Rhinoplasty is a surgical procedure that changes the shape of the nose. Rhinoplasty is performed both to change the shape of the nose and to correct breathing problems.
The upper part of our nose consists of bone and the lower part of cartilage. Rhinoplasty (nose aesthetics) makes changes on the cartilage and bone structure.
While planning rhinoplasty, other parts of the face are also evaluated. The skin structure has a special importance here. Whether the skin is thin or thick is an important factor affecting the surgical results. While talking about expectations, this should be shared with the patient.
When surgery is decided, a special surgical plan is determined for each person. Rhinoplasty is not a standard surgery. It is a dynamic surgery with many variables.
Nasal deformities may develop due to congenital family genetic origin or subsequent trauma.
What kind of risks can rhinoplasty carry as it is a surgical procedure?
As with all other surgeries,
-Bleeding
-Infection
-Anesthesia side effects
are the major problems that come to mind in the first place.
Although the problem of infection is a problem that we see relatively less, we are more careful in revision surgeries where we use grafts.
Other possible risks we may face are:
– Numbness around the nose
-pain swelling discoloration
-trace scar
-opening in the cartilage area in the inner part of the nose (septal perforation)
– second operation requirement (revision rhinoplasty)
Medical resume:
First of all, a medical history is taken from the person who wants to have rhinoplasty. Have you ever had surgery before, have you had any problems with it? Does he/she have a chronic disease? Does he/she have a tendency to bleed? Allergic conditions etc.
Physical examination:
Nasal examination is done both externally and internally endoscopically. Some laboratory tests and anesthesia examination are performed.
Nasal skin structure, cartilage and bone structure are evaluated and information is given about the effects on the outcome of the surgery.
In the second step after the examination, your photos are taken from various angles. In addition, with the modeling called digital imaging, information is given about the possible image before and after the operation. Information is given about how much of the person’s wishes can be realized, taking into account their structural characteristics.
Evaluations are made by taking into account the motivation and wishes of the patient in order to meet the expectations of the person.
For example, if it is noticed that the chin is behind in the facial evaluation, it may be recommended to bring it forward with an implant or filling.
A companion is sufficient to care for personal needs after the surgery.
Nutrition and drugs
Due to their blood thinning effects, aspirin and derivative pain relievers, herbal teas should not be taken 2 weeks before and after surgery.
If you smoke, you should quit. Smoking slows down the healing process and paves the way for infection and edema.
Anesthesia
Since rhinoplasty is a surgery performed with general anesthesia, it will be useful to give some information about it.
General anesthesia is a state of complete sleepiness and no painful stimulus is perceived. First of all, your vascular access is opened, as in the serum insertion process, and anesthesia drugs are given from there, then a breathing tube is placed through your throat to support your breathing after you are completely asleep.
Rhinoplasty operation is performed either without a closed incision or with the help of an incision from the tip of the nose, as in the open technique.
These techniques are not superior to each other, they are just a difference in approach.
In the open technique, there are 3-4 stitches at the tip of the nose, these are either self-dissolving stitches or are removed after 1 week. There is no trace problem.
The cartilage and bone formation that divides our nasal cavity into two is called the septum.
During rhinoplasty, the curved cartilage is corrected and the obstruction blocking the airway is removed.
Apart from the septum, there are nasal meats, which we call blood, on both sides of the nose. These are usually enlarged and laser shrinkage is applied in the same session.
After waiting for a while in the wake-up room after the operation, the patient is taken to the room.
Oral feeding is not done for 3-4 hours after general anesthesia in order to protect our lungs in case of possible vomiting.
Post surgery
Lying in the supine position with the head up is recommended for less bleeding and swelling. However, as long as the nose is protected, there is no problem in right and left turns.
There is a silicone pad with a central channel in the nose, although breathing is not a problem at first, but later it can be blocked by clots or nasal secretions. Watering in the eyes, nasal discharge, pressure in the ears, difficulty in swallowing may occur due to nasal packing.
There is a special porous splint on the outside of the nose.
It is normal to have bleeding in the form of slight leakage from the nose.
Swelling and bruising in the under-eye and face area can be seen especially after the second day. All of these go away after 1 week.
Hospital stay is usually 1 day. Postoperative pain relievers are given intravenously. There is no problematic pain, it is easily tolerated.
After 2 days, the special tampons in the nose are removed.
Sprays, pain relievers and antibiotics are used against crusting, drying and congestion in the nose.
One week after the operation, the flood, which is put in the feces of the nose, is removed and the nose is closed with special tapes and followed for 1 week in this way. The bandage period can be extended depending on the condition of the person.
To summarize briefly the issues to be considered after the surgery:
-Compelling sports such as aerobics, pilates, yoga, swimming, etc. should be avoided.
– pay attention to the splint on the nose while bathing j
Hairdresser-style hair washing should be preferred.
– the nose should not be blown strongly
You should be more gentle while brushing your teeth.
– Optical or sunglasses should not be worn for 4 weeks after the surgery. Pressure on the nose skin may leave a scar.
– Avoid contact with the sun’s rays on the nose for 4 weeks. 30 factor sunscreen can be preferred. Sun rays can cause color changes on the nose skin.
– The nose changes over the years whether it is surgery or not. It takes 1 year for the swelling and edema to go away after surgery and to take its final shape.
What is the difference between rhinoplasty and deviation surgery?
In rhinoplasty, the curvature (deviation) in the inner part of the nose is corrected and the outer part is intervened, and the appearance and shape changes.
When deviation surgery is performed alone, the airways are opened, but the nose does not change in shape. Sometimes, the problem is solved with an aesthetic approach (functional rhinoplasty) as only deviation surgery will not be enough in very advanced nasal curvatures.
Is rhinoplasty a simple operation?
No. Rhinoplasty is a dynamic and complicated surgery. The nose is changed in three dimensions according to the facial structure. A personalized operation is performed, taking into account the cartilage, skin structure, etc., almost like a tailor.
Will I need to stay in the hospital?
Generally, 1 day of hospitalization is sufficient unless there is an extra situation. After 1 week and 10 days in total, it is possible to return to normal business life and activities.
Does private insurance cover it?
All aesthetic operations are not covered by private insurance.
Can the shape of the nose after the surgery be seen beforehand?
With some computer imaging programs, adjustments can be made to the profile and front images to give an approximate idea.
Is rhinoplasty a painful operation?
No, for most people, it is in the range of 0-4 out of 10, as in post-operative evaluations.
Will there be a tampon in my nose?
Special splints made of soft silicone with a channel inside are used in the nose, it is usually taken within 2 days, sometimes it can be left without problems even for up to 1 week, depending on the condition of the person.
How long does the swelling last?
There may be minimal bruises under and around the eyes, and they disappear completely within 1 week and 10 days.
Does plastic surgeon or ENT doctor have importance in choosing a surgeon?
Both branches perform rhinoplasty, technically different things can be used, it is necessary to focus on the result.