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Anatomy of the Nose

In addition, the procedure to be performed on a patient with thin nose skin and the procedure to be performed on a person with thick skin will be different from each other.

Again, according to the region where the person lives, it is necessary not to go beyond the rules and expectations of the society. For example, while small noses are characteristic in Asia, wider noses are in Africa and longer noses are in Europe. While deciding on the nose shape, a common point should go with the approval with the doctor in line with the patient's medical conditions, expectations and wishes.


Surgical Anatomy Of The Nose

Although the nose does not seem to have a complex anatomical structure like any other organs, it is consisted of many functional and aesthetic details. To be able to perform a Rhinoplasty surgery the structure of the nose should be evaluated thoroughly. Structures that influence the external appearance include the skin, which varies in thickness and the underlying bony/cartilaginous skeletal roof. The soft tissue that covers the nose, external blood supply, external nerves supply should be evaluated all carefully. The tip of the nose is found on the cartilages that support the tip as columns. What we call columella, is the bridge of the tissues that separates the nostrils at the bottom of the nose, is beneath the tip. On the supporting umbrella-shaped cartilage, there is another cartilage that extends upwards and sits on the septum, which is the main supporting cartilage. The cartilage, together with the nasal bone roof, prevents the nasal ridge from collapsing.

In addition, it acts as a hammock to prevent the sides of the nose from collapsing due to negative pressure during deep breathing. It is very important that these two cartilage structures are preserved in functional surgery and that this structure is not damaged while shaping.Inside the nose there is the mucous membrane that covers the respiratory tract.

Moisture-forming cloths are hidden inside to prevent the nose from drying out. Since this mucosa is removed during the operation, the patient may observe a dry inner nose. In order not to experience this adverse effect, the mucosa should be removed very carefully during the surgery.

Another structure that should be considered in the nose in surgical anatomy is the concho. These structures, which grow in nasal curvature and allergic conditions and block the nasal passage, actually take on the task of heating and cooling the air during breathing. In pathological growths, they should be reduced by surgery and the clogged passage should be opened.

In functional and aesthetic surgeries of the nose, the skin that covers all of the above-mentioned structures also has folds that are compatible with the underlying structures. When the nasal skin, which has a very high blood supply, is separated from these structures, it should be covered over the nose to form these folds after the surgery. 

Evaluation Before The Surgery

For Rhinoplasty surgeries, unlike other aesthetic surgeries, patient-surgeon dialogue, sharing expectations, possiblities, the proportion of the patient’s face and are very important. While evaluating the nose structure to be shaped, the ratio of the upper jaw, lower jaw, cheekbones to the nose, and the width of the forehead area are important.

For example, shortening or reducing the nose too much in a person with a long chin may have negative visual consequences. Therefore, focusing only on the nose in nose surgeries can be disappointing even if a good nose is done alone.

In addition, the planned nose shape for men and women are completely different because the nose structure is different in men and women. Uniform nose shape surgeries in aesthetic nose surgeries may cause undesirable results in the long term. As a result, nose shapes differ according to the face, person and expectations. Before the operation, the doctor and the patient should agree. 

Rhinoplasty Prices

Development of technology, globalization, and the increase in doctors and hospitals, rhinoplasty prices are much more affordable than when they were first heard. Before the prices were so high that rhinoplasty operations could only be afforded by people with high income levels until the last 10 years.

Developing technology and ease of access to everything have reduced rhinoplasty prices. As competition between hospitals and doctors increased, discounts, campaigns and payment facilities made the prices of rhinoplasty affordable for everyone. Although the price is important, the priority of someone who decides to have surgery is to find a doctor who gives him confidence and contact him. The most useful formula for someone who decides to have an operation to decide which doctor they want is to look at the price-quality ratio. It should not be forgotten that the importance of health makes small price differences unimportant.



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Rhinoplasty Techniques

There are basically two different surgical techniques in rhinoplasty. Open and closed rhinoplasty

Open Rhinoplasty: It is a surgical technique performed by removing the nasal skin with incisions made from the tip of the nose and inside the nose. 

Closed Rhinoplasty is performed using only incisions made inside the nose. It is a surgical technique that is performed through the space opened between the nasal skin and cartilage and bone structures without completely lifting the nasal skin. 

Surgical Technique

Whether it is open rhinoplasty or closed rhinoplasty, the operation is performed aiming to reach to the cartilages on the tip of the nose. The cartilages form the Nasal Tip. Surgical touches around the area aims to increase or decrease the angle of the nose and the lip or to lift the nasal tip.Since the caartilages are the supporting coloums of the nose, cartilage greft or removal can be performed.The cartilage structure behind and above is the septum cartilage that divides the nose into two.Since most of the curvatures are related to this cartilage, the internal curvatures of the nose are corrected with the interventions made to this cartilage. In addition, this region is a spare cartilage source to be used to support the nose. If needed, cartilage can be taken from this area and used in another area of the nose. 

The place of the removed cartilages is repaired by the body with cartilage formation over time. Above the septum of this septal cartilage are cartilages that support the nasal ridge and are called the upper lateral cartilages. These structures, together with the bone above, are the main cause of the arch. If the arch part is to be corrected in the surgery to be performed, this cartilage part is removed together with the bone or it is collapsed downwards.

The roof of the nose that forms the nasal bone structures is the cause of the hump the patient has. In cases where this bone structure is desired to be reduced and narrowed, it is freed by cutting from the sides and then narrowed in coordination with the cartilages and placed in its new place. What we have mentioned so far are the general applications in the rhinoplasty concept. In the next stage, according to the patient's nose structure and expectations, personalized applications such as reducing the wings of the nose, excisions in the turbinates and supporting the nose with cartilage where necessary are added to the surgery. 

Rhinoplasty surgery is performed under general anesthesia in 1-3 hours depending on the size of the problem. Depending on the anesthesia, the person stays in the hospital for 1 night and can be discharged the next day after the doctor's control. After the first day with painkillers to be used in the hospital, there may be mild pain for the first week. The pain can be easily controlled with prescribed painkillers.

Applying ice regularly to the face after the surgery will accelerate the reduction of bruises and swellings. After the procedure, a silicone tampon and a splint are used in the nose. The silicone pads used have holes that will not prevent the person from breathing. With regular nasal washing after the procedure, breathing can be done easily through the nose.

These silicone pads and splint used will stay in the nose for 5-7 days and then they will be removed by the physician. After the surgery, people can take a shower so that the water does not touch the nose. After the operation, the bruising and swelling will disappear completely within 10 days, and it will take a period of 6 months for the nose to take its final shape.

After Rhinoplasty

Rhinoplasty surgery is performed under general anesthesia in 1-3 hours depending on the size of the problem. Depending on the anesthesia, the person stays in the hospital for 1 night and can be discharged the next day after the doctor's control. After the first day with painkillers to be used in the hospital, there may be mild pain for the first week. The pain can be easily controlled with prescribed painkillers.

Applying ice regularly to the face after the surgery will accelerate the reduction of bruises and swellings. After the procedure, a silicone tampon and a splint are used in the nose. The silicone pads used have holes that will not prevent the person from breathing. With regular nasal washing after the procedure, breathing can be done easily through the nose.

These silicone pads and splint used will stay in the nose for 5-7 days and then they will be removed by the physician. After the surgery, people can take a shower so that the water does not touch the nose. After the operation, the bruising and swelling will disappear completely within 10 days, and it will take a period of 6 months for the nose to take its final shape. 

FAQs

Is there an age limit for rhinoplasty?

Rhinoplasty should be applied immediately in cases of severe nasal obstruction and difficulty breathing. But, if the nose does not cause any health problems and the surgery is performed for aesthetic purposes only, the person should wait until he/she finishes his/her body development.

Can the patient choose the shape of his/her own nose?

The shape of the nose is determined by considering the patient's desires and expectations in beside the doctor's advice, one of the most important factors in deciding the shape of the nose are gender, face shape, and skin type. 

Is it possible to obtain a natural-looking nose with rhinoplasty?

If the patient wants a natural-looking nose, he/she should inform the doctor about that. The shape of the nose can be shown to the patient in advance before operating using computer programs, Thus, the patient has the chance to see how the nose will be made and can share the points he/she wants to change with her doctor and have a natural nose. 

When will the bruises and edema pass after rhinoplasty?

There will be edema and bruises for up to 1 week postoperatively, but these bruises and edema will disappear over time. 

How long does a rhinoplasty take?

The duration of the operation varies from 1 to 3 hours depending on the technique used and the procedures will be performed. 

Why is revision(secondary rhinoplasty) surgery performed?

Patients who have had a previous rhinoplasty but are still not satisfied with the results or who have health problems such as breathing difficulties after surgery can have a second rhinoplasty to fix these problems, the second rhinoplasty is called revision rhinoplasty

Will be there any scars after rhinoplasty surgery?

There won’t be any clear visible scars after the completion of the surgery and recovery period. 

What is nose filler?

It is the procedure of injecting filler into the depressed areas on the nose to correct the shape of the nose by filling the depressed areas caused by the nose bridge. 

What is the non-surgical rhinoplasty?

It is a non-permanent technique applied to patients with small nasal complaints. Since it non-surgical operation there won’t be incision and suture, only the filling material or dermal filler is taken from the patient's own body and injected to the area where he/she is complaining about. The permanence of non-surgical rhinoplasty differs on the filler materials used. 

Is rhinoplasty painful?

Due to the surgical interventions made on bones and tissues, minor pains may be felt for a few days after surgery, but these pains can be easily controlled with painkillers. 

What is the reason behind bruising post-rhinoplasty?

The amount of swelling and bruising varies depending on the performed techniques during rhinoplasty. Having swelling, bruising and edema post-rhinoplasty is normal due to the interventions performed on cartilages and tissues. This bruising, swelling and edema will fade rapidly. 

When will the tampon and splint be removed? Is this procedure painful?

The tampon and splint are removed 4-6 days post-rhinoplasty and the procedure of removing them are not painful. 

What is the duration of stay in hospital after surgery?

It is enough to stay in the hospital for 1 night after rhinoplasty. The patient is discharged the following day after undergoing all the check-ups. 

Does rhinoplasty solve breathing problems?

If the breathing problem is caused by the deformities of the nose, the problem can be easily solved by rhinoplasty

When can I return to my daily life after surgery?

The patient can return to his/her daily life right after being discharged but usually, patients do not prefer to go outside while the tampon and splint are still there. The tampon and splint are removed approximately 5 days post-rhinoplasty and a small tape will be placed on the nose, this tape is removed approximately 14 days post-rhinoplasty. which means the return to daily life is up to the patient. 

What is the best season for rhinoplasty?

Rhinoplasty can be performed in the 4 seasons but we can say that the best seasons to undergo rhinoplasty are winter and spring due to the necessity of protecting the nose from sunlight post-rhinoplasty. Patients who want to have rhinoplasty in summer should protect their noses from sunlight especially for the first 1 month after rhinoplasty.

Can the final result of rhinoplasty be seen through the nose job imaging systems?

An exact result should not be expected because these digital images are mostly two-dimensional and are intended to elucidate the general shape of the nose lines desired by the patient and to make the final decision by both the patient and the doctor.

Recently 3D images have also appeared, but as mentioned previously, an exact result should not be expected. These images are used to show the things to be done during the surgery and to show an approximate result.  

Is there a risk of having Secondary rhinoplasty Surgery?

If the nose shape was not satisfying after the operation or a pathological problem is encountered, a second operation can be performed. However, the second surgery is much more difficult than the first one, that’s why the first surgery should be performed very carefully.

If the first operation was not successful, when should I have the second operation?

If necessary, a second operation can be performed after 6 months or 1 year after the first operation.  

Are there alternatives to surgery?

As alternative methods, there are methods such as nose fillers and nose hanging, but the results of these methods are not permanent and their complications are quite high. 

How many times do I have to come for check-ups after surgery?

Check-ups in the first 10 days are very important, in the period it is enough to make check-ups once per month. After that, the patients go to check-up once every 3 months, the patient will continue having check-ups for a year. However, the appointments of check-ups can be changed according to the state of communication between the patient and the doctor. For example, if the patient is living abroad and cannot come for check-ups continuously, the doctor can check-up the patient by sending him pictures taken in specific positions as requested by the doctor. 

Facts about rhinoplasty

Everyone cares about his appearance, facial and body beauty and wants to have proportional facial features. The nose is the organ that most affects the aesthetic appearance of the human face.

With advanced technology and techniques, rhinoplasty surgeries have become much more painless and easier, which has motivated and increased the demand for people who want to have the nose they dream of.

Previously, rhinoplasty was not preferred by males, but when some celebrities performed a rhinoplasty and started sharing and publishing their before and after operation photos on social media rhinoplasty became highly desirable by males.Rhinoplasty is one of the most desirable cosmetic surgeries.

Choosing the right doctor is very important in rhinoplasty so when choosing your doctor, you can get advice from people who have had rhinoplasty surgery and were satisfied with their doctor.

The best doctor for rhinoplasty is the doctor who gives you the most confidence. Before you decide where to have your rhinoplasty, you can ask to see the before and after photos of rhinoplasty performed by the doctor you want him to perform your rhinoplasty.

One of the most asked subjects about rhinoplasty is the prices. Prices vary according to many factors as we mentioned above. Even the price of rhinoplasty in Istanbul may differ from the price in other cities because of the rent and expenses in Istanbul are higher than in other cities. 

estetik cerrahi

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