Cosmetic surgery of the nose (rhinoplasty)
Introduction
Nose is significant aesthetic unit of the face. The appearance of the nose is mostly genetically determined. However its shape can be also altered as a result of an injury or previous surgeries. Bumps and irregularities may be present on the nose and its size and shape may not be proportional to the rest of the face. These alterations can be corrected by the cosmetic nose surgery which is one of the most frequently performed cosmetic surgeries.
What is the cosmetic nose surgery (rhinoplasty)?
By performing the cosmetic nose surgery it is possible to correct especially the shape and the size of the nose in the relationship to the face as a whole (proportions). The aim of the surgery is to improve the balance of whole face and so to improve patient´s self-confidence as well. Another "side-effect" of the surgery can be the improvement of breathing too.
What is possible to change by the surgery (rhinoplasty)?
With the help of this surgery we can improve:
- The size of the nose given the balance of whole face.
- The width of the nose in its bony part, nasal dorsum, the size of nostrils as well.
- The nose profile with a visible bump or depression on the contrary.
- The nasal tip which is enlarged or bulbous, descending in the shape of a beak or upturned.
- The nostrils, which are large, wide or uplifted
- The nasal asymmetry.
For whom is the cosmetic nose surgery (rhinoplasty) advisable?
The cosmetic nose surgery is advisable for individuals whose nose development has been fully completed, not before 15, better since 18 years of age. The decision to undergo the cosmetic nose surgery is always very important and it should be a result of careful analysis considering not only the aesthetic point of view given the whole face but also the motivation of a patient to undergo the surgery.
The ideal candidates are healthy individuals in good condition who do not suffer from life-threatening illness or health status, that can worsen the healing process and recovery, patients with the positive life attitude, well motivated with clearly defined aims of the surgery. Smoking worsens the healing process and can cause the incidence of complications.
Is the cosmetic nose surgery (rhinoplasty) performed under general or local anaesthesia?
It is possible to perform the surgery under general and under local anaesthesia as well. The complete anaesthesia is more appropriate in the majority of cases. The local anaesthesia can be administered in minor surgeries if patient wishes so, but it does not have to be tolerated well. When local anaesthesia is used, you can feel some discomfort, but you should not feel pain.
How long does the surgery take?
The surgery takes usually 1-2 hours, depending on its complexity.
What is the procedure of the surgery like?
Before the start of the surgery itself, it is important to perform an analysis of a shape and a size of the nose and to define the problem which is going to be solved. The shape of the nose is determined by the bony frame in its upper part and by the cartilages in its lower part. The nasal tip is formed by cartilages which lead from the middle part outwards. The surgery itself takes approximately 1-2 hours. The surgical incisions are made inside the nostrils, so they stay hidden afterwards. The closed approach does not involve separating of the skin from underlying cartilage of the nasal tip, whereas the open approach does. The difference between both methods is that the open approach allows more transparent access when operating the nasal tip cartilages, but at the cost of a small scar on a lower middle part of the nose (collumela). We can achieve good result by choosing any of the methods. The correction itself is based on shaping the cartilages and bones to the required shape (osteotomy, reducing of adding of the bony tissue or other tissue). Afterwards the surgical incisions are sutured by adsorbable sutures and the plaster is placed on the nose. A tamponade or a silicon reinforcement is inserted into the nostrils. The plaster is used to keep the proper shape of the nose and to provide undisturbed healing after the surgery.
What is the treatment after the nose correction (rhinoplasty) like?
As it is common in other surgeries, after the cosmetic nose surgery (rhinoplasty) it is necessary to expect the bleeding from the surgical wounds, formation of bruises from haematomas and swelling around the nose and in the area of eyelids. The post operative pain is eased by analgetics (painkillers). The swelling and haematomas usually subside within several days after the surgery. The tamponade is usually removed 2nd up to 3rd day, in exceptional cases 5th day after the surgery and the plaster is left for approximately 10 days. After the plaster removal we recommend soft massages. Increased physical activity is not advisable for approximately 6-8 weeks (due to the congestion) and it is necessary to prevent possible nose trauma. Although the major part of the post operative swelling subside within first few days, small swelling can remain for approximately 3 months after the surgery and the final result is stable after 1 year. During this period the nose is more sensitive to the cold and it can get swollen in warm weather, it can change its shape due to the traction produced by scars. After this period the result of the surgery is permanent.
What result can we expect?
Although the perfect appearance is not the aim of the surgery, the surgery can help you to improve the proportions and overall facial balance and so improving your self-confidence. The final result of the surgery can be sometimes changed during the healing process, the changes can not be assumed precisely, due to the flexibility of the cartilage tissue.
If you have any question or comment, do not hesitate to contact us.