What is Rhinoplasty Surgery?
Rhinoplasty is a nose reshaping and restructuring surgery. The main goal to re-make the nose to appear functionally and aesthetically better.
The nose is an organ located in the center of the face and plays a very important role in facial appearance. Each nose has a unique shape. Even small changes in the nose can affect facial appearance. People often want to have rhinoplasty surgery to regain the ideal nose shape. The harmony between generally accepted proportions and parts of the face can be the key to a beautiful look. Although it is accepted that many people with an attractive appearance have harmony in their faces, it is not possible to talk about a standard of beauty adopted by all people
The fact that the nose is located in the middle of the face in both horizontal and vertical plan has made it the center of attraction. The nose consists of skin, subcutaneous, muscles, bone-cartilage skeleton and mucosa, respectively, from the outside to the inside. Inside the nose, there is a wall of cartilage and bone called the midline septum. On the outer walls, there are functional structures called concha that heat and humidify the breathing air. One of the most important factor is ‘’Skin thickness’’ which is determining rhinoplasty results. The bone-cartilage skeleton changes during surgery. While it shows all the changes under the thin skin, thick skin may prevent the changes made. Medium skin thickness is best for a better result.
What needs to be considered before the procedure?
Before having a rhinoplasty surgery, it is very important that you inform your doctor who will perform your surgery with all your complaints that lead you to this surgery.
In addition to the problems you want to be corrected due to aesthetic pain, if you have complaints such as nasal breathing, runny nose, nasal discharge and headache, it will help your doctor to resolve your other problems in the nose area during the surgery.
Please consult your doctor about the problems you have identified personally and the changes you want to make in your nose shape and exchange ideas together. Whether your expectations from the surgery match your current facial aesthetic proportions and normal nasal functions, as well as the possibility of surgical techniques should be clearly stated by your doctor. Avoiding post-operative disappointments will be possible by making this discussion adequately and by mutual agreement with your surgeon who will perform the surgery on the planned changes.
At this stage, measurements to be made at the points determined on your photographs, your existing face and neck measurements, and the appropriate measurements of your nose according to your face can be calculated.
Although your preoperative evaluations and photo shoots are made in an upright position, it may be difficult to decide on the amount of tissue to be removed, especially due to the injections made during the surgery and the skin edema that may occur. For these reasons, in order for your surgery to result in the desired way in the long term, the necessary calculations and planning should be done before the operation and your surgery should be performed in accordance with this plan.
While some problems that seem to be very large by the patients can be corrected by applying a simple surgical procedure, some problems perceived as very minor can be partially corrected with a difficult and long surgical intervention. Considering the long healing process after rhinoplasty and factors such as the tissue characteristics of the patient and the healing properties of the wound, it may be necessary to perform a small corrective operation after the completion of the recovery, at an average rate of 5-15% in all aesthetic nose surgeries.
The first two days can be a little difficult, but it is usually not painful (the level of pain is defined by most patients as 3-4 out of 10. Make sure to use your medications to relieve pain). You may feel nauseous. Not being able to breathe through your nose but mouth can make it challenging for you to sleep.
To minimize swelling, sleep with 2 large pillows. This also helps reduce bruising and limits bleeding.
You can return to your daily activities on a basic level after the first day. Be advised to not bend, play with your nose, and not to lift anything heavy. Here, the word heavy can be known as anything heavier than 2 kilograms.
If you have a tampon in your nose, it should be removed on the second day thus you are advised visit your surgeon.
You will feel your splint loosen in 4 to 7 days.
At this point, you will be able to see that nose started to take its new form. The swelling will still continue. However, swelling is generally symmetrical.
You can return to work (or school). Besides, you advised not to lift heavy objects and avoid exhaustive activities. However, in some cases, patients may be asked to take 2 weeks off for recovery.
To be able to avoid sunburn, you are advised to avoid the sun for at least two months, wear a hat or use sun screening creams.
Towards the middle of the second week – 10 days after the nasal aesthetic surgery – the bruises usually decrease significantly. Generally, after 1 week or less, swelling and bruises become almost unnoticeable. If you are one of the patients who are recommended to take 2 weeks off, you can return to work or school on the 14th day.
For contact sports or very heavy exercises, you should wait at least 1 more month. If you wear a protective mask, you can return to sports sooner. Follow your surgeon’s recommendations throughout the healing process. In this process, most of the swelling will be over. The swelling which is at the tip of the nose will take long time to heal. As the days pass, you will see that your nose becomes more elegant.
Between 2 – 3 months you will start to look better every day. At this point, the swelling in the nasal arch disappear almost completely. The tip of your new nose may still be a little numb but the feeling will pass over time. Even if you have an open rhinoplasty, your surgery scar will be hardly visible to naked eye.
After 12 months of your rhinoplasty operation, almost all of the swelling in your nose will dissapear. At this stage, you should be examined by your surgeon to evaluate your surgical result and to check the scar tissue.
- The patient can return to normal life, as the molds are removed after one week.
- Light exercises can be performed such as walking only after 1 week of post-op.
- Any type of activity that is exhaustive have to be avoided at the first stage.
- You can swim with the head out without diving deep.
- Two days after the operation, you can take a shower with the head back. Only after one week later you can start to have a shower.
- You are advised to visit your surgeon at the first, third, sixth and first year of your operation.
The cartilages in the structure of the nose undergo a change with aging. Therefore, just aging causes our nose to sag a little. Trauma of these cartilages due to an accident or surgery, accelerates the changes that come with aging (apoptosis). Therefore, the nose becomes more sensitive and fragile after aesthetic nose surgery. While it takes about 2-3 months for the swelling to go down, the nose takes a much longer time, such as a few years, to take its final shape. In this process, the prominent changes are millimetric dissolution of cartilages and soft tissue changes. While the cartilage changes cause the nose to shrink a little more and weaken the cartilage support and fillings, soft tissue changes differ according to the skin type. If the post-operative edema cannot be resolved by massage and other methods in thick-skinned noses, this swelling can turn into a permanent tissue and make the appearance of the tip of the nose rough. In thin-skinned noses, it may be possible that the skin adheres to the underlying bone and cartilage tissues and creates unwanted indentations and protrusions after surgery.
Although everything has been done after aesthetic nose surgery, the complaints of inability to breathe may not go away or may become apparent. The reason for this may be the recurrence of the corrected curvature due to the cartilage memory or the edema of the mucosa in the nose due to allergic or other reasons.
In noses with prominent curvature or asymmetry from the outside, even if everything is corrected during surgery, full recovery may not be achieved due to soft tissue recessions and cartilage memory during the recovery period. This is especially true in patients whose nose has been curved since childhood.
In cases where the nasal bones need to be broken, there are other risks brought by this breaking process. If a controlled fracture has not been achieved (due to previous fractures, etc.), it may be difficult to maintain symmetry. Again, crushing creates more swelling and edema; In the postoperative period, discoloration may occur under the eyes, especially in patients with dark skin color.
You can view other problems that may arise in aesthetic nose surgeries from the informed consent form. Legally, you should read this form in the first interview, ask your doctor about the parts you do not understand, and he should also specify the risks that may come to the fore, especially in your case.
In order to correct the problems that may arise due to all these reasons in aesthetic nose surgeries, lightening creams, steroid injection, filling material application, a second surgical intervention under local or general anesthesia may be required.
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