|
Plastic Surgery of Nose
(Rinoplasty)
Plastic surgery of nose is
the most preferred plastic
surgery by both women and
men.
PLASTIC SURGERY OF NOSE
The process in rinoplasty is
reshaping the nose by
changing the structure of
bones and cartilages. To
acquire a more aesthetic
nose shape, we sometimes
need to cut the bones and
cartilages. Sometimes,
unlikely, we need to fill
the gaps and change the
shapes.
It is better to accept that
rinoplasty or plastic
surgeries of nose are the
most difficult surgeries
with a lot of unknowns.
WHY IS PLASTIC SURGERY
DIFFICULT?
Plastic surgery of nose is
hard because nose is like a
closed box and you have to
make the operation from just
one side of that box. There
are lots of unknowns in this
surgery because the bones
and cartilages that form the
frame of nose present as a
complete but they are
independent from each other
and they may act different
in the recovery period.
Because of that reason it is
the plastic surgery which
the revision, namely
readjustment operation is
implemented the most. A
doctor in world class is
accepted that he has to make
a revision on a patient in
every ten. On the other hand,
when this surgery is carried
out well, it has really good
results.
SURGERY
Rinoplasty surgery can be
performed by two techniques
which is open and closed
techniques. By the closed
technique all the cutting is
made inside the nose.
Surgeon fulfills the surgery
by working inside. By the
open technique a 3-4mm
cutting is made to open the
tip of the nose.
The difference between two
techniques is related to the
domination of the doctor on
the technique. The closed
technique which is made from
the tip of the nose is more
like making the surgery in a
bottle. There will be no
problem if you just plan to
extract something from
inside the bottle.
Nevertheless, it is really
hard if you want to build a
ship model inside. By the
open technique surgeon can
see the front 2/3 part. It
has been always a discussion
among the doctors that which
technique is better and
there is not a conclusion
yet.
As you can understand from
the definitions that I made
my choice is open technique.
The reason for that is that
I do not believe it may
result well if you perform a
surgery like that which you
should do no mistake,
without seeing. It is
already a fact that even the
closed technique supporters
cannot object, lots of
surgical maneuvers and
corrections which cannot be
even imagined in close
technique. I believe that it
reduces the possibility of
revision after open
surgeries.
The greatest handicap of
open technique is that it
leaves a scar on the tip of
the nose. Bur this becomes
almost unclear after a well
done operation and it
remains under the nose. The
majority of the patients
forget about it afterwards
the surgery.
About this topic you should
consult to your doctor
though and you should trust
in him. All the surgeons
will take the best results
by the methods that they
know the best. That I
explain above is just my
opinions.
I SEE VERY BAD SURGERIES,
WILL I BE THE SAME?
I also see noses which are
unnatural, very small and
when looked across the
nostrils can be seen. I told
you in another page how you
figure out a nose operation
that is made bad. Remember
that the result of the
surgery is dependant on the
techniques, skills and the
desires of the doctor.
Giving an upturned nose
shape just by minifying the
nose results an unnatural
appearance. With modern
techniques, the location,
place and shape of fibers
can now be changed almost
without taking anything out.
If you inspect this pattern,
you can see one of the most
often done mistakes. This is
the method which is mostly
used in old techniques. In
past, in order to indicate
the nose as upturned, the
nose was minified as much as
possible and the starting
point of the nose was taken
as low as possible. Thereby,
nose would have created an
illusion as if it is
upturned but the result
would have not been natural.
What is essential is to
start the nose where it
should start from the point,
namely to start from same
level of the pupils and give
all the shape with respect
to it.
HOW CAN I FIND OUT HOW
WILL MY NOSE WILL BE AFTER
THE SURGERY
There are computer programs
for that purpose. Your
doctor will probably make
sense about it by one of
those programs. But with
those programs, a real
surgery plan cannot be made
but just a common opinion.
Your doctor would want to do
some measurements on your
pictures he is using one of
the techniques that is
dependant on measurement. In
order to do this, he will do
the measurements by making
you hold a scale while he is
taking pictures or he is
going to print the picture
in real size.
I do sensitive measurements
before the surgery and
calculate the golden ratios
and ideal face profile. With
the results of my
calculations I draw a
profile picture with my hand.
For the details of profile
work, click here.
COMPICATIONS AND PROBLEMS
THAT CAN OCCUR
The risk of bleeding which
is in every surgery can be
more serious in rinoplasty.
Especially if some
operations other than
plastic surgery will be done
in order to get rid of sinus-if
it is necessary, it should
absolutely be done- the risk
of bleeding increase. Nose
is an organ which contains
medium size veins inside.
But generally this kind of
bleeding does not become
dangerous and can be stop by
simple tampons. After the
operation, adherences could
occur which is called sineţi
in the respiration ways and
those could make you inhale
harder than before operation.
The treatment of it is
generally easy but a second
surgery would be essential.
There could occur a whole in
the part called ‘septum’
which forms the middle of
nose. Usually this is not a
problem but causes some
noise when inhaling.
Treatment of it is hard and
it needs re-operation.
At nose there occurs almost
no infection. This organ is
strong to bleed and
resistive to inflammation.
If there occurs infection
then you can get in the
medicine literature.
Nevertheless, after the
operation, if you have
aesthetic problems,
deformations or you do not
like the shape of your nose
nobody will get surprised.
So, the most often
complication of this surgery
is aesthetic.
|
|
OFFENLY ASKED
QUESTIONS
Should this surgery
be done by a plastic
surgeon or by a
specialist of ear-nose-throat
(ENT)?
Your doctor can be a
plastic surgeon or
ENT specialist. I
recommend you to
have it by a plastic
surgeon though, but
there are some ENT
specialists which do
this surgery very
well. But this is
not a surgery that
you can say ‘while
we are doing this
surgery let us take
this bone out also’.
Sometimes it is
really hard to
correct this kind of
retouching. Talk to
your doctor
everything in detail.
Do you break the
bones?
We do not break the
bones. If we want to
reshape or take some
parts out, we cut
them. For this use,
we use thin cutters.
Sometimes bones are
being rasped.
Can this surgery
be done by local
anesthesia?
If it is going to be
something related to
bones- mostly it is
necessary- local
anesthesia is not
appropriate. This is
a surgery which
general anesthesia
is a must.
Is it a must to
use tampons?
When tampons are
removing is it going
to hurt a lot?
You do not have to
use tampons. Even,
after most of the
operations there is
no need to use
tampons. Tampon is
just in need if
something serious is
done inside the nose.
Now, modern tampons
are not long as
meters like they use
to say in past.
Taking tampon out
might discomfort you
but it is no more a
process with pain.
Consult to your
doctor about this
topic, and find out
if you need to use
tampons and if it is
needed which tampon
you should use.
In rinoplasty, is
the aim minifying
nose and take bone
out?
The answer of this
question is
absolutely no. In
this surgery the
goal is to give the
desired shape to the
nose. Unlike it is
thought, this is
done by magnifying
nose but not
minifying it. At the
back of the nose
there is a bone
called hump (actually
it is mostly
cartilage) and if
there is extra on
it, it is absolutely
remove, but mostly
in this kind of nose,
there is lowness and
it needs to heighten.
Even if the tip of
nose seems fat, the
actual matter is the
shape of it and
minifying it or
getting it thinner
just exaggerates the
problem.
TIPS
• If we say
Rinoplasty is the
hardest plastic
surgery we would not
overestimate it. It
is a surgery when it
is done well you get
satisfied and when
not, hard to correct.
• The noses that we
emulate which is
European and
upturned, is not
tiny but quite high.
Thus, noses that
made upturned just
by minifying, do not
seem natural
WHAT YOU
ENCOUNTER BEFORE AND
AFTER SURGERY
This is a surgery
that is between
small and medium
degree. You have to
faint in the
operation and I do
not recommend you to
have the operation
with local
anesthesia. Surgery
must be in an
operating room and
it does not need to
have an intensive
care room with full
formation.
I do not recommend
you to have this
operation in a
consulting room.
Your doctor can be a
plastic surgeon or
ENT specialist. I
recommend you to
have it by a plastic
surgeon though, but
there are some ENT
specialists which do
this surgery very
well. But this is
not a surgery that
you can say ‘while
we are doing this
surgery let us take
this bone out also’.
Sometimes it is
really hard to
correct this kind of
retouching. Talk to
your doctor
everything in detail.
There will be a cast
after this operation.
There might be
tampons inside the
nose. Now, it is
easer to remove new
generation tampons.
The tampons that
your friends call as
meters and meters is
become history.
I can say that you
will have
difficulties in your
first night. To
inhale from the nose
would be hard even
there is no tampon.
You would have a
headache, you have
to put ice on it
regularly and it is
hard to sleep. But
in the morning you
feel better. How
much tumescence you
will have is
dependant on the
process in the
operation, habit of
your body and of
course on your
doctor. In the
second operations
tumescence would be
more. In the first
24 hours there will
be a leakage at the
tip of your nose and
it is normal.
If you throw up much
do not get afraid.
Some patients
swallow some blood
during the operation
and it causes to
throw up. Do not
afraid, if the
bleeding is not
fresh and continuous
but inform your
doctor.
After the second day,
you can turn back to
the routine, for
example you can go
to a movie. And
after casts removed
it helps to reduce
tumescence to put a
small tape on the
nose.
THE REPORT CARD
OF THE SURGERY
The type of
anesthesia: General
Where should the
surgery be done: In
an operating room of
a hospital.
Surgery duration:
1.5 to 2 hours
Duration of staying
at hospital: can be
discharged at the
same day.
Pain after surgery:
There can be a light
tingle for a few
days. Painkiller is
adequate.
Tumescence,
purpleness: 3 to 7
days, sometimes
around the eyes.
Dressing: if there
is, it is removed in
the following day.
The cast is removed
at 5th day.
Sewing: If open
rinoplasty, sewing
of the tip of the
nose is removed at
5th day. Can be
turned back to work
in 3 to 7 days.
Sports: After 2
weeks long joggings,
after 2 weeks,
sports, basketball,
boxing and the
sports that are done
by body to body
after 5 weeks.
Last shape: usually
at second week
tumescence is almost
gone. But for the
last shape earliest
estimation, 6 months
needs to pass. But
if there is
tumescence between
the eyebrows to
forehead it lasts
for at least one
year.
|
