RHINOPLASTY & NOSE JOB
Rhinoplasty is an operation in which the nose is reshaped. The nose can be reduced and enlarged, the angle of the upper lip can be changed, the shape of the tip of the nose can be changed, the indentations and protrusions can be corrected. During the operation, the surgeon reaches the bone and cartilage supporting the nose with a small incision. Depending on the desired result, some bone and cartilage can be removed or added. Most of the time, the sliding septum cartilage disrupts the symmetry of the nose, closing the nostrils and preventing comfortable and healthy breathing. Rhinoplasty operation, which is performed together with deviation (intranasal deformities that make breathing difficult) under anesthesia, can increase your quality of life by obtaining a healthy respiratory and aesthetic appearance.
WHAT IS RHINOPLASTY ?
The operations performed with the aim of giving the nose a more beautiful and aesthetic appearance are called nasal aesthetic surgery or rhinoplasty. Aesthetic rhinoplasty is one of the most frequently performed cosmetic surgeries with positive results.
In surgeries performed to change the external appearance of your nose, which is a very prominent structure in terms of aesthetics, very important functions such as breathing and smelling must be preserved in the best way possible. In order for your rhinoplasty to be functionally as well as aesthetically successful, that is, in order for you to be able to breathe and smell comfortably through your nose after the surgery, it is very important to solve the functional problems such as curvature (deviation), enlargement of the concha (lower turbinate hypertrophy) or sinusitis, as much as possible, in the same surgery. is important.
Surgical techniques and technologies used in aesthetic and functional surgeries of your nose, which is one of the most striking structures in your facial anatomy, are constantly evolving to provide better visual and functional results, as well as to provide a faster and more comfortable recovery period after surgery.
In order to obtain aesthetic and functional results that will be considered successful in nose surgeries today, it is important that your doctor who will perform your surgery is highly experienced in the field of nose surgery, as well as being able to follow and apply current information, surgical techniques and technologies on this subject.
Patient happiness is the most important criterion of success in aesthetic nose surgeries, which can only be possible if the nose has the desired appearance and breathing comfortably at the end of the surgery. In order to achieve the visual results you desire in your rhinoplasty, your expectations from the surgery should be fully understood by your doctor before the surgery. Three-dimensional digital animation systems, which have been used in recent years, allow you to fully express your expectations from the surgery by applying the possible results of the surgery on digital images, while helping your surgeon to plan interventions that will meet these expectations.
TYPES OF RHINOPLASTY
It is an operation that is generally performed under general anesthesia. Very rarely, nasal tip aesthetics, which we call tip plasty, can only be performed with local anesthesia. How to make nose aesthetic procedures. There are two types of rhinoplasty techniques, Open and Closed techniques.
Successful results are obtained in both methods and they have their own advantages and disadvantages. We can say that they are more comfortable in shaping as they can reach the nasal septum more easily in the open technique. The only disadvantage of this operation is the scarring at the tip of the nose. However, this scar is a very minimal scar and it completely heals over time.
In closed nose aesthetic procedures, the nose is not opened and the operation is performed by entering through the nostrils. It is much more comfortable than open operation, but it is not preferred in serious radical interventions. Prolems such as nasal tip drop and postoperative revision rates are higher than the open technique.
In recent years, Piezo technique has been applied to shape the bones in open and closed nose aesthetic operations. Thanks to this technique, the cartilage and tissues around the bones are not damaged in the operation and this accelerates the healing process. It is the procedure that we shape with ultrasound energy without breaking the nasal bones. Whichever method is preferred, people do not feel any pain because it is performed under general anesthesia. Generally, the operation is completed by shaping the nose according to the predetermined modeling.
The open rhinoplasty technique is a preferred method for patients who have significant deformity or asymmetry at the tip of the nose, who have had previous surgery, or who need to intervene in the severe curvature of the septum in the same session with aesthetic surgery.
Open rhinoplasty approach is preferred more because of the problems at the tip of the nose in most of the patients who will undergo rhinoplasty, and because of the frequent curvature of the nose in our geography.
In the open approach, the operation is started by making a horizontal incision in the middle of the skin section (columella) between the two nostrils, and after the nasal skin is lifted in this way, all the cartilage and bone structures forming the nasal tip and nasal ridge are revealed and the surgery is performed under direct vision.
In the surgery performed with this method, it is easier to place cartilage supports on the needed areas and fix them with stitches, fix the intranasal veil by correcting and provide symmetry, and at the same time, risks such as changing the shape of the nose or nasal tip, falling of the tip of the nose, slipping of the intranasal veil (septum) are minimized. is reduced.
In open technique surgeries, when the incision made at the tip of the nose is closed with the correct technique and using appropriate suture materials, it heals completely in approximately 1.5-2 months.
Closed rhinoplasty is a rhinoplasty technique made by cutting the inside of the nose. It is performed without lifting the nose with incisions made from the inside of the nostrils. With a scalpel, an incision of approximately 3-4 cm is made from the inside of the nose, not from the wing. In this way, the cartilages and bones of the nose are reached. In this area, the skin is removed in the area to be intervened, then bone parts are removed if bone is to be taken. Or if cartilage parts are to be removed or added, these procedures are performed. This incision is then closed with sutures.
Closed rhinoplasty takes less time than open rhinoplasty. Things to consider beforehand are the same for both approaches. If drugs such as blood thinners and aspirin are used for a different reason, they should be discontinued for a certain period of time before the operation by consulting the doctor. In fact, only the surgical approach is different between closed or open rhinoplasty.
Since the tip of the nose is not opened in closed rhinoplasty, the recovery time may be a little faster.
While it is possible to perform some operations inside the nose by directly seeing and measuring the nose in closed rhinoplasty, this is not the case in closed rhinoplasty. In the closed method, for example, it is not possible to stop a bleeding vessel, but in open rhinoplasty, it is easier to stop if there is a bleeding in the vessel by seeing that vessel. This also reduces the formation of bruises. A certain amount of bleeding occurs in all standard surgeries. Or there is already some bleeding when there is an incision. In closed rhinoplasty, if the person performing the surgery is not well-versed in the surgery, risky results and complications are slightly higher. Since closed rhinoplasty is performed by feeling the cartilage, vein and muscle structure in the nose, the learning curve is more difficult. Open rhinoplasty is also done visually, so the learning curve is a little easier.
Closed or open rhinoplasty is not a process that the patient should question. Closed or open rhinoplasty is a matter for the surgeon to decide with which the surgeon will achieve the best and most successful result, in other words, it is a preference that directly concerns the surgeon.
Dark-skinned, black or thick-skinned people have a risk of over-appearing surgical scars. Edema may be more in individuals with thick skin. Also, it takes longer for the inner cartilage shape to appear. People with thin skin get results a little easier.
FREQUENTLY ASKED QUESTIONS
What are the Complications and Possible Problems?
The risk of bleeding in every surgery may be more serious in rhinoplasty. Especially if non-aesthetic procedures are to be performed in the nose to relieve nasal congestion, which must be done if necessary, the possibility of unwanted bleeding increases. It is an organ that contains medium-sized vessels in the nose. But this type of bleeding usually does not reach dangerous levels and can be stopped with simple tampons. Adhesions called synechia may develop in your airways after surgery, and these can make it harder for you to breathe than before the surgery. This is usually easy to treat but may require a second surgery.
Very rarely, a hole may occur in the structure called the "septum", which forms the middle of the nose. This is usually not a problem, but in rare cases it can cause a sound when breathing. It is difficult to treat and requires reoperation.
Infection in the nose is almost impossible. This organ, which has a very strong blood supply, is very resistant to inflammation. If infection develops after this surgery, you can enter the medical literature.
But if you experience aesthetic problems, deformities or don't like the shape of your nose after this surgery, no one will be surprised. Therefore, the most common complication of this surgery is aesthetic.
What Preparations Are Made Before Nose Aesthetics?
Nose aesthetic surgery is a type of operation that is mostly performed under general anesthesia. In simple rhinoplasty operations that require only small touches, local anesthesia can also be applied according to the surgeon's preference. While the operation takes 2 hours on average, a rhinoplasty operation usually takes 1 day with preoperative preparations and post-operative applications and observation periods. Information about which products or drugs the patient should not consume before rhinoplasty surgery is explained in detail by the specialist doctor who will perform the rhinoplasty. A special procedure may be required for the use of some herbal teas, blood thinners, medications, nasal sprays. The rhinoplasty surgeon, who is an expert in his field, shares the obligations of the patient before this rhinoplasty in detail. This process is personal, just like a rhinoplasty operation, and varies from patient to patient.
Things to Know After Rhinoplasty
• Tampon is applied during the nose operation. The removal time of these tampons is determined by your doctor. We usually remove the silicone pads within 2-7 days.
• After the surgery, you may have a slight burning sensation in your throat, dryness and sore throat because of the tampons. This will pass in 3-4 days.
• There is generally no severe pain after the procedure. For mild pain, your doctor gives you painkillers.
• You may also have swelling and bruising under your eyes after the operation. These will go away on their own in an average of 3-4 days.
• You may have a slight bloody discharge in your nose, this is normal. When blood comes from the mouth and nose heavily, this situation is alarming and a doctor should be consulted when this situation occurs. In addition to these, you should also consult your doctor when you have high fever, headache and foul-smelling discharge.
• After the operation, you must wait 4 hours for food intake and at least 3 hours to drink water.
• After the operation, you should rest until your tampons are removed. Avoid exercise and strenuous sports.
• Do not consume very hard foods and especially try not to consume extremely hot drinks.
• Sleep on a high pillow that is above your heart level.
• When you need to pick something off the ground, do it without bending your head too much.
• Do not lift heavy.
• You should not blow your nose for a while.
• Do not take steamy or very hot baths and stay in the shower as short as possible.
• Do not touch the sun too much and avoid sunbathing.
• Medicines with blood thinning effects should not be used after the operation as well as before the operation.
Who Cannot Have Rhinoplasty?
There are various health problems that are considered as contraindications for rhinoplasty (conditions that should not be applied):
1. BODY DYSMORPHIC DISORDER
Body dysmorphic disorder is a psychiatric disorder and is a state of extreme prejudice about one's image. Due to this extreme level of prejudice, the person may be influenced by even small flaws that are very difficult to notice from the outside, triggering sociological and psychiatric conditions such as socialization problems, low quality of life, depression and suicidal tendencies. It is appropriate for the physicians who will perform rhinoplasty to know these patients, who cannot be satisfied with the postoperative results, and to mediate in the realization of the necessary psychiatric evaluation.
2. OBSTRUCTIVE SLEEP APNES
Obstructive sleep apnea is defined as cessation of breathing due to recurrent obstruction of the airways during sleep. Physicians should be more careful because of the high probability of developing undesirable conditions before surgery in patients with this disease. If this condition is present in patients who need rhinoplasty, the patient's breathing should be supported with devices such as CPAP in order to minimize the risk.
3. BLEEDING DISORDERS
Care should be taken as various undesirable situations may occur after rhinoplasty in people whose blood coagulation is adversely affected. In order to prevent this situation, it is necessary to question any excessive bleeding or bruising or the use of supplements and vitamins that are effective in clot formation during the pre-operative interview with the patient. Nose bleeding is one of the most common complications after rhinoplasty. In people with bleeding disorders, nosebleeds may be excessive and it may be necessary to intervene in the bleeding vessel with endoscopic or angiographic methods.
As a general approach, people who have undergone rhinoplasty surgery before and are not satisfied with the results should wait at least 1 year before making a new evaluation. At the end of this period, the final results of the previous operation are evaluated and a second correction operation can be applied if necessary.
Is There an Age Limit for Rhinoplasty?
Of course there is an age limit. As a result, it is not a method that can be applied to people of all ages. The lower age limit is 16 for young girls and 18 for boys.
The upper age limit, if there is no health problem that will prevent people from undergoing the operation in general, does not actually exist.
In other words, as an upper limit, people of all ages can have a rhinoplasty operation.
But of course, it is necessary to carry out the necessary controls and determine whether the persons are suitable for the operation. Only then can the best decision be made.
How to choose a rhinoplasty doctor?
The person who will have rhinoplasty usually makes a choice between a plastic surgeon and an otolaryngologist. Functional surgery of the nose is basically in the field of otolaryngologist; Although rhinoplasty seems to be in the field of plastic surgery, it can be performed by experienced surgeons by both branches. The patient who decides to have rhinoplasty should give an idea about what he wants to change in his nose, and the doctor should give the patient an idea about what can be changed. In this regard, the physician should use the available technological 2D and 3D visual tools to show the patient how the post-operative appearance will be approximately. A plastic surgeon can also solve problems with breathing in the nose. Nose aesthetics is more complex than functional surgeries. Both branches can handle two trades. Here, the patient's preference is important.
Is Intranasal Tampon Applied in Nose Aesthetics?
Rhinoplasty surgery takes 1-2 hours depending on the method used by the doctor and the condition of the patient. The methods used in the nose aesthetic process may vary from person to person. General anesthesia is applied depending on the operation so that the patient feels more comfortable and does not feel pain.
The surgeon anesthetizes your face with a local anesthetic and gives you a strong intravenous sedative. When the effect of the drug wears off, the person feels sleepy and does not remember much about the surgery. Surgeons decide on the best anesthesia for your needs.
After the necessary anesthesia is applied, the doctor begins the surgical procedure. The operation is decided with the patient before the operation and the intervention process begins. Nasal tissue should be protected for the first few days after nose surgery. After the incisions are made, a splint is placed to protect them. The doctor may apply a tampon to the nose.