Rhinoplasty (Nose Jobe)

The most distinctive feature of one’s body is the face, and the most prominent organ of the face is the nose. The nose is often referred to as an aesthetic organ but in the face area, it is one of the structures that have very important functional properties in our bodies. The aesthetic and functional problems of the nose might be acquired or congenital, people resort to Rhinoplasty surgeries to get rid of these problems and get the nose shape they dream of.

Anatomy of the Nose

Even if the nose does not seem to have a complex structure like other organs, it has very fine functional and aesthetic details. The nose roof forms cartilage in front, bone structure in the back and above.

The cartilage and bone structure in the center of the nose provides strong support for each other. The cartilage structure is not monolithic but differentiated in different shapes and designed in different thickness and character.

The cartilage that forms the nose tip is located in a place that allows it to hold the tip of the nose and the nostrils. There is also the bridge of tissue called “Columella” which separates both nostrils from each other.

Above this cartilage another cartilage extends upward and lay over the septum, this cartilage and roof bones prevent collapsing of the nose surface. It also acts as a hammock to prevent a collapse of the nose edges due to negative pressure during deep breathing. It is very important to preserve these two cartilage structures during the surgery.

Mucous membranes are covering the respiratory tract in the inner part of the nose. These membranes contain moisty secretion glands to prevent dryness of the nose.

Since this mucosa will be removed during the surgery, nasal dryness may be seen in the postoperative period. Therefore the mucosa must be removed very carefully To avoid this negative effect.

Another structure that should be considered in the nose anatomy is turbinates… These structures grow in Nose curvature and allergic conditions and obstruct the nasal cavity, actually undertake the task of heating and cooling the air during breathing. In the case of pathological growth of turbinates, they must be reduced by surgery and the obstructed nasal cavity must be opened.

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

The Evaluation Before Rhinoplasty

Rhinoplasty is somewhat different from other cosmetic surgeries. The patient should tell his/her doctor about his/her desires, in return, the doctor will explain things that can be done to the patient because the consistency of the nose shape with the rest of the face is very important. also considering the upper jaw, lower jaw, cheekbones nose and width of forehead area are important When evaluating the nose structure to be shaped.

For example, shortening the nose for a person with a long jaw may have negative consequences in terms of appearance. Therefore focusing on the nose shape while planning for rhinoplasty might be disappointing even if we got the shape of the nose we wanted.

Also, the shape of the nose will be completely different in both men and women because the structure of the nose is already different between them. in the long term, undesirable results may occur in case the surgery is performed to change the shape of the nose tip only.

As a result, the shape of the nose varies according to the face and desires of the patient that’s why the doctor and the patient must fully agree on the details of the operation before performing it.

Techniques of Rhinoplasty Surgery

There are two different surgical techniques in rhinoplasty which are the Open and Closed rhinoplasty.

Open Rhinoplasty

Which is a surgical technique performed by removing the nasal skin with making incisions from the nose tip and from inside the nose.

Closed Rhinoplasty

Which is a surgical technique performed by making incisions only from inside the nose. It is performed through the gap between the nasal skin, cartilage and bone structures without removing the nasal skin completely.

Let Down Rhinoplasty

Surgery technique

Regardless of the technique performed (Closed or Open)After entering the nose, the cartilages at the tip of the which is the cartilages that form the nose tip are reached.

The surgical interventions made here are made to increase or decrease the angle between the nose and the lips or to raise the nose tip.

Since they are structures that support the nasal wings functionally, cartilage extraction or cartilage insertion can also be performed if required.

The septum cartilage lay Right behind these structures, most of the nasal curvatures are associated with this cartilage, therefore inner septum curve can be corrected by performing surgical interventions to this cartilage.

However, this region is also the source of replacement cartilages that can be used to support the nose, cartilage can be taken from this region and placed in another area of the nose If needed and new cartilage is created by the body instead of the taken one over time.

The upper lateral cartilages which lay over the septum cartilage and support the nasal ridge above the septum and the upper bone are the main cause of the nasal hump.

If the nasal hump will be corrected during surgery, this cartilage should be taken out with the bone or dropped downwards.

The bone structures that form the nasal roof are the cause of both curvatures and hump of the nose. This bone structure is reduced and cut from the sides in case the nose will be narrowed, after that the cartilages are coordinated and placed in their new place.

These are the general applications in the concept of rhinoplasty. The following applications to be performed such as shrinking nose wings, excision of turbinates, and supporting the nose with cartilage if necessary are added to the surgery depending on the one’s desires and nose structure.

Period After Rhinoplasty Surgery

Rhinoplasty surgery performed under general anesthesia and it takes between 1 – 3 hours depending on the size of the surgical intervention will be performed.

The patient should stay in the hospital for 1 night due to general anesthesia and he/she may be discharged the next day after the doctor’s check. There might be slight pain for the first week.

These pains can be easily controlled by taking the prescribed painkillers.

Post_op regular ice application over the facial area will accelerate the reduction of bruises and swelling. also, silicone tampon and a splint will be placed after surgery.

The placed silicone tampon has holes that do not prevent the breathing process of the patient. This splint and tampon remain for 5 – 7 days after that they will be removed by the doctor.patient can have a shower after surgery in a way that water does not touch the nose.

Post-operative bruises and swelling will disappear completely within 10 days, and it will take about 6 months for the nose to take its final shape.

FAQ

There are some factors should be considered when planning the shape of the nose such as Gender, face structure, also social and cultural characteristics can be mentioned. Rhinoplasty planned for a male nose should be different than the rhinoplasty planned for a female nose. A person with a long face should have a different nose shape than a person with a rounded face. Still, we should not go beyond the rules of the society where the person lives. For example, while people in Asia are characterized by small noses, people in Africa characterize with wide noses and long noses in Europe.  We shouldn’t go too far beyond these features. When deciding the shape of the nose, the patient’s desire and expectation should meet in a common point with the doctor’s opinion according to the medical conditions of the patient.

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.

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.

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.

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

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

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

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.

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.

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.

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.

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

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.

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

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.

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.

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.

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

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.

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.

  • 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.