- Who is candidate for rhinoplasty ?
- The first consultation
- Review about the rhinoplasty
- Rhinoplasty risks and complications
Plastic surgical procedures have to be performed by plastic surgeons !
Nose surgery is a common aesthetic surgical procedure. The nose is situated in the central part of the face, thus it is a determining factor of this part of our body. With the other parts of the face it enhances harmony and creates a balanced image. Even the most little, unwanted detail – which does not harmonize- has big significance. Every face is different, thus different shapes of nose can fit to the harmony of it. Rhinoplasty corrects the formal abnormalities of the nose. It modifies the osseous and cartilaginous parts of the nose to achieve the wanted result. Thus structural changes will happen in the nose. The nose surgery makes a new shape to the nose, to enhance its proportion and make the face more younger. In reasonable cases the result can be enhanced more with other procedures (Botox treatment and wrinkle filling). The goal of the plastic surgical operation is to make the nose natural, which is harmonised with the face and with all its details.
We always plan the operation personally fitted to the patient. The procedure affects the osseous and cartilaginous parts of the nose in case of need. After the remodelling of the frame of the nose we have to adjust the soft tissues to the new shape. Changes in the frame and soft tissues of the nose will result in a natural new-shaped nose which fits into the harmony of the face. In the case if there are respiratory problems because of the nasal asymmetry and deviation or the enlargement of the inner structures of the nose, the nose surgery will be performed with septal surgery by the help of an ENT specialist. If it is necessary we will perform other procedures simultaneously with the rhinoplasty to achieve more younger appearance (facial, forehead, eyelid surgery, laser rejuvenation and resurfacing and wrinkle filling). The plastic surgery of the nose can be performed in whatever age above the age of 18, when the face and all its characteristic parts achieved their final shape.
After rhinoplasty it is forbidden to blow your nose in the first 2-3 weeks, till the total mucous membrane adherence is not developed. Six weeks after the surgery You have to avoid stiff sports and physical activity! You have to avoid sunbathing and solarium in this period!
The final result of the nose surgery will be visible after the total cessation of the swelling. We can ensure the 80% of the development of the final shape. The other 20% is influenced by the body’s own reactions (scarring). It is a natural expectation that women and men wants to have a harmonious and confident appearance in all ages. Rhinoplasty enhances the harmony of the nose and the face, thus increases the confidence, assurance and young, dynamic appearance of the patients.
The appearance is very important in the view of personality. The well-implemented nose surgery will make a positive change for the patient, because the appearance will change beneficially and the inner harmony will be enhanced. These effects ameliorate the confidence of the patients, thus their privacy and social welfare.
WHO IS CANDIDATE FOR RHINOPLASTY ?
- Your nose is too big in relation to the other facial structures.
- Your nose is humped from profile.
- Your nose is too much wide in front sight.
- The nasal tip is drooping or is too upturned.
- The nasal tip is large or bulbous.
- Nostrils are too large.
- Your nose is not in the facial centerline or it is deviated.
- The nose is asymmetric as a result of previous traumas.
The rhinoplasty can help in all of these. The surgery of the nose can not correct all the expectations -sometimes unreal-, which were dreamt by the patients. We can not resolve everything with the operation. On the one hand it has limits by the techniques of the operation, on the other hand just only those corrections can be performed which are fit to the harmony of the face.
THE FIRST CONSULTATION
At the consultation we will discuss Your problems, expectations and desired outcome. We will talk about everything which is in connection with the rhinoplasty and important in the aspect of the nasal correction. We will examine the nose and the face, and their proportions, situations to each other. We will put attention to the genetic factors, which can influence the operational plan. We will draw attention to the occurent asymmetry. We will check the quality and quantity of the nasal skin and fatcontant. There is asymmetry which even can not be corrected with rhinoplasty. We will give You some advices about those procedures, which can reconstruct the youthful nasal and facial appearance. These are performed usually together with the nose surgery: endoscopic forehead plasty, upper and lower eyelid surgery, facial plasty, wrinkle filling and laser rejuvenation and resurfacing.
We will take some photographs –from different directions- about the present condition. The photographs allow the patients to examine and evaluate the nose from different directions. We will show you the probable operational result with the help of computer modelling.
You will be asked about Your medical conditions, medical treatment, drug allergies, use of current medications and previous surgeries, procedures. It is very important to get accurate information about every medical conditions to plan the procedure with the best thoughtfulness. After the proper information the well-planned rhinoplasty will ensure You the biggest satisfaction.
REVIEW ABOUT THE RHINOPLASTY
THINGS TO DO BEFORE THE OPERATION
Before the rhinoplasty some examinations can be necessary to be performed: blood test, ECG, chest X-ray, and craniofacial CT in case of need. With the results, the operation will be performed in the best security. If You smoke, take aspirin or other blood thinner medications, or any anti-inflammatory drugs or other medications, please let us know! This drugs can increase bleeding or can cause other interactions during the general anaesthesia.
The nose surgery is often performed in general anaesthesia (in special cases it can be performed in intravenous sedation or local anaesthesia) with hospital background. For Your security during the surgical procedure which is performed in general anaesthesia we check Your heart rate, heart beat, blood pressure and blood oxygen level with monitors. For Your bigger security antibiotics are administerd during the nose surgery.
In the case of local anaesthesia the injection process is a little bit unpleasant, but after that the operation is totally pain free. In this case the patient is awake during the whole operation. Certainly, thus she/he can hear the noises during the procedure: the noises of the bones during the reshaping of the nasal bone. The local anaesthesia is recommended for those, who are not disturbed by these unpleasant noises. In the case of general anaesthesia the above mentioned inconveniences do not exist, the patient is sleeping during the whole operation.
In the case if the patient has septal deviation as well, which causes problems, the correction of the deviation will be performed simultaneously with the plastic surgical operation by the cooperation of an ENT specialist.
In the case of full nasal correction we reconstruct the osseous, cartilaginous and soft tissue parts of the nose. Usually if we make a change in the osseous part, then it is necessary to adjust the cartilaginous part to the new osseous contour. In the case of partial nasal correction we only reconstruct those parts which are necessary to be reshaped and we do not change all the structure.
The incision is usually inside the nose. In the case of more complicated corrections or reoperation it can be necessary to perform the operation from bigger incision. In this case we make a little incision across the columella, the narrow strip of tissue that separates the nostrils. After the total recovery these scars are invisible or they are in partly hidden position: in natural creases.
The operation normally takes 1-1,5 hours, which can be more longer in the case of secondary nose surgery.
After the rhinoplasty there are always leaking blood and oedema, which cease spontaneously and will be totally absorbed in a short-time period. To decrease these and to achieve the most accurate adhesion of the soft tissues we will put tampons into the nostrils. With this the recovery will be faster and saftier, and the amount of oedema and leaking blood after the operation will decrease. The tampons will be removed the previous day after the procedure. In that case, if septal deviation surgery was performed as well or we made more complicated procedure with the reconstruction of the osseous part, these tampons can be stayed for longer period.
The biggest inconvenience is the dryness of the mucous membrane in the gullet caused by the tampons.
At the end of the procedure we put the plaster on the nose and gauze to the nostrils which are fixed by bandage. The plaster decreases the oedema and protects the nose during sleeping and from external injuries.
Secondary (revisionary) rhinoplasty:
Secondary (revisionary) rhinoplasty means the plastic correction of the previously operated nose. 20% of those patients who had nose surgery before need the revisionary procedure. In the nasal plastic surgical procedure there are so many difficulties and unpredictable factors. In the case that the patient is not satisfied with the result of the operation, does not always mean that the operation was performed incorrectly. It can happen that the nose surgery looks like as it will be favorable, but months later unfavorable changes will happen because of unpredictable processes. It is recommended to wait at least on year for the second operation, because the nasal appearance can enhance in this period. Even two years can past till the total change. In that case if the expectations of the patients are realistic and the plastic surgeon agrees with the problem, revisionary operation can be necessary. These operations are always more complicated, difficult than the first ones, because the operational area is not intact any more. The soft tissues are more cicatricose, thus neither their blood supply is perfect. One part of the tissues can be deformed or missing, other parts can be in unfavorable location or situation. The operation is usually longer because of the above mentioned reasons. After secondary rhinoplasty the recovery needs more time: the nose is swollen for longer time, its sensitivity takes longer and the final shape can develop later.
THINGS TO DO AFTER THE OPERATION
It is recommended to spend the night in the hospital after the operation which was performed in general anaesthesia. If it was performed in local anaesthesia or intravenous sedation You can go home after the operation. After the nose surgery it is always suggested to relax and spare yourself with due foresight. The first 1-3 days after the operation can cause more inconvenience, but this is just a temporary problem which is caused by the oedema and the bruises. After the plastic correction swelling and hematoma will develop around the eyes. In the case of partial rhinoplasty these malformations are smaller and last shorter time. The initial decoloration and oedema are just temporary and will disappear fast. These are natural consequences of the procedure. The total absorbtion of the hematoma takes 2-3 weeks. After the cessation of the swelling the nose is a little bit swollen, but the formal correction can be seen well and the nose does not make the feeling of an operated external respiratory organ in the outsider. These malformations will disappear without any sign.
Usually it is not necessary to remove the stitches. The internal stitches will absorb by themselves. If there was incision in the columella between the nostrils, these stitches need to be removed after 5-7 days.
In the first few days after the operation it is suggested to sleep with upraised upper body. In the first week it is forbidden to do all those kinds of activities which can cause nasal or facial congestion. For example: strain, whatever kind of intense thermo effect, hot, hot-spiced food and alcohol consumption.
In the first 2-3 weeks after the nose surgery it is forbidden the blow your nose till the total adhesion of the mucous membrane.
It is recommended to use the special plaster in the first two weeks, dependently of the plastic procedure. Six weeks after the operation avoid any stiff sports and physical activity! During this period You have to avoid sunbathing and going to the solarium! 10 days after the surgery you can put a slight make-up which can hide the slight decoloration. It is forbidden to put make-up on the scars.
After every plastic surgical procedures You have to return for follow-up care regularly, thus after the nose surgery as well. The regularity of this depends on the type of the procedure and other personal feautures of the patient. At the previously discussed follow-up cares we will examine the operational area and discuss about the things to do in the future. Please remember that if You have any questions or problems, please do not hesitate to contact us independently the appointment!
The new shape of the nose is visible after 1-3 months but the final shape will develop just several months later because it needs more time that the skin gets the new shape of the osseous and cartilaginous parts and totally fades onto them. We can ensure the 80% of the development of the final shape. The other 20% is influenced by the body’s own reactions (scarring). This little deviation –after the appopriate waiting time- can be corrected with a second procedure. It is suggested to wait at least one year with this because in most of the cases it will disappear by itself.
During the full rhinoplasty we reconstruct the osseous structure as well. The performed nasal bone break will heal with connective tissue not with osseous tissue, thus its resistivity against the stronger traumas decreases. Certainly this does not apply to the every day, normal lifestyle. Fighting sports, ball games and all of those sport activities which are accompanied by close fight or bigger hits to the nose are not recommended because they can cause nasal deformation again.
RHINOPLASTY RISKS AND COMPLICATIONS
If the operation is performed by a qualified plastic surgeon, the operation and the post-surgical recovery period will be without any unexpected episodes. The nose surgery as all other surgical procedures can have complications, even ideally. Besides the generally presented complications ( bleeding, infection, poor healing of incisions ) – which are very rare -, can occur some special complications because of the rhinoplasty, for example: little scragginess on the nose. Directly after the operation snuffles or nasal sloughness can develop, which may require the usage of nasal ointment or nasal spray. Insensitivity is a rare complication which takes short time and will disappear by itself. Among the special complications the most severe is the cartilaginous necrosis which is caused by infection. This can be accompanied by temporary respiratory malfunction. Later, operational correction can be necessary to be performed.
With the most modern devices, materials and stitches which were inserted by the most friendliest techniques it can happen that the colour of the scar will be brisk and red, thick in touch and a little bit widened. This depends on mostly personal liability, thus it can have significant differences. This malformation decreases by the time, thus the scar will be thinner and its colour will lighten. If this does not occur, we remove the scar and treat the new scar with other special scar-treating methods.
The complications can be vanquished or revised with the appropriate treatments and procedures, thus they do not effect the final result of the operation or slightly influence it.
The nose surgery reshapes the nose, thus it makes the face more harmonious and younger. In reasonable cases we can enhance the surgical result by other procedures (Botox treatment and wrinkle filling). The plastic correction of the nose makes women and men more self-confident and gives them back their assurance. You have to know that the operational scars will pale and fade into their environment but never will be invisible.
The result of the nose surgery is final. Changes by normal aging have effect on the nose as well. Gravity and changes in the flexibility and water-content of the tissues, other alterations with aging have effect on the quality and quantity of the facial and nasal tissues. These influence the appearance. If the years let sign on the nose and on the face, other facial rejuvenation procedures can be necessary to be performed, which can reconstruct these signs.