Rhinoplasty

Rhinoplasty – Description

Rhinoplasty (nose job) is a popular option with many cosmetic benefits, however, rhinoplasty has evolved to have much more versatile applications, correcting breathing and improving the patient’s quality of life.

Our nose is the central organ in our face and plays a key factor in proper breathing. Our nose is perhaps one of the most important features of our face and plastic surgery can correct both functional and aesthetic abnormalities of it.

Rhinoplasty – Aesthetic applications (nose reshaping)

1. Fix the nose shaft
2. Reduction and/or increase the nasal bridge.
3. Increase or reduce the length of the nose.
4. Increase or reduce the crowns.
5. Reduce the width of the nose.

Rhinoplasty – Reconstructive applications (nasal function improvement)

1. Restore the operation and appearance of the nose after an accident.
2. Improvement of breathing.

What needs to be done before Rhinoplasty

Once the Plastic Surgeon has a complete history of the patient, he / she should fully inform him/her about the procedure. Then the surgeon will take some photos of the area to be treated.

The operation is recommended for women over 17 and for men over 18 years of age, because development of the nose completes at the end of puberty.

The following instructions should be followed:

1. We do not take aspirin, anti-inflammatory drugs or herbal supplements 20 days before surgery, because they all increase the chance of bleeding during and after surgery.
2. Alcohol should be discontinued at least 2 weeks before the surgery.
3. We must not drink coffee 48 hours before the operation.
4. Vitamin C is suggested 3 weeks before the operation.
5. To avoid any infection, you should put a local nasal mucosal ointment, an active substance against bacteria.
6. The patient should not eat and drink water 12 hours before the scheduled operating time.
7. The person concerned should have cleaned very well the area of the face and for women they should not wear make – up.

Rhinoplasty – Type of anaesthesia

The above procedure is usually done with general anesthesia. Sometimes, it can be done with local anesthesia or even sedation.

Rhinoplasty – Hospitalization

After the surgery, the patient should stay for a few hours in the hospital and not drive for the first 24 hours. Patients are rarely hospitalized in the evening.

Rhinoplasty – Operation technique

There are 2 types of rhinoplasty operations:

• Open rhinoplasty

In open rhinoplasty the incision is carried out in the narrowest part of the penis (the point between the nostrils) and extends into the nostrils.

• Closed Rhinoplasty

In closed rhinoplasty the incisions are performed in the nostril mucus. Depending on the type of changes required for each patient, either the open or the closed method is selected.

The duration of the surgery may be from 1 to 3 hours, depending on the type of surgery.

Rhinoplasty – Postoperative instructions

• During sleep, you should sleep with 2 pillows under your head for the first 7 days after surgery.
• In the first 72 hours after surgery, you should put some during the day crushed ice in an ice cube bag to reduce bruising and swelling. Be careful! Do not push the nasal splint.
• Swelling is normal 48 hours after surgery, which peak between 48-72 hours.
• If you are in deep pain, take painkillers every 3-4 hours. Avoid alcohol with them. Painkillers should not be taken with an empty stomach. If you are not in pain then you do not need painkillers.
• If you suffer from postoperative anxiety, please contact your doctor.
• Immediately after surgery you should start a light liquid diet. The next day you can start a gentle, regular diet, but for 2 weeks you have to avoid foods that require excessive movement of the lips, e.g. Apples, corn, etc..
• You may have nasal blood secretions for 3-4 days, and you may often need to change the gauze under your nose. Do not scrape or clean your nose, as this may exacerbate secretion. You will be able to remove the gauze from the nose and the strip from your cheeks when the secretions stop.
• To avoid bleeding, do not puff or blow your nose for the first 2 weeks after surgery. Try not to sneeze, but if this happens, sneeze from the mouth.
• As long as you have the nasal narthex, you have to be careful if you chose to go for a swim. You need to prevent water from going into the narthex.
• Keep the inside of your nostrils and your sutures clean, using Q-tip together with a thin layer of antibiotic ointment. This will prevent the creation of a crust. You can move the Q-tip through the nose until the cotton, but no more. As long as the movements in the nose are soft, there is no risk of injury.

Rhinoplasty – General Postoperative instructions

Avoid intense activities that will increase heartbeats to 100 / min (e.g aerobic exercise, heavy objects or crouching) for the first 3 weeks after surgery. After 2 weeks you will be able to gradually increase your activities and normalize them at the end of the third week.

• Avoid hurting (pinching) your nose for the first 4 weeks.
• After removing the narthex, do not wear glasses or anything else on your nose for 4 weeks. The glasses will be attached to your forehead (your doctor will tell you how). You will be able to wear contact lenses as soon as the swelling has subsided.
• The skin of your nose will be sensitive to sun exposure after surgery. Protect your nose from excessive sun exposure for the next 6 months after surgery. Wear a wide hat and / or put a very high protection sunscreen (with a mark of 20 or greater) with UVA & UVB rays if you are going to be exposed to the sun for long.
• The nasal splint will be removed 6 – 7 days after surgery.
• After removing the narthex, you can wash your nose gently with a mild soap and you can put make-up if you want to. If your nose is dry, you can put a moisturizer.
• You may feel the tip of the nose sometimes numb after rhinoplasty and your front teeth strange, but this feeling will slowly disappear.
• Most of the swelling will be gone 2-3 weeks after surgery. Typically, the remaining 10% of the swell needs about 1 a year to go. You may feel your nose stiff when you smile or not as flexible as before. This is not something that is easily noticeable and things will slowly return to their normal.
• Avoid lifting heavy objects for the first 3 weeks after surgery.
• Follow your doctor’s instructions for using medicines.
• If you experience nausea, vomiting, rash, shortness of breath, diathermy after taking your medication, if you raise a fever of over 38 degrees C, show redness in the skin or if you feel pain in the operating area, contact your doctor immediately.
• After removing sutures and splints, it is recommended to use saline to gently remove any crust inside the nose, especially if you have internal nose surgery, such as diaphragm correction or abdominal resection of the lower nasal nodule.
• You can use nasal spray periodically only for the first 2 weeks after surgery to improve breathing. Also, if are traveling with a plane, the spray will keep your ears and nose from getting blocked.
• If you notice severe bleeding (if you need to change gauze every 30 – 40 minutes), call your doctor immediately. You should keep your nose high and press it gently for 15 minutes. You can use a nasal spray to stop bleeding. It usually stops with these steps.

Rhinoplasty – Complications

• Rhinorrhoea: Rhinorrhea is the secretion of light-colored blood from the nose. The latter is treated by lifting the head, but also by pressuring on the base of the nose. Surgery is rarely required.
• Inflammation: During surgery, antibiotics are given, and in some cases the antibiotic treatment continues for some days after the surgery. Inflammation is pretty rare after a rhinoplasty.
• Abnormalities on the surface of the nose may occur if the cartilage is not cut smoothly. These abnormalities can be seen on the skin.
• Diaphragm punching is a rare complication.