The aim of rhinoplasty is very important. What is the meaning of beautiful nose? Does it mean ideal forms and proportions? Or does it mean finding the most compatible form for face features under the guidance of an expert?
This is vital because those questions should be addressed before the nose surgery with the help of pre-operative planning. That affects patient satisfaction and success rate of a surgery.
When we follow standard medical procedures, we will provide healthy nose functions, beautiful and natural looking nose and an easy recovery process. During this procedure, a facial analysis is performed to examine skin condition, skin thickness, cartilage strength and nasal airway due to avoid breathing problems. After facial analysis, the bridge of the nose is evaluated and the ideal place is determined for it. In case of an aquiline nose, the humb is removed or filed down. In case of broad nasal problems, the nasal broadness is narrowed down. Likewise, just the opposite is also possible if needed. The correlation between the bridge and tip of the nose is evaluated and the angle can be adjusted depending on the gender. The angular point is often flat or flattish for male patients, while female patients mostly desire for supra tip break point which makes sure the tip of the nose is slightly up than the bridge of it. Contrary to popular belief, if the tip of the nose is tilted not from there but by over increasing the nasolabial angular point (that is, by uplifting the upper lip), the result would be a “hog nose” as it is named colloquially which might be aesthetically beautiful in profile but not from a frontal view as the nostrils would be visible. The tip of the nose can be touched to reshape, esspecially more round look can be achieved from sharp looking which will give more beautiful and natural look. Nose wings can be narrowed down and nostrils can be shrinked if they are too large. The airway is also intervened to solve any existing breathing problems.
Before the surgery, patients’ expectations and complaints are listened with the help of detailed examination. During this examination, the nose is evaluated in terms of aesthetic/cosmetic look and breathing problems. Because if there is a breathing problem, plastic surgeons can fix it during the aesthetic surgery. Pictures of the patient are taken for a detailed facial analysis and ideal nose, in line with patient’s facial characteristics, is discussed and determined. Personally, I check patients picture before the operation, and show how it will look like after the operation with the help of digital tools. This also helps me to understand my patients’ expectations. Of course, patients get answers to their questions and get rid of their worries after seeing the simulation. Patients who smoke are supposed to quit smoking 6 months before the surgery and not smoke for a long time after the surgery since smoking blocks healing process, causes problems during awakening and has many other harmful effects on health.
Surgery can be performed under local or general anaesthesia depending on the procedures. There are 2 main different techniques are used for rhinoplasty / septorhinoplasty surgeries. One of them is the “Open Technique” and the other is the “Closed Technique”. The open technique in rhinoplasty basically involves an incision on columella which is at the tip of the nose. While the closed technique in rhinoplasty involves incision only in the inside of the nose. Since the open technique is surgically easier, it is more common. However, personally I prefer “Closed Technique” because the open technique leaves surgical scar at the tip of the nose, but closed technique does not. So, with the help closed technique you will not understand if a nose has been operated. Moreover, since the veins passing through the tip of the nose are not damaged with cutting in the closed technique, the healing process is faster after the nose operation. The nose is much less swollen and it heals faster. For patients who have only breathing problems, surgery is performed with less trauma by endoscopic nose surgery techniques.
Nose operations last between 30 minutes to 2 hours, which has been an issue for patient’s relatives waiting outside the operating room. Patient’s relatives waiting outside the operating room begin to worry and think something has gone wrong if it takes more than that timing. Surgeries are like air travels. Travelling from Istanbul to Ankara takes 1 hour on the air, but there are surely times you need to spend before and after the flight. All in all, this flight takes up to 3 hours. Also in each surgery, there are certain things we need to do like; preparing the room, anesthesia process, awaking process, transferring the patient to the room…This timing may seem very long to the patients’ relatives, but it is normal process and timing. Therefore, I explain this in details to my patients to set the right expectation. I want to say patients who has tomophobia that with the help nowadays technology and improvements it is easy to handle pre and post operation phases.
Patients can be discharged from the hospital on the day of operation or one day after the rhinoplasty. This fact shows you having a nose surgery is not scary as it seems. It is not a barrier for traveling. If there is an aesthetic surgery, we use a cast during 1 week. If it is a surgery for breathing problems, new generation, modern silicone tampons are placed inside of the nose just for 2 days. I do not prefer using some extra bandages after removing the cast 1 week later. On the contrary, I do recommend some massages and tell patients to protect their noses against any external factors. Patients can do the followings at home; take a shower one day after the surgery. If the patient still has a cast on the nose, hair should be washed with head back, like hairdressers do. Nose should not be touched with the water. Body can be washed anytime. Since the first 48 hours following the surgery is the healing process, swelling on the nose will increase progressively. That is why we use cast to minimize this. But nearly 80-90% of swelling will go away in the coming 2 months. The cast is removed after 7 days of nose surgery. After removing the cast there will be minimum swelling and most of it will go away in 2 months after the surgery. Until the cast is removed (first 7 days after the operation), the patient should put pillows on her/his back. With the help of this there will be less swelling. In addition, ice can be applied to the face after the operation to minimize the swelling. The patient can get back to her/his daily life next day after the surgery. Once the cast is removed, nothing remains to prevent patient from doing whatever he/she does in social or professional life. In other words, there will be no visible bruises and swellings on the face 1 week after the surgery. Of course, the given time may vary depending on the severity of operation, atraumatic technique used by the surgeon and the healing capability of the patient.
Septum is a partition seperating two chambers, such as that between the nostrils. Septoplasty is a corrective surgical procedure to straighten the nasal septum and eliminate difficulty in breathing.
Rhinoplasty is an aesthetic surgery procedure for reconstructing the form of the nose. Surgical complaints may vary by area, therefore if a surgical intervention only in the tip of the nose, it is called tip plate/mini-rhinoplasty.
It is a surgical procedure applied to correct difficulty in breathing, restore functions and reconstruct nasal form. This is one of the most common surgical operations.