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Rhinoplasty

Rhinoplasty

Rhinoplasty is the operation of reshaping the nose by shaping the cartilage and bone structure (enlarging, reducing or changing the shape). Nose size can be reduced, enlarged, nostrils can be reduced, nose tip can be reshaped, the proportion of the nose to lips and forehead can be corrected in a way to provide compliance between the nose and face. The cartilage and bone curvature distorting the symmetry are corrected both internally and externally. The aim is to obtain a nose which is proportional to one’s face, well-angled with forehead and lips has re-shaped nasal tip and can function properly. Rhinoplasty makes your appearance more beautiful.

Rhinoplasty is difficult because the bones and cartilages forming the structure of the nose are arranged in a special 3-dimensional structure and act independently of each other but as a whole. Since the nose allows us to take a breath, the operation must not disturb this function. For this reason, rhinoplasty requires the second revision most around the world.

How is rhinoplasty performed?

The operation is performed in two methods. Open and closed techniques.

In the closed technique, all incisions are located inside the nose. There is no permanent external scar. In cases where we only need to reduce the nostrils, an incision is made on nasal wings and there is a scar on the nasal skin. In the closed technique, it is possible to shape the nose by giving a minimal damage to the structures that allow the cartilage and bones to stand independently from each other but as a whole. If you know where to make the appropriate action, the closed technique is not a difficult technique where swelling is less and naturalness is more.

In the open technique, an incision is made from the tissue on the midline of the nasal tip and nasal skin is striped, the whole anatomical structure is seen more clearly. However, the 3-dimensional structure of the nose is damaged meanwhile, and the nasal structure is reshaped with several stitches at the end of surgery. This manifests itself with harder recovery tissue and more swelling. Operations performed with open techniques require a longer time for the nose to get the normal tissue softness.

Regardless of what technique your surgeon uses, it is important to respect the tissues to pay attention to the facial proportions while shaping the nose and not to reduce the nasal cartilage and bone structure irreversibly.

How is the pre-operative period?

The pre-operative procedure starts with interviewing your doctor. This interview is important for you to understand your wishes and what you expect from this operation and to understand your doctor. Rhinoplasty is the most difficult operation in terms of plastic surgery. The result of the surgery depends on the professional knowledge and experience of your doctor and the techniques which are applied when shaping your nose. Besides, your nasal structure is very important as well. Everyone’s nose has a different cartilage-bone size, shape and different skin structure. Corrections that are needed to be made in every nose are different from each other. “Less is enough” in rhinoplasty, in other words, cartilage and bone tissues should be reduced in a controlled way and the nose should not be reduced excessively. Thus, you do not have a nose with a caved shaped, tiny nasal tip and nostrils that are seen directly when looked from the opposite direction. The most important point that you need to specify during the interview is to describe what kind of nose you do not want to obtain after the surgery. Your surgeon will also describe where and what changes to be made and explain the approximate result by making an examination.

It is possible to display the post-operative view of the nose approximately by working on photographs which are taken from sides, thanks to certain computer programs. However, these programs are two-dimensional, and you can only see the sides of the nose; it may not be realistic because 3-dimensional images are not possible.

Should the surgery be performed under general anaesthesia?

In recent years, there is a concept called as nasal tip aesthetics. We can achieve satisfactory results by making an intervention only on the nasal tip in very few people. Because the nose is a whole. While shaping the nasal tip, the residue bone and cartilage tissue should also be compatible with this shaped tissue. If a very little intervention is to be made on the nose, it can be performed under local anaesthesia. It is appropriate to perform rhinoplasty under general anaesthesia.

Is nasal packing uncomfortable? Is it very painful to remove?

We now use soft materials which are in the shape of a leaf, have a groove in the middle where the patient can get a breath and are easy to remove. In this way, such legend as “I have suffered a lot while packing is removed, even more than the operation” has come to an end.

How is the post-operative period?

After the operation, you come to your bed with a supportive material (splint) placed in your nostrils to protect your nasal shape and with silicone packing. There may be pain and tingling, headache, sense of fullness, sleep disorders and nausea during the first night. There may be a mild blood leakage from the nasal tip. Swelling may increase on the 2nd day. A bruise can be seen which varies from person to person. Swelling and bruises on the face disappear mostly within 10 days. Patients can return to work after the 5th day. You can go on a walk 2 weeks after the operation and start more physically demanding sports after 6 weeks.

Splint on your nose will be removed on the 7th day. However, when it is removed, you will see that your nose is swollen. The nasal tip and nasal root are swollen at most. Swellings are significantly reduced in about 2 months, but it is necessary to wait for 6 months to achieve the final shape of the nose.