that it has angulation because the nostril orientation with where this should end up being are not on the same plane. One is more of a like nostril is like this, but the space inside the nose is curved. So this flexible joint allows the internal stent go exactly where we want. And also if you look carefully, the top portion of this is wider than the bottom portion, so it creates then facilitates that hinge effect.
(10:35):
The internal portion of the stent follows the natural anatomy and doesn’t get stuck in somewhere. And also the front portion, this leading portion is beveled so that it can go in the nostril easier. The other devices that we used to use, they have the leading opening like this that it is cut off and it requires a little bit forcing, pushing and it can also damage some of the sidewall of the nose. But ours is beveled. The one that is done is beveled so that it slides in very nicely. Essentially every device that we use in surgery medical field that is going to be stay in the body for a short period of time is made out of silicone. Silicone is the most inert material that doesn’t cause any reaction but doesn’t promote infection. And in fact, in a way facilitates healing.
(11:56):
And we use actually silicone on the scars that they don’t heal properly because again, it improves the healing. So this is all medical grade silicone. Essentially everybody who has seen and used it, they really like it a lot because again, it is serving them as favorably as it is serving me. So they like it a lot. It is on the market and all they need, and it is actually available through an internet order. All they need to do is go to www.bstentrhino.com, www.bstentrhino.com. The only patients that I would not use this stand on if somebody has nose infection, but if I’m operating on somebody who has nose infection for drainage of infection is not for rhinoplasty, I wouldn’t do primary rhinoplasty, secondary rhinoplasty, on somebody who has infection that I know is present. One of the enormous benefits of this stent, which is again unlike the stents that they were in the market, is this portion that after the stent is removed, following the course of healing, seven, eight days or whatever the surgeon decides and the stent is extracted, pulled out, it can be washed and this part can be detached from this part.
(13:52):
So these will be used as the nostril support, nostril dilator, nostril, conformer. And that is the part that actually a good deal, more attractive actually to some of the surgeons who are using this. And they tell us that actually, I really like this part. Obviously this is worn in the evenings on the weekends or as many hours as the surgeon chooses. It’s not around the clock, but it can be removed, cleaned, and put back in. So that creates a major, major advantage to this device. There are some things that are on the market that they are actually not anatomical. They haven’t been designed the way these are designed. They’re actually circular. The nostril is not circular, but this is again an oval shaped wider at the base portion, the bottom portion. Pretty soon we are going to have this part on the market separately, sterilized packaged for patients who do not need a septoplasty, the surgeon is working on the nostrils and would like to keep the shape of the nostril in a certain way.
(15:20):
And it is again called nostril conformer, nostril dilator. And it is going to come in two sizes also and would be on the market fairly soon. That would be through the same website as well. There are some actually misconceptions. Some surgeons think that actually presence of this part, presence of this part will prevent application of ointment, antibiotic ointment on the incision that it is in this area. That’s not true because actually this loops like that and there’s a space between this and the base of the nose. So patients can actually apply ointment. The other concern that some surgeons could have, they instruct their patients to spray the nose inside of nose with saline. But when these are in place, you don’t even need it. But if you need it, if you need to wash it out, you can actually use this part and irrigate the device both at the same time because when they sit there, they’re essentially in continuity and you can use a syringe to irrigate.
(17:01):
You can use a baby suction bulb to irrigate with saline inserting inside this without really causing any damage to the tissues. So if anything, actually this this is advantageous and it would be serving better than just irrigation alone. It was rarely needed for my patients, but we have told them they can do that. I always think about how we can improve the things, why we shouldn’t accept a status quo as that this is perfect and we can’t make it any better. That goes with my techniques, that goes with my results, that goes in every aspect of my life actually. How can I do something better? Not that I’m not happy about my success or whatever I’ve done. It is just that, I think it would be wise to think, okay, yeah, this is good, but can I do it? Can I make it any better? That’s always in my mind, no matter what I do.
Announcer (18:12):
To learn more about Dr. Guyuron and the Zeeba Clinic, go to headonwithguyuron.com. Follow Dr. Guyuron and the Zeeba Clinic team on Instagram @DrBahmanGuyuron. Spelled G-U-Y-U-R-O-N. Head On is a production of The Axis, theaxis.io.
