The internet has revolutionised how we access health information, but is relying on Dr Google a good thing?

A new study has evaluated the quality of sinusitis videos on TikTok. Published in Otolaryngology – Head and Neck Surgery earlier this year, UChicago Medicine researchers found that nearly half of the videos viewed contained misleading or inaccurate content from content creators with no medical experience or expertise.

The researchers conducted a comprehensive search on TikTok using popular hashtags like #sinus, #sinusitis, and #sinusinfection, aiming to capture a broad spectrum of content.

Only 55.5% of all videos were categorised as factual, meaning that nearly half contained inaccuracies or misleading content. Videos from medical professionals had the highest proportion of factual content at 84.4%, significantly higher than content from non-medical influencers, which only contained 45.3% of factual information.

Where to source your health information online

“When you’re getting health information online, it’s always important to consider who’s providing it?” ENT surgeon Mr Annakan Navaratnam explains. “Are they a specialist in that area? Are they a generalist? Have they fact-checked everything?”

YouTube recently introduced an accreditation process for health-focused channels as part of its commitment to connecting viewers with health content from authoritative sources.

“A good person to follow on YouTube is Dr Karan Ranjan, a general surgeon in the NHS, who dispels common healthcare misconceptions. He provides high-quality information, debunking popular healthcare facts and exploring things that might sound slightly wacky, but he will then show there’s actually good evidence that they work.”

Sinusitis misinformation and misconceptions

Sinusitis, an inflammation of the sinuses, is a common condition. It’s estimated that 11% of UK adults experience symptoms at any time. Despite its prevalence, many patients opt for self-treatment and look online for guidance.

TikTok is fast becoming the dominant platform for online health information, with an estimated 2.2 billion users predicted by 2027. Its short, catchy video format makes it easier for users to share content and for health misinformation to quickly go viral.

When evaluating the sinusitis videos on TikTok, researchers even noted a trend where individuals inserted whole garlic cloves into their noses to alleviate congestion.

“There are many misconceptions online about sinusitis treatments and even what sinusitis is. Some people think sinusitis is just allergies, some people think it’s just an infection. However, sinusitis is much more complex than that. It ranges from the common cold, which will often resolve on its own, right up to a serious disease related to asthma and other medical problems, or a secondary issue to dental infections and, in some cases, tumours.

“By and large, the treatment for sinusitis should be topical nasal steroids, antibiotics when required and nasal washes,” Annakan recommends. “Anything outside of that can often cause you more problems. Putting things inside your nose, such as garlic, will risk you having a foreign body stuck there and a high chance of infection.”

As well as irritating the nasal lining, the practice also poses the risk of inhaling garlic deep into the nasal passages.

“I have had to take lots of things out of people’s noses that they have used to treat sinusitis, garlic being one, because someone saw a video about it being helpful!”

For more advice on sinusitis treatments, call +44 (0)203 627 2918 or email secretary@annakan.co.uk to arrange a consultation with Mr Annakan Navaratnam.

Choosing the right surgeon is the most critical decision you make when deciding to undergo a rhinoplasty procedure. Although rhinoplasty is the earliest performed plastic surgery procedure – ancient Indian surgeon Sushruta, known as the Father of Surgery, is known to have performed rhinoplasties as early as around 600 BC – it is a highly challenging operation. Many plastic and ENT surgeons choose not to offer this complex surgical procedure.

The purpose of a rhinoplasty

Rhinoplasty can be undertaken for reconstructive reasons, functional improvement, or aesthetic enhancement. Aesthetically, patients may wish to address features of the nose that have caused dissatisfaction or distress for many years. These can be issues with the nose bridge, nasal tip, size of the nostrils, or how the nose harmonises with the other facial features.

Functionally, rhinoplasty can address irregularities that impede air flow through the nasal passages, impacting breathing function. This can be caused by too narrow nasal passage or a deviated septum, whether genetically or as a result of trauma. Form and function are often intertwined, so both surgical approaches may be required.

Reconstructive rhinoplasty is required to rebuild deformities in the nose, which may result in tumour removal, infections, trauma or congenital issues. Reconstructive surgery is often needed if prior rhinoplasty surgeries have negatively affected function. Reconstructive revision rhinoplasty techniques typically require bone or cartilage grafts taken from other body areas such as the ear or rib.

Rhinoplasty surgeon choice

A plastic surgeon performs both reconstructive and aesthetic surgery and can operate on nearly any area of the body, including the face and neck, arms, breasts, back, abdomen, buttocks and thighs.

Otolaryngologists, also known as ENT surgeons, focus on diagnosing, evaluating, and managing diseases of the head and neck, principally the ears, nose, and throat. They undergo extensive training that allows them to perform complex functional or cosmetic surgical procedures that affect the structures of the head.

Annakan Navaratnam is a Consultant ENT Surgeon who is part of the Craniofacial team at UCLH, where he works with Ophthalmologists, Neurosurgeons and Maxillo-Facial and Plastic surgeons in the management of complex craniofacial presentations such as patients with cleft lip/palate and congenital syndromes.

“In my reconstructive and craniofacial surgery work,” Annakan explains, “I often must make extensive changes for patients that have congenital malformations or significant trauma. Understanding how to reconstruct a nose completely allows me to understand the subtle changes required to produce the aesthetic outcome my rhinoplasty patients expect.”

A question of facial balance

“The nose is never assessed in isolation, and often, a very underdeveloped chin can give you the appearance of a prominent nose and both aspects of the face will need to be addressed.”

“If the mid-face is underdeveloped that it can make nose appear flatter or broader. For my cleft patients I often must reconstruct the mid-face area. The nose needs to be built on a solid foundation.

“The nose is a complex anatomical 3D structure of bone and cartilage, so you’re not simply making something bigger or smaller in a 2D plane. Also, every action has a reaction. So, if you reduce the dorsal hump, you could compromise airflow. If you refine the nasal tip, you could make the nasal airways slightly narrower. It is essential to consider all these factors to find the correct balance.”

Factors to consider when choosing your rhinoplasty surgeon

Choosing your surgeon depends on several factors:

1. Your specific needs: Do you have significant functional issues that are causing breathing difficulties, or is your primary concern the external appearance of the nose?
2. Your surgeon’s expertise: Do they have the training to perform this often challenging and complex surgical procedure?
3. Experience: Does the surgeon perform a significant number of rhinoplasties and focus on this procedure?
4. Before and after photos: Does the surgeon have before and after images of past patients so you can ensure that their results reflect the outcome you wish to achieve?
5. Patient testimonials: Do they have past patient feedback that helps you understand how they achieve patient satisfaction?

To find out more about Mr Annakan Navaratnam, call +44 (0)203 627 2918 or email secretary@annakan.co.uk to arrange a consultation.

Rhinoplasty surgery is continually evolving, and one emerging trend is ethnic rhinoplasty. The ethos of ethnic rhinoplasty is that it respects and enhances the unique features of the patient’s ethnic background while addressing their aesthetic concerns or specific functional issues.

Supermodel Bella Hadid, who is of Palestinian descent, underwent rhinoplasty surgery at the age of 14. In an interview with Vogue magazine last year, she said, “I wish I had kept the nose of my ancestors… I think I would have grown into it.”

“I don’t like using the term ethnic rhinoplasty as all rhinoplasty operations should take into account and respect patient’s cultural and ethnic background,” Mr Annakan Navaratnam explains.

“Unfortunately, much of our surgical training typically focussed on ideal Caucasian aesthetic features of a slightly over-rotated nose, very defined tip, narrowed nostrils and a flat or slightly concave bridge. Now, though, many of my Asian patients no longer want this identikit, Caucasian nose.

“The idea that one nose fits all is largely obsolete. As a surgeon, you must take functional and aesthetic considerations into account. It is crucial to establish how the nose fits with the rest of your facial features, ethnicity, skin type, and how this may change over time.”

Why the rhinoplasty consultation is critical

“The consultation with the surgeon is critical. It is essential that I explain the procedure in detail as well as the recovery timeline patient’s can expect.

“Patients are often concerned about any external incisions and whether they will have scarring. So, I show examples of the incisions we use and how this can differ for different skin types. If you have darker skin, you may experience more prominent scarring, whereas if you have a lighter skin type, it may be quite red initially before it settles down.

“Their skin type might also affect how I execute the procedure. Patients from the Middle East or South Asia often have very thick skin, and I may need to position the nose slightly higher than I would with other patients, as I know that the skin density will press the nose down until it gets to its final position.

“I try to show my patients before and after images, specific to their skin type and ethnicity if possible, and then explain what timeline they can expect.”

Ethnic rhinoplasty vs traditional rhinoplasty

“In the 1980s and 90s, many surgeons typically performed a reduction rhinoplasty which would just reduce everything to make the nose smaller. There were two issues with this. One is that it might not fit with the rest of the patient’s facial features. Secondly, it often leads to a nose that functions poorly. In my practice, I do a lot of revision surgery for patients that have had cosmetic rhinoplasty and ended up with a smaller or concave nose which has significantly compromised their nasal airways.

“I often see this in patients that have undergone a de-hump without adequate reconstruction. They are initially happy as the swelling masks gives the bridge of the nose a smooth appearance, but after about six months to a year, they’ll notice the structure has dropped, compromising both the aesthetic and functional outcome.

“In general terms, we now make smaller, more subtle changes that enhance their other facial features rather than drastic ones. If someone asks me for a tiny, petite nose that doesn’t fit with their face and is likely to compromise functionality, then I would counsel them properly, and, in the end, I might not be the right surgeon for them.”

To discuss your aesthetic concerns, call +44 (0)203 627 2918 or email secretary@annakan.co.uk to arrange a rhinoplasty consultation.