Rhinoplasty
What is nose aesthetics / Rhinoplasty surgery?
With nasal cosmetic surgery (Rhinoplasty) deformities of the nose can be corrected and an aesthetic appearance can be obtained, while respiratory problems can also be corrected. Although it varies from person to person; In some noses, the excess belt should be reduced; raising the nose, some of which are sunken, can be considered as a shortening of some long noses.
The purpose of rhinoplasty should be to breathe effectively and to achieve a natural nose that is compatible with the person’s chin, eyes, cheeks, ears and even the entire face.
Structure of the nose; In the clinics, all the structures that provide the shape and posture of the nose may have intervened. From the forehead-nose junction, which we call the nasal root, to the hard part that extends from the central part of the nasal spine to the arch that feels like a bone to the touch, the upper part; Form the bony roof of the nose. This bony roof is supported by a high school colon instead of the term which extends from the base to the upper palate and the nose is separated as two separate holes. This supporting structure is connected to the base of the head in the back.
Central part of the nose; It is mainly the region made up of the structure of the cartilage, which covers the point of the arch on the back of the nose and between the tip of the nose and the root of the nose. At this point in the procedures are the “nasal valves”, particularly effective in breathing. Especially in inexperienced hands, deformities are caused by deformities, and the appearance of the open roof is caused by poorly organized repair of these areas.
The bottom / tip, on the other hand, is the nose-like area that can come to the fore especially in passport photos, which is now complementary to the bottom of the nose. The skin envelope that covers the entire bone and cartilage roof varies in each region, while the nose is thin at the top and middle, it is relatively thicker at the tip of the nose. It is located between the skin of the bone cartilage in the muscles.
The upper parts of the nose are more visible from the profile photos. In fact, throughout this process, we take a lot of photos from almost every angle before and after the surgery and try to see the same things when talking about the nose in detail.
With rhinoplasty surgery; We can change the size, shape or proportions of your nose, but it is best to decide together, taking into account the aesthetic proportions of your entire face, your wishes and expectations as you do it.
One of the basic rules of good plastic surgery is; It is to have a say in the correction of birth defects that we call congenital anomalies (cleft lip and palate) or extensive lesions involving the inside of the nose. On top of all this, of course, improving breathing difficulties is the procedure without exception.
Who is rhinoplasty suitable for? Who are the candidates for rhinoplasty?
Rhinoplasty interventions can be performed for two different reasons in terms of aesthetics and function. Respiratory problems are problems that reduce the quality of life and pose many health risks. Snoring at night, frequent headache attacks, chronic runny nose, sinus attacks, inability to smell, can cause many problems such as a feeling of congestion.
In addition to those with breathing problems, those with an excessively arched nose, those with a large nose, those with a high nasal root, those with a low nasal tip, those who laugh with a low nose, those who have had previous surgery unsuccessful nose, in short, anyone with a stinging appearance problem in the nose can apply …
There should be an intermediate consensus between the patient and the surgeon discussing all these processes in detail. It should talk in detail about the operations planned by both sides.
Who can undergo rhinoplasty?
The important thing in rhinoplasty is not the age limit; It is the development of the bone and cartilage structure. The operation can be performed after the development of the muscle bone has been completed and when there are no problems in the examination results.
Generally, the rhinoplasty operation is performed at the age of 18 and above.
People who are physically healthy and have no diseases that could prevent surgery
People with a positive outlook and a realistic goal of improving their appearance.
What needs to be considered during the rhinoplasty preparation process?
DİYET SEÇİMİ: Choice of diet; Before any surgery, it is important that patients eat a healthy diet. Proper nutrition will speed recovery and minimize the risk of infection.
KULLANILAN İLAÇLAR: Medicines used; You should tell your doctor about all medications you use. Some medications can cause problems before or after surgery. The doctor may temporarily stop the patient’s use of a drug or suggest a safer alternative.
SİGARA İÇME ALIŞKANLIĞI: Habit of smoking; Using tobacco slows blood flow throughout the body. Since oxygen cannot reach the tissues quickly, the recovery period of smokers is long; there is a high risk of infection. Starting at least 2 weeks before the surgery; smoking should not be allowed. In general, my suggestion is not to use it at all.
ALKOL KULLANIMI: Use of alcohol; Preoperative use of alcohol increases the risk of anesthesia as it will burden the liver. Alcohol consumption must be stopped at least 10 days before the operation.
İLK GÖRÜŞME: Initial Interview: In the first meeting we will hold with you, you will be asked in detail your reasons for the surgery, what you are aiming for and how many times you have planned surgery.
In the examination, the nose will be examined in detail. In particular, the strength of your cartilage, the structure of the bone, the tissue that covers the inside of the nose, called the mucosa, will be examined in detail. The structures of the nose that moisten and heat the air, which we call friend, will be examined in detail. The structure of the skin will be examined in detail. The relationship between the facial features, nose-cheek, jaw teeth will be examined and detailed information will be provided. Sometimes computed tomography may be done to see the back parts of the nose,
which cannot be seen on physical examination, most clearly requiring necessary blood tests.
After providing you with the information you need in the decision phase, I recommend that you meet two or three different doctors as a personal preference.
In planning the intervention, we will be able to see the results of the intervention to be performed on you frontally with the help of some auxiliary programs on the photos taken from various angles of your nose and we will be able to talk in detail. By having more concrete information, naturalness or artificial image, we will have progressed into a more transparent process by talking about these photos.
This way, you will be able to see if the look you want is right for your face, have a chance to discuss with your doctor, and clearly express your expectations. Before cosmetic surgery, communication in this opening is very important and necessary for all stages of the operation.
Surgical process of rhinoplasty
The rhinoplasty operation takes about 2-3 hours, depending on the technique used and the patient’s condition. In every surgery,ta,
Anesthesia
-General Anesthesia
General anesthesia; it is a state of complete sleep. Usually, he doesn’t remember much after entering the operating room. During the initiation of the surgery, a complete sleep state is created by performing some procedures by the anesthetist. The main reasons for this may not be a comfortable process with local anesthesia, especially since the operation is performed on the head area. It is more comfortable for the patient and the surgeon to perform the nasal cosmetic operation under general anesthesia.
-Local Anesthesia
He is just numbing his nose and surroundings with the help of a small needle. These types of operations are most effective with small touches. Performing full local anesthesia can be uncomfortable for the patient and surgeon.
-Sedation + Local Anesthesia
Before local anesthesia, it is performed with a sedative administered intravenously, then pain is controlled with small needles made in the local procedure.
Surgical operation
It is the most exciting point of the operation. After anesthesia, small incisions are made in the nostrils according to the closed technique. The skin is then carefully lifted to access the underlying bone and cartilage. The surgeon can remove tissues when needed and use a variety of methods to minimize the impact on surrounding tissues while achieving the desired results. When the reshaping process is complete, the doctor puts the skin back into the new contours of the nose so that there are no problems. The open technique can be applied in congenital nasal problems with severe curvature.
Closed rhinoplasty is a surgery performed with special incisions made entirely from inside the nose with no visible incision in the nose. It is possible to perform many operations that can be performed with the open technique. It is a more laborious and special intervention.
Open rhinoplasty is the surgery performed by making an incision in the skin located in the midpoint that separates both holes in the nose.
BUFFER
She generally does not use tampons after nose surgery. In patients with severe nasal curvature, silicone splints are sometimes used to support the corrected cartilages during the operation. Cloth swabs used in the past stuck to the nose and caused severe pain when removed. The silicone splints we use now do not cause any adhesion, so they do not cause pain.
Planning of post-operative care
The operation does not always require the lying position. However, after general anesthesia, it will be advisable to remain in the hospital under supervision for 6-8 hours for precaution and importance. The anesthetic effect will disappear 6-8 hours after the operation. So you can meet your daily needs.
With the nasal spray, the nose is moistened 2-3 times a day. It is important to keep your head at a higher level.
Sun protection will speed up healing. If you have a very allergic body, you will be prescribed an anti-allergic tablet to avoid sneezing.
What awaits you after rhinoplasty surgery ?
It is normal to experience mild to moderate pain and discomfort after rhinoplasty surgery.
It will be checked with the medications you will be prescribed. You will feel much better after 48 hours.
There may be bruising and swelling after rhinoplasty. These symptoms usually worsen on the second day after surgery and gradually improve thereafter. The amount of bruising that occurs varies from person to person.
The silicone splint, which is inserted into the nose in 5-6 days and retains its new shape, is removed. During this time, your splint will loosen every day after the surgery.
Recovery process
In general, most of the recovery is completed at the end of the first 7-10 days. Bruising and swelling usually gradually subside after the first 10-14 days. The edema disappears within 6-18 months and the nose takes its final shape. You can use the glasses after 2 months.
Factors that affect the healing process; Both the surgical technique and the various patient-related factors are at the forefront.
Factors such as the breaking of the nasal bones (osteotomies), the degree of dissection / ascent of the soft tissues from the bone-cartilage frame and whether the surgery is performed open or closed are decisive in the healing process. Other factors affecting the healing process are the patient’s age, skin thickness, diet, bleeding tendencies / disorders, and the use of blood thinning medications. Most of these variables are not under the control of the patient; However, by following these recommendations, the degree of bruising and swelling can be minimized. Your doctor will tell you which medications you shouldn’t use.
Swelling
After the first postoperative week, the nose will gradually narrow as the days go by, in other words, the edema will subside. The texture of the skin and many factors will affect its durability.
The patient appears to have a swollen nose for several months. In about 3-4 months, most of the swelling will disappear, but it will appear larger in photos. It may take up to a year for the final shape to become noticeable. Typically, the last area to decrease will be the tip of the nose.
Bruises
Avoiding things like multivitamins / herbal remedies / teas that contain high levels of vitamin E, ginseng, ginko is important as they can cause bleeding. If you have a history of bleeding disorders or a history of drug use (aspirin) that can cause bleeding, your doctor should be informed prior to surgery.
Ice packs applied to the cheeks for the first 48 hours can be helpful for bruises. Smoking should definitely be avoided. Generally towards the end of the first week, the bruises begin to subside. You can take herbal supplements like papaya extract and arnica.
Sun
Skin that heals after rhinoplasty is more sensitive and more sensitive to the harmful effects of the sun. During the first few months after rhinoplasty, patients should wear sunscreen and / or a hat to avoid the problems mentioned above. This period should be continued for 2-6 months while out in the sun.
Back to work
You may be ready to go back to work or school after 10-12 days, depending on your activity level. Generally, after 2 weeks, you can resume most of your normal activities.
Sport
The nose should be protected from contact for about a month after the operation. For this reason, lifting weights, strenuous activities, and heavy sports should be avoided. From the second week onwards, exercise, swimming and individual sports are recommended.
Rhinoplasty operations are easy?
Rhinoplasty surgeries are moderate surgery based on the patient’s opinion. The pain is not severe, but there may be some discomfort. If the comparison of the impact and the difficulty is made; satisfaction is high.
What are the aesthetic procedures in arched noses?
A nose shape that we frequently encounter especially in our societies, especially in the central part of the back of the nose, is the hump, which is clearly visible in profile photographs, and the protrusion described as hump.
Operations on the upper nasal root?
The area between the two eyes of the nose and the junction of the forehead. The high here creates an image that joins the nose to the forehead. This area should be reduced to the ideal point for best results.
I have thick skin, does it affect the result?
There are advantages and disadvantages of having thick skin. The most important drawback is that the resizing process can be limited. We can achieve better results by thinning the skin during surgery, but there are some restrictions on this process.
I have thin skin, what should I expect from the surgery?
Having thin skin has its pros and cons, just like having thick skin. However, the best part is that the nose reflects the process performed in the roof of the bone cartilage outward. The skill of the surgeon is important here.
I have a long nose, does it get shorter?
It is the length of the long nose from the root of the nose to the tip of the nose. A sharper and more dynamic image is provided by shortening the procedures that can be performed on the estaca by bringing the base of the nose upwards.
Can I be operated on again after rhinoplasty?
The nose is a dynamic organ. The surgeon’s experience and nutritional knowledge should be high. In any repetitive surgery, the structures that make up the roof of the nose can be damaged. Secondary (secondary) surgeries can be more difficult.
Procedures that can be performed with rhinoplasty
Since the nose is located in the center of the facial area, all organs should be in harmony and harmony in the concept of cosmetic surgery, even if the entire focus is the nose. If you have a large or wide face, a small nose may attract more attention. Other processes can be included in this period during the recovery period. Many procedures within the vital physiology of tissues can be incorporated in a single operation. There are many benefits of a plastic surgery specialist in this regard. Because the plastic surgeon has control of all the structures of the face, both aesthetically and functionally.
Jaw surgery
Chin enlargement and reduction are the two most common treatment methods combined with rhinoplasty.
At first glance, there is a surprising connection between the chin and the nose. Sometimes, implants can be used in such procedures.
Blepharoplasty (Eyelid Surgery) – Lifting of the eyebrows (Lifting)
It is an excellent way to relieve droopy eyelids and drooping eyebrows and give patients a younger look. There are several methods to lift the eyebrows while making invisible incisions to tidy up the eyelid.
Enlargement of the cheeks – Thinning of the cheeks
To keep the balance between the nose and cheeks, sometimes it is necessary to fill the cheeks a little, and sometimes a small incision can be made through the mouth and a thinning of the cheeks can be applied. Cheek filling can be done with a synthetic or fat graft change, with the person’s core tissue.
Face lift
It is a much more comprehensive and effective procedure that affects the entire appearance of the face. This application is particularly used to remove wrinkles around the eyes, cheeks, chin and mouth and to treat sagging skin. Support can be applied to some filled stitches.
We will consult with our patients who intend to undergo surgery and ask together the answers to many questions.
- Am I suitable for rhinoplasty? Am I a good candidate for rhinoplasty?
- What are my expectations?
- Are the results I expect from nasal surgery realistic? Does it fit my face?
- Is it possible to predict the result with Before After Photos?
- Will there be scars from surgery? Will there be a visible scar?
- Method of anesthesia and my preference?
- What procedures will be performed on my nose, should it be done?
- What are the points that influence the outcome in the postoperative period? Which ones am I responsible for?
- What will the recovery period be like, what controls and suggestions will be in the process?
- What are the risks and complications that can occur (undesirable and unexpected outcome)? how is it prevented?
- What other questions do you need to worry about?
Frequently Asked Questions and Answers
Is there an ideal age for nose aesthetics?
The important thing in rhinoplasty is not the age limit; It is the development of the bone and cartilage structure. However, it can be done from the age of 18-20. Sometimes it can be at a young age, but the parents must have consent.
Do nose aesthetics and eating habits affect recovery?
It should be kept away from salt, which can raise blood pressure, and the desired meals can be eaten after 1 day. Smoking is not allowed after surgery.
When can i start what kind of exercise can i do after rhinoplasty?
Heavy lifting and sports that require more effort should not be done in the first month, the simple walking exercise can be done after 2 weeks. How long will the shape of the nose remain after the surgery?
When can I see the result of the rhinoplasty?
In fact, you will certainly have an idea of the posture of the nose after the first splint is removed, but you should wait at least two months for the final version.
Is it possible to preview the results of the nose aesthetics?
With digital imaging technology, it only has a beneficial effect in terms of giving ideas and seeing the same things you and me. It will make the person who wants a natural or aesthetic nose more objective.
Does its shape change over time?
After the first nose is opened, it will shrink to its final shape in the same posture and position. After that, we don’t expect a change under normal conditions.
How long after can I have my nose filler?
Surgery is the best decision after the nasal filling has been completely removed from the body. After surgery performed in the presence of filler, there may be a change in shape in the nose after the filler melts. The surgeon should be informed about this issue if the filling procedure has been done previously.
I have already undergone a rhinoplasty, are there different risks in the second surgery?
Any surgery that is undergone can make it difficult to achieve the optimal result. In some cases 3rd e. 4. If there is no tissue to shape the nose in surgery, the necessary cartilage bone tissue can be removed from the ear or rib and the nose can be reshaped.
How does my surgery season affect the healing process?
The seasonal change is of little importance, as I generally use a closed surgery technique.
How do you determine if the surgery is open or closed?
In fact, in general, the closed surgery technique is more difficult and requires experience, I generally prefer closed surgery in my clinical practice. If there is an advanced curvature or a thick skinned nose, an open technique to thin the skin can be applied. Usually determined by the common preference of the surgeon and the patient.
In addition to the deformity, I also have a breathing problem. Will my respiratory problem also disappear at the end of the surgery?
Of course, the opening of the airways is part of this surgery, the cartilage structures of the flesh (concha) that block the airways will be corrected.
Can i do skin care after rhinoplasty?
Indeed, skin care can be done by gently massaging the skin surface after 1 month. However, it will be necessary to wait 2-3 months for more difficult procedures that can cause trauma.