This procedure is known as rhinoplasty and it involves the reshaping of a person’s nose in order to provide it with a more anatomical aspect in accordance with your physiognomy.
There are many rhinoplasty techniques, however they are normally grouped in two types of procedures:
- Open rhinoplasty: An incision in the nasal columella is made in order to approach the different structures of the nose more easily.
- Closed rhinoplasty: the incision is made in the nasal vestibule, thus not being necessary to perform a “visible” incision in the columella .
According to the type of patient, the plastic surgeon will decide which technique is more suitable to obtain the best result in the nasal reshaping. Although rhinoplasty is a surgery mainly carried out on young people, the age range of patients is very wide. It is during the first decades of life when the nasal appendix is a focal point for glances and central axis for human relations. When someone decides to have their nose operated, they must know all the details of the procedure, the advantages and the possible complications, the clinic where it will take place and the postoperative care. Any doubt you may have must be conferred with your doctor or you could even look up information in other sources available to you, like different publications and even the Internet.
Rhinoplasty can be carried out on any adult person who presents a malformation in the natural morphology of the nose, although the most common ages range from 18 to 40 years old.
The ideal patient is a physically and mentally healthy young man or woman who has a big nose (rhinomegaly) and wishes to provide their facial anatomy a more harmonious look. However, if the patient is over 40 years old, this type of surgery will make their face look younger.
In general, this surgery is very satisfactory, but due to the singularity of personal characteristics, each case must be properly personalized and the indication and therapeutic technique for each patient studied carefully.
A nose can be operated on not only for aesthetic reasons, there are as well repairing reasons. A deviated septum, with or without obstruction of the airways, as a consequence of a serious traumatism is an inconvenient sequel that can limit somebody’s life. Thanks to plastic surgery, these post-traumatic nasal malformations can be corrected satisfactorily, improving the existing nasal deformation and the functionality of the organ.
To sum up, both aesthetic and repairing rhinoplasty are procedures that in the hands of a plastic surgeon offer enough guarantees for any person who really needs to benefit from the correction and/or improvement of their pathology or malformation.
In nose surgery general anaesthetics is customary, as it keeps the patient relaxed and fully asleep, with completely absence of pain and it especially allows for total control of the airways, a matter of key importance for the development of the surgery.
General anaesthetics allow the surgeon to act more confidently and above all it provides the patient security.
In some occasions the surgery can be carried out under local anaesthetics together with sedation. This anaesthetic keeps the area to be operated on numb by infiltrating a local anaesthetic complemented with the administration of an intravenous sedative. This gives the patient a state of relaxation and comfort that make the time of the surgery more agreeable.
The decision of what anaesthetics to use depends on the patient’s preferences but the final decision is the surgeon’s discretion.
The complications arising from anaesthetics are rare and they include allergic reactions to the anaesthetics (very rare), postoperative nausea and/or vomits or presence of temporary pain in local anaesthetics.
The breakthroughs in medicine we see everyday have allowed the patient to feel more comfortable in the operating room as the security that drugs and anaesthetics methods presently provide minimize the complications that can derive from any anaesthetic action.
The word rhinoplasty comes from Greek and is used to refer to the surgical art of “modelling” or “shaping” the nose:
RINOS – Nose PLASTOS – Shape
Different surgical manoeuvres might be used during surgery such as filing the back, fracturing the nasal bones to make the nose thinner, reducing the nostrils, raising and sharpening the point, retouching the nasal septum –known as septoplasty- in order to open the airways or to obtain cartilage to remodel the point or the back, etc.
Which manoeuvres must be applied is determined for each patient before surgery and they depend on the patient’s morphology. You will be informed by your plastic surgeon and they will be explained to you for a better understanding of the procedure.
Although it is not an extremely complex surgery, it calls for the expertise and training of the plastic surgeon in this field and as well the right cooperation of the patient. Each surgical manoeuvre serves a definite purpose and they will be chosen according to the patient’s needs, always with the aim of getting the harmonization of the facial features by reshaping the nose.
OPEN OR CLOSED RHINOPLASTY
The surgical decision to carry out an open rhinoplasty or a closed one depends on the surgeon and the type of nose, always taking into account the patient’s opinion.
An open rhinoplasty is carried out through the columella (the frontal part of the nasal septum) and its scar is barely visible aesthetically within a few months; whereas a closed rhinoplasty is carried out through the nasal vestibule (inside the nose) and its scar is invisible. The best type of rhinoplasty is applied to each individual case. The most advisable technique for each case is assessed with the aim of obtaining the most satisfactory and desirable result. Sometimes the nostrils must be reduced, which involves additional external scars regardless of the chosen technique (open, closed), but they are located in the natural fold of skin of the nostrils.
RISKS OF RHINOPLASTY
Rhinoplasty, like all surgeries, implies the acceptance of some risks or possible complications. Although they are rare, the patient must know about them, fully understand them and assume them by signing a an Informed Consent, a written document drafted by the doctor in which you can find the details of the surgery and the risks that may arise as a consequence of such surgery.
The risks of a rhinoplasty are not different form those of other surgeries: bleeding, infection, anomalous scarring, and anaesthetic problems.
To those risks we must add the ones derived from this specific surgery: unsatisfactory aesthetic result (light asymmetries, dysmorphia, cartilage swelling), changes in the respiratory function (obstruction in the airways), unaesthetic scars, etc.
In plastic surgery, we must take into account that we are reshaping an existing nose and not creating a nose “a la carte”. In those cases in which the result is not the expected one, which can vary between a 5% and a 10%, some small retouches can be carried out to get fully satisfactory results.
The postoperative period after a rhinoplasty does not demand great care. During the first days, you must not touch the splint placed over the nose after the surgery, nor the nasal packing (it will be removed within 2 or 5 days depending on each individual case), you will be prescribed only some painkillers and some anti-inflammatories if necessary, as well as some antibiotics if the doctor thinks it fit.
During the first days, the nose and the areas next to it will present swelling and bruising, but they will disappear gradually as time goes by. The nasal splint will be removed after 7-10 days, but you must be especially careful not to receive any kind of traumatism as the pain could be considerable and some possible alterations to the operated structures could happen resulting in a nasal deformity.
You will also be required to avoid sun exposure or UVA rays in order to avoid swelling and a dark pigmentation in the nose skin.
A light massage with anti-inflammatory or moisturising cream will help lymphatic drainage and endonasal washes with saline solution will provide a better lubrication of the nostrils and cleaning of the mucosa.
An important job of the patient after the surgery is to look after their nose.
The results of a rhinoplasty depend on the patient’s and the surgeon’s levels of demand and expectations prior to the surgery.
After a few days, the results are already noticeable but it is not until a year has gone by that they can be considered definitive. Obviously, most of the cases are excellent and the person’s satisfaction is very high when they see that the aesthetic improvement and the harmonization of their faces have been perfectly achieved.
The main goal in rhinoplasty is not to change the face of the patient, but to make their main defect inconspicuous and to improve the general harmony of their faces.
ADAPTATION OF THE NEW NOSE TO THE FACE
The adaptation is fast but progressive. In the beginning, the nose is swollen, in pain and with some bruising, so the result cannot be seen immediately. As the nose goes back to its usual state, the satisfaction of the patient grows as the results can be seen more clearly. The adaptation of the patient to their operated on and aesthetically improved nose will allow them to feel better and more self-confident.
– Information obtained from www.secpre.org