RHINOPLASTY (NOSE AESTHETICS)
All surgeries related to aesthetic improvement and functional improvement of the nose outside the nose are called rhinoplasty. The nose carries characteristic features of the person. The nose, which is highly effective in aesthetic appearance, can seriously change the facial appearance even with minor changes.
The desired result in a good rhinoplasty surgery is not only to meet the aesthetic expectations of the patient, but also to obtain a natural result that is suitable for the general face. The naturalness of aesthetics is important. Before the operation, the points that the patient cares about are determined, the patient’s deformities and the general condition of the face are taken into consideration.
Apart from aesthetic appearance, an important issue in rhinoplasty surgeries, if necessary, is to ensure that the nose is in good condition in terms of functional aspects, to correct the problems that may cause nasal congestion and to enable the patient to breathe better.
Process Before Rhinoplasty (Rhinoplasty) Surgery
Before the operation, you should consult your doctor to determine how you will take blood thinners and other medicines.
Nose Aesthetics (Rhinoplasty) Surgery
The operation is performed under general anaesthesia over a period of 2-4 hours.
Micro rasps, microtips and piezo device, which is an ultrasonographic method, are used in the operation. Depending on the condition of the nose, the doctor applies open or closed rhinoplasty techniques and a protective rhinoplasty technique called preservation rhinoplasty. In the operation, after the deviated septum is corrected, all deformities, the hump (arch) on the back of the nose, the nasal bone side walls, and the cartilages at the tip of the nose are corrected. If the patient has had previous surgery and/or if the cartilage in the nose is not sufficient, cartilage taken from the ear is used. Absorbable sutures are placed in the nose. Silicone tampon is placed, the back of the nose is plastered and aesthetic plaster is placed.
In the first days, there may be mild bruising and swelling around the eyes and nose. It largely passes at the end of the first week.
After Rhinoplasty Operation
After 1 week, the plaster is removed.
For 15 days, no water contact should be made to the nose.
For 2 months, glasses should be worn.
It is necessary to lie at an angle of 30 degrees in the first weeks.
The nose is fully in the desired condition within 6 months – 1 year.
What is Nose Aesthetics (Rhinoplasty)?
Rhinoplasty is one of the most common plastic surgery procedures worldwide, performed for aesthetic or functional reasons (to improve breathing difficulties).
How many types of rhinoplasty surgeries are there?
We can basically divide rhinoplasty into 4 types of operations:
Open Rhinoplasty: An incision is made along the columella, which is the tissue strip between the nostrils. This operation method provides the surgeon with more visibility and precision.
Closed Rhinoplasty: All incisions are made inside the nose. It is an option with less tissue intervention. However, it provides less access to the nasal structure.
Functional Rhinoplasty: It is usually performed together with septoplasty, which corrects the nasal septum, in order to correct breathing problems as well as aesthetic reasons.
Revision Rhinoplasty: It is performed to eliminate problems resulting from a previous operation that did not heal as expected or did not achieve the desired result.
Is rhinoplasty a simple procedure?
Rhinoplasty is considered one of the complex cosmetic surgeries. The nose is a structure that plays an important role in facial symmetry. The procedure requires skill and precision because even small changes can significantly alter the appearance and function of the nose. The surgeon must be experienced in both aesthetic concerns and nasal anatomy to achieve satisfactory results.
What is the process before rhinoplasty surgery?
Although it may vary from patient to patient, the process before rhinoplasty basically includes the following:
- Since the operation will be under general anesthesia, do not eat or drink anything after midnight.
- Wear a button-down top so that you do not pull anything over your head after the operation.
- Smoking can hinder healing and increase complications.
- Stay away from alcohol, as it can dehydrate you and weaken your immune system.
- Stay away from the sun and tanning beds to protect your skin.
- Consult your doctor about stopping blood thinners and certain supplements one week before the operation.
What are the advantages of pre-operative planning with a nose simulator?
How is rhinoplasty surgery performed?
The steps of rhinoplasty surgery are generally as follows:
- Step: Anesthesia
The surgery is performed under general anesthesia. You will meet with a general anesthesiologist for pre-operative preparations.
- Step: Incision
Rhinoplasty is performed using a closed procedure, where the incisions are hidden inside the nose, or an open procedure, where an incision is made along the columella, the narrow strip of tissue that separates the nostrils.
Through the incisions, the skin covering the nasal bones and cartilages is gently lifted, providing access to reshape the nasal structure.
- Step: Reshaping the Nasal Structure
The nose can be reduced by removing bone or cartilage. Some rhinoplasty surgeries may require the addition of cartilage grafts. Cartilage is most commonly taken from the septum. Sometimes, the ear or, rarely, a section of rib cartilage can be used.
- Step: Correcting Septum Deviation
If the septum is deviated, it can be corrected and the protrusions inside the nose can be reduced to improve breathing.
- Step: Closing the Incision
After the structure under the nose is brought to the desired shape, the nasal skin and tissue are re-draped and the incisions are closed. Incisions can be made to change the size of the natural curves of the nostrils.
What is the process after rhinoplasty?
After rhinoplasty, you will stay in the hospital for 1 night unless your doctor requests otherwise. Every patient recovers differently after rhinoplasty surgery. The amount of swelling and when you will see your results vary from person to person. The recovery process after rhinoplasty is relatively simple, but it requires patience and following the doctor’s instructions. Today, the recovery processes of rhinoplasty surgeries are more comfortable than in the past with the developing methods.
The following may occur after rhinoplasty surgery:
- A splint is worn for one or two weeks to minimize swelling and maintain the new shape of your nose while it heals.
- The tampon placed inside your nose is usually removed within 24 to 48 hours after surgery.
- Swelling and bruising may occur around your nose and eyes, and it may take a few weeks for these to disappear. You may experience mild facial swelling, especially in the morning, for up to a year after surgery.
To speed up your recovery, you can:
- Avoid strenuous activities such as heavy lifting, aerobics, and running for a few weeks.
- Keep your head elevated and avoid putting anything (such as glasses) on your nose for at least 4 weeks.
What is the Piezo technique in rhinoplasty?
Although traditional rhinoplasty is widely used, Piezo is a preferred alternative because it creates less precision and trauma and offers faster recovery.
Piezo rhinoplasty uses an advanced technology called piezoelectric ultrasonic vibrations to reshape the nasal bones without damaging the surrounding soft tissues such as skin, cartilage and mucosa. Unlike traditional rhinoplasty, which usually involves breaking and reshaping the nasal bones with manual tools such as hammers and chisels, piezoelectric technology minimizes the risk of unwanted damage by precisely targeting the bone with ultrasonic waves.
Piezoelectric devices produce mechanical vibrations that are effective for bone but harmless to soft tissues through crystals. This allows surgeons to shape the nose with greater precision and control, reducing complications such as excessive bruising, swelling and post-operative trauma.
How is piezo rhinoplasty different from traditional rhinoplasty?
The differences between piezo and traditional rhinoplasty can be listed as follows:
Instrumentation and Technique:In traditional rhinoplasty, bone shaping is usually done using chisels, rasp and hammers, which require significant manual force. While this approach is effective, it can inadvertently damage surrounding tissues, which can lead to longer recovery times.
Piezo devices work with ultrasonic vibrations that specifically affect bone tissue without damaging surrounding soft tissue. Thus, surgeons have a clearer field of vision throughout the procedure. This produces more accurate and predictable results in nose shaping.
Control:Since the instruments used in traditional techniques are stronger, small and fine corrections on the bone are more difficult to control. Surgeons need to be more careful when using chisels or hammers.
In piezo rhinoplasty, the precision of the device provides millimeter-level control over bone cuts and reshaping. This precision makes it easier to achieve the desired aesthetic results with less risk. The method is especially beneficial for patients undergoing secondary rhinoplasty (revision rhinoplasty) or those looking for more minimal aesthetic touches.
Effect on Soft Tissues: Patients undergoing traditional rhinoplasty may experience more bruising and swelling because the soft tissue around the bone is affected by the force of the method.
Since the ultrasonic waves in piezo rhinoplasty only affect the bone, surrounding tissues such as blood vessels and nerves remain largely untouched. This can mean less swelling and bruising and, in many cases, a shorter recovery period.
Post-operative Recovery: Recovery from traditional rhinoplasty can take several weeks, and patients experience more intense bruising, swelling and discomfort, especially in the early stages. In some cases, it can take up to a year to see the final results.
Since there is less trauma in piezo rhinoplasty, patients generally experience faster recovery times with less bruising and swelling. There is less post-operative pain.
The piezo technique minimizes the risk of complications such as bone fractures, tissue damage or unwanted irregularities in the nasal structure. This reduces the possibility of revision surgery.
Frequently Asked Questions About Nose Aesthetics (Rhinoplasty)
Are the results of rhinoplasty permanent?
Rhinoplasty results are long-lasting. However, the nose can change shape over time due to other factors such as aging or trauma. While most of the swelling after surgery subsides within a year, subtle changes can continue to occur over time.
Are there risks to rhinoplasty?
As with any surgical procedure, rhinoplasty carries certain risks. However, major complications are rare when the surgery is performed by a qualified and experienced surgeon.
Some of the complications may include:
- Infection
- Delayed wound healing or scarring
- Breathing difficulties
- Numbness or change in skin sensation
- Septal perforation (a hole in the septum)
- Need for revision surgery
Will my nose scar?
Scarring depends on the technique used. Open rhinoplasty may leave small scars, while closed rhinoplasty usually leaves no visible scars.
When will I see the full results?
Although the final results of the surgery can be seen after a year, most patients get an idea of what the results will look like around 4-6 months.
What are the risks and complications?
As with any surgical procedure, there are risks such as infection, bleeding and dissatisfaction with the aesthetic result.
Can rhinoplasty be combined with other procedures?
When your doctor deems it appropriate, rhinoplasty can be combined with procedures such as septoplasty (correction of bone and cartilage tissues due to respiratory problems) or eyelid surgery and facelift.
When is a revision surgery necessary?
Rhinoplasty can be completely transformative, but it also carries the risk of being dissatisfied with the results. A procedure performed to correct problems from a previous rhinoplasty procedure is called revision rhinoplasty (secondary rhinoplasty). Some of the most common problems for which revision rhinoplasty is preferred include:
- Nasal asymmetry
- Nasal airway obstruction
- Collapsed cartilage or bone
- Collapsed nasal valve
- Extensive and deep scarring
- Unnatural appearance
In addition to these concerns, some patients may also request a revision simply because they feel the results are too noticeable and exaggerated. In these cases, revision rhinoplasty offers patients the opportunity to correct problem areas and achieve more natural-looking results.
Is revision surgery different from the initial procedure?
Revision rhinoplasty can be longer and more complex than the initial procedure. While the initial procedure typically takes 1-2 hours, revision rhinoplasty can take twice as long due to existing scar tissue and previous changes to the normal anatomy. Therefore, revision surgery is a serious decision that should not be taken lightly. However, a primary rhinoplasty performed by a novice surgeon can be corrected in a revision by an experienced rhinoplasty surgeon.
Scar tissue from the initial rhinoplasty can be problematic during revision surgery and limit the potential outcome. On top of that, wound healing after revision rhinoplasty can be unpredictable. These are all things to keep in mind when making your decision, which is why choosing an experienced surgeon is so important.
- Can piezo rhinoplasty be applied to everyone?
Piezo rhinoplasty is particularly suitable for bone shaping. Cartilage modifications or traditional methods for nasal reconstruction may sometimes be required.
- Am I a good candidate for piezo rhinoplasty?
Ideal candidates for piezo rhinoplasty include those who want to shape their nasal bones with minimal trauma and faster recovery. The technique is especially useful for those with sensitive nasal structures or those who have undergone revision rhinoplasty. However, your surgeon will decide which technique is right for you.
Sources:
- https://www.mayoclinic.org/tests-procedures/rhinoplasty/about/pac-20384532
- https:/ /my.clevelandclinic.org/podcasts/head-and-neck-innovations/from-rhinoplasty-to-reconstruction-the-art-and-science-of-facial-plastic-surgery
- https:/ /www.webmd.com/beauty/cosmetic-procedures-nose-job-rhinoplasty
- https://pubmed.ncbi.nlm.nih.gov/39117869/
- https: //www.ncbi.nlm.nih.gov/pmc/articles/PMC8748595/
*The article was updated on 27-09-2024.