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WHAT IS RHINOPLASTY - CORRECTION OF THE NOSE?
Rhinoplasty – aesthetic and functional nose surgery, in other words means shaping the nose. If patient needs surgical correction of the nasal septum (septum) also, we are talking about septorinoplasty.
Probably the most common consultation in head and neck plastic surgery is certainly the one about the possibilities of improving the function and appearance of the nose. The reasons can be different. The bad appearance of the nose since childhood, changes caused by aging or the result of an old injury. In that case, along with rhinoplasty, old scars on the skin often have to be corrected. It is undeniable that the nose has the greatest influence on the appearance of the face. Even small changes in its appearance can contribute to a significant improvement, and thus to the overall aesthetic harmony of individual parts of the face.
The main goal of the operation is to improve the aesthetic appearance so that the nose is in a more correct relationship with the rest of the face. At the same time, we are thinking mostly about the central focus of the observer of our face, which are our eyes and, to a lesser extent, our ears.
Images of our patients before and after rhinoplasty faithfully illustrate this concept.
AESTHETIC AND FUNCTIONAL RHINOPLASTY - CONSULTATION
The first and most important step
Regardless of whether the reason for the operation is functional (difficulty breathing) or aesthetic, choosing a qualified operator is the most important step in making a decision. A trained head and neck plastic surgeon performs nose, ear and throat operations and plastic surgery of the head and neck. These facts guarantee the safe performance of the operation.
The first and most important step in planning the operation is to examine the nose. We must also assess its relationship to the rest of the face. This includes a detailed consultation where the surgeon must find out your reasons for the operation.
You should think about what really bothers you about your nose. You should also be able to explain it clearly during the consultation. A convenient way is to make a small list. Don’t worry, all surgeons like precision and clear expression 😊.
An accurate and in-depth understanding of your problem, attitude and expectations is an essential part of planning the intervention. After all, the same applies to any other aesthetic surgery. For example, your surgeon wants confirmation that you are asking for the surgery because YOU want it, not to please someone or something else.
You should also understand that it is not possible to simply take a photo from the Internet and expect it to become your nose. It is certainly very important to look at photos and imagine what your nose might look like, More importantly, it is unrealistic to expect a plastic surgeon to “give” you someone else’s nose.
As already commented, the outcome of your surgery may depend on several important factors. These include skin thickness, size of other facial structures, cartilage and bone strength as well as breathing condition prior to surgery.
The thickness and type of skin can affect the success and final appearance of the nose after surgery.
Your functional needs may be a limiting factor in what can be done aesthetically. Additionally, the way the tissue underneath the skin (scar tissue) can affect healing, sometimes in unpredictable ways.
What does your surgeon want to hear?
Tell your operator how you want your nose to look. Be open to suggestions and opinions from your doctor if he informs you that your wishes are unrealistic or suggests alternative changes. For example, most patients want a straight nose in profile, but in some facial configurations a minimal hump can look even better.
Duty and professional standards oblige the operator to answer all your questions. In this way, you get complete information about the possibilities and limitations of rhinoplasty, as well as the mandatory safety for the patient. We must take this into account when making a decision for or against surgery.
Your operator and you must agree on the goals of the procedure. If you have doubts or additional questions after the consultation, arrange another interview at the Polyclinic. Alternatively, choose a “second opinion” interview with another surgeon, it’s a great way to make everything important fall into place. You should be confident and satisfied with the chosen surgical plan and have realistic expectations of what can and cannot be achieved.
Photography
Photographing and planning the surgical procedure are an integral part of the preoperative preparation. Your surgeon will explain to you how the cartilaginous and bony structures of the nose can be shaped to give the nose a new shape and how. For example, reshaping the chin can further improve the desired results. As part of rhinoplasty planning, we do photography documentation from several viewing angles.
The relationship between the eyebrows, nose and chin. It allows measurement of projection (how far the tip of the nose goes forward) and rotation (position of the tip of the nose up or down).
This view shows possible curvature of the nose, possible problems with deviation of the nasal septum. It also shows the width of the nose well.
Shows the triangular shape of the nasal tip, the width and shape of the nostrils. It also shows the columella (skin between the nostrils).
This view shows the harmony of the nose with the cheeks and other parts of the face.
Assessment of the nose during facial expressions such as laughing.
Simulation of the results
Some surgeons like the so-called simulations of results. Others draw on printed photographs or explain surgical procedures graphically for patients to understand. Each of these methods is equally valuable. The surgeon chooses the one he is most comfortable with.
Although computer simulation results can be exactly what you want, we should be emphasise that it is only about harmonizing wishes, i.e. surgeon’s preferences when planning the procedure. That picture does not show the result as it will be after the actual surgery.
It should not be forgotten that a good part of rhinoplasty is a matter of aesthetic criteria and the taste of the surgeon. It is part of what is known in the professional literature as the “Art of rhinoplasty”. This makes a very important part of the concept of rhinoplasty.
Be sure you understand the goals of your prospective surgeon! The fact is that there is no such thing as a “perfect” rhinoplasty. Even if a surgeon performs identical surgery on identical twins, there is no guarantee that the noses will look the same. It is always about variations in the long-term healing process.
Ideal age for rhinoplasty
Many questions focus on the minimum or maximum age for surgery.
Aesthetic nose surgery is best done after the physical growth of a young person is over. This usually means 16 years for female, 17-18 for male patients. The exceptions are very severe deformities with difficulty breathing. If this is the case, surgery can be performed at an earlier age.
On the other side of the age spectrum, we can perform rhinoplasty in the elderly if there are no other medical obstacles. In older people, the cartilage becomes thinner and loses its elasticity. This typically leads to the “lengthening” of the nose and the fall of the tip of the nose. Then the nose can consequently look more humped than at a younger age. There may also be a decrease in the space inside the nose and difficulty breathing.
All of this can be the subject of additional surgical steps to improve or prevent the problem.
SURGICAL TECHNIQUES OF RHINOPLASTY
How is the operation performed?
Rhinoplasty – aesthetic and functional surgery of the nose, begins with incisions (cuts) to access the cartilaginous and bony structures of the nose. Most incisions are made inside the nose, ie. they are invisible from the outside. In other cases, the incision is made in the area of the columella (skin between two nostrils). In the next step, the cartilage and bone are removed, added or reshaped to give the nose a new look. For example, if the tip of the nose is too large, the operator can reduce its size in this way.
At the end of the operation, surgeon closes the incisions with surgical sutures, and place immobilization (plasters and a plastic splint) on the outside of the nose. The nose is usually closed with antibiotic gauze as a tamponade from the inside on both sides to maintain the stability of the nasal septum (septum) and keep the shape achieved at the end of the operation.
Risk factors for rhinoplasty are generally small, but all of them will be discussed in consultation.
AFTER THE OPERATION
Minor swellings and hematomas around the eyes and surrounding facial tissue may appear in the first few days after rhinoplasty. In this case, cold compresses help reduce swelling and the feeling of pressure. In case of pain, we give analgesics. If the nose is closed with tamponade, it is removed 3. – 5. day after surgery.
After detamponade, intensive nasal blowing should be avoided for the next week. Immobilization serves as protection against trauma, ie. to keep the structure of the nose stable for 5 – 7 days. It is very important to follow the instructions of the operator, and especially to keep your head raised while lying down and sleeping immediately after surgery (couple days). Patient should avoid increased physical activity for several weeks after surgery.
Excessive sun exposure, strenuous exertion and the risk of injury should also be avoided. If you wear glasses, be careful not to press on the skin of the nose in the sensitive operated area. It is necessary to adhere to the recommended controls for the purpose of monitoring healing. Any unusual changes should be reported to the operator.
Finally, we bring another example of the results of nasal surgery – rhinoplasty, where long-term stability and projection of the nose and proper breathing function were maintained.
