Nose Correction (Rhinoplasty, Septorhinoplasty)

INTRODUCTION


Nose surgery is one of the most common aesthetic surgeries (Rhinoplasty) which often has its functional aspect, besides the aesthetic, in terms of improving the breathing function (Septorhinoplasty). It is also considered one of the most demanding, most precise and most complex aesthetic operations

This is a surgical procedure which can change the size and the shape of both the whole nose as well as a part of it. The nose is a structure in a relatively small area with a large number of different tissues which are in close and complex anatomical and functional relations: cartilage, bones, muscles, ligaments, skin subcutaneous tissue and mucous membranes, but the surgical procedure always affect each of these components to a lesser or greater effect.

Corrective possibilities are numerous and all of them can’t be counted, but the structures which are most commonly corrected are: the tip of the nose, nasal bridge, nasal alas and nostrils, nasal septum and the nasolabial angle. The nose can be shortened or extended, reduced or augmented, straightened, narrowed or widened, the nasal bridge bump removed, the tip of the nose can be reduced, narrowed, elevated or its appearance completely changed, the septum can be straightened and/or shortened, nasal alas reduced, nostrils narrowed and these are only some of the possibilities.

Each face is different and each nose is different, so it’s clear that each nose operation will always be different. A same nose, even if perfect, on different faces won’t always look well. This is why it’s exceptionally important to observe the nose as a part of the whole face, not just an isolated feature, when planning the operation.

PREPARATION


In order to have this procedure, the patient must be 18 years old because then the growth and development of bone and cartilage structures of the nose and face will have been completed. If there are some difficulties in terms of breathing problems, or if there is a previous nasal injury, it is necessary to do an X-ray of nasal bones and nasal septum. Allergic reactions (allergic rhinitis) also has to be recorded, as well as possible previous operations and injuries. Smokers should know that their healing can be slower.

It is very important to understand the wishes and expectation of each patient because it would be useful and desirable to jointly look at and comment photos of noses of various celebrities and non-celebrities which the patient likes.

OPERATION


It is usually performed with general anaesthesia or rarely with local anaesthesia with intravenous sedation. It lasts approximately 2 hours, and depending on the complexity of the procedure it can take twice as long.

There are two main surgical methods, closed and open. With the closed method, all incisions are made within the nasal cavity, so there are no external scars. With the open method, there is a small incision of 5mm in length on the vertical section between the nasal openings – columellas, but it is also virtually invisible after healing. The open method is recommended for extensive work on the tip of the nose, asymmetries, as well as secondary and tertiary rhinoplasty and all those cases where cartilage transplantation is required.

At the end of the procedure, tampons are placed in the nasal cavities, and a compression mask is placed on the nose. The patient stays in the hospital for one day. The tampons are removed after 3-7 days, and the compression mask is removed after 7-8 days.

RECOVERY AND COMPLICATIONS


Swelling and bruising occur around the eyes and the can be of varying degree, which largely depends on the individual reaction of each patient’s tissue. Possible discomforts may include temporary headache, increased lips dryness, weakened sense of smell and numbness. In most cases there is no pain.

Most of the swelling and bruising recedes within 2-3 weeks and the patient can go back to work after that period. Smaller swellings, especially in the nasal tip region, may persist much longer, but they are less noticeable. Strenuous physical activities are not recommended for a month (gym, jogging, fitness, swimming, etc.), and exposure to strong sun should be avoided up to two months.

The physician will give you the necessary instructions on the use of cold compressions, how to sleep, wash your hair and face, etc.

During this period, when the nose is swollen, the patient will find it difficult to wait for the nose to get the desired appearance, so it is very important for the surgeon and their family and friend to show support. Nose healing is a slow process, but it will look better with each day, and after several weeks it will start to take its true form. The final result, however, can be determined only after 6-12 months, which is significantly influenced by factors such as skin type, patient’s age, individual healing ability, etc.