Rhinoplasty Surgery
Nose Aesthetic Surgery (Rhinoplasty) Ankara
The nose is a building block that significantly affects the beauty of the face. Even a small change in size or shape can drastically change a person’s appearance. The aim of rhinoplasty is to improve the nose aesthetically and harmonize it with other features of the face. If surgery on the nose is performed only for aesthetic purposes, it is called Rhinoplasty. This operation can also help reshape the airway inside the nose so that the person can breathe more easily, and if it is performed along with rhinoplasty to improve breathing difficulties, it is called Septorhinoplasty. In rhinoplasty, problems from the back of the nose to the nostrils and tip of the nose are corrected from an aesthetic point of view. The nose size is changed to be compatible with the general appearance of the face. The width of the nose or the size and position of the nostrils is corrected. If present, the saddle on the back of the nose is straightened. The enlarged or bulbous, drooping, upturned or hooked nose tip is made aesthetically elegant and attractive. Meanwhile, respiratory disorders are also treated. A beautiful nose should breathe well, and a nose that breathes well should also look beautiful. Rhinoplasty surgery, defined classically, was basically the process of removing some of the structures within a nose. Nowadays, in order to make the patient’s nose more aesthetically beautiful, some strengthening and repositioning of some structures are performed, as well as removing excess parts of some structures.
What is Structural Rhinoplasty?
When rhinoplasty surgery was first described by Joseph, it was an operation to reduce the size of the nose as much as possible by removing only the bones and cartilages of the nose, and this procedure was called excisional rhinoplasty. The first effective alternative rhinoplasty technique to excisional rhinoplasty was Structural Rhinoplasty, preserving as much skeletal support as possible to avoid the complications of removing too much cartilage. Rather than cutting, removing, and discarding large amounts of nasal cartilage that could cause nasal collapse, structural rhinoplasty used repositioning and reshaping (folding) the tip of the cartilage to achieve a more attractive contour. Additional structural reinforcements were made in the nose by placing cartilage supports where needed.
What is Preservation Rhinoplasty?
Basically, it is a surgical technique that preserves the ligaments of the nasal muscles (can be thought of as the ligament that forms the attachment points of the nasal muscles) and the anatomical structures of the nasal dorsum. There are two important ligaments, the Scroll ligaments and the dermocartilaginous (Pitanguy) ligament. The nasal muscles fix the internal nasal valve using the Scroll ligament and open it when needed. Pitanguy ligament has an important role in nasal tip aesthetics. If the Pitanguy ligament is not managed properly during surgery, it may be the cause of nasal tip drooping in the postoperative period. The most important part of the nasal dorsum is the keystone area, as the name suggests. In this region, six different anatomical structures, three cartilage and three bone, come together. If the keystone area is damaged by surgical intervention during rhinoplasty and cannot be repaired well, serious aesthetic and functional problems may occur.
Structural Preservation (Hybrid) Rhinoplasty
Structural-preservation rhinoplasty combines two popular rhinoplasty philosophies (structural rhinoplasty and preservation rhinoplasty) with the goal of maximizing aesthetics and function. While structural techniques are generally applied to bone structures, preservation rhinoplasty techniques are applied to the cartilage roof and nasal ligaments.
What kind of aesthetic gains occur with Rhinoplasty Operation?
A nose that is incompatibly large or small with the face can be reduced or enlarged in a balanced manner by rhinoplasty. If there is an unattractive hump on the back of the nose, it can be removed and a more attractive nose can be created. If there is a wide bone nasal base, it can be narrowed. If there is curvature or crookedness on the back of the nose, it can be straightened. Problems such as wideness of the tip of the nose, drooping or drooping nose, width of the nostrils, and downward displacement of the tip of the nose while smiling can be corrected after aesthetic nose surgery.
What kind of improvements in breathing are achieved with the septorhinoplasty operation?
Septum deviations that block the airway, turbinate growths, and internal and external valve problems that reduce airflow can be treated with this intervention. Straightening the septum and treating valves of the nose improves airflow and facilitates breathing. These reduce or completely eliminate nasal obstructions. In people with sleep problems due to nasal obstruction, septorhinoplasty operation generally improves sleep quality. Corrections inside the nose can reduce sinus problems such as sinusitis by improving sinus drainage. A crooked septum can cause intranasal bleeding. Septorhinoplasty can reduce or eliminate these bleedings.
What should be taken into consideration before Nose Aesthetics (Rhinoplasty) Surgery?
Before the rhinoplasty operation, it is necessary to stop taking blood-thinner medications, especially aspirin-derived painkillers that will cause bleeding during and after the surgery, one week in advance. In addition, vitamin E, fish oils, and some foods such as garlic thin the blood and may cause bleeding, and these should not be used before surgery. If someone has used an acne medication called roaccutane, it should be discontinued one year in advance to avoid wound healing problems. Limit alcohol consumption before and after surgery. Smoking and alcohol use can negatively affect the healing process. It is important that you stay away from smoking and alcohol for at least 2 weeks before the surgery.
Is the thickness of the skin important in Rhinoplasty Surgery?
Yes, the thickness of your skin is very important in rhinoplasty surgery. This is one of the key factors that can affect the final outcome and potential limitations of surgery.
Rhinoplasty surgery is basically a surgery in which deep structures such as bone and cartilage are shaped. These structures are shaped to give the nose an aesthetic beauty. Thick skin can mask the aesthetics performed on the underlying cartilage and bones, making it difficult for the surgeon to achieve precise definition and refine the desired shape.
In very thick and oily skin, it takes time for the edema to subside because the elasticity of the skin will be low after surgery. The gaps may be filled with scar tissue. In very thick skin, the cartilages under the skin usually become thin and weak. The surgeon must be very careful. Thick-skinned rhinoplasty candidates should be informed that post-operative swelling will last much longer than other people. Classically, after rhinoplasty surgery, the swelling decreases by descending from the upper part of the nose. In other words, swelling at the root of the nose, which usually subsides in 3 months, may last up to 12 months at the tip of the nose. For this reason, revision surgery for the nose is not performed before 1 year, except in very urgent cases.
The nose is shaped more easily with rhinoplasty performed on people with thin skin. It allows the surgeon to achieve finer details and definitions, potentially leading to more beautiful results. People with thin skin experience faster recovery after surgery. The swelling goes down quicker and the final results appear quicker.
On the contrary to people with thick skin, care should be taken as very thin skin will directly reflect the interventions made on the cartilage and bones. Thin skin requires a more delicate procedure to avoid problems such as cartilage and bone irregularities.
Can a design for post-operative results be made on a computer before rhinoplasty surgery?
Yes, post-operative design can be made on the computer before rhinoplasty surgery. It offers several benefits: Patients can see a virtual representation of the expected results after surgery, allowing them to better understand what to expect. It facilitates communication between patient and surgeon by visually displaying desired changes and possible limitations. Surgeons can use this tool to plan surgery more precisely, taking into account facial proportions and individual anatomy. Computer-generated designs help manage expectations by highlighting what is achievable and the possible differences between different outcomes. As a result, both patients and surgeons can feel safer knowing that the desired aesthetics are compatible.
However, it is important to note the following: Simulations are predictions. Final results may vary slightly depending on the tissue’s response to surgery, the healing process, and individual differences. It is not an accurate representation of the final outcome as unpredictable factors may occur during surgery. As a result, designing postoperative views on the computer may be useful for the surgeon and the patient to understand each other. If the surgeon shows the changes he intends to make on the patient’s nose before the surgery and shares it with the person who will be operated on, and if this is liked, they will have an example that they can safely develop.
How long does nose aesthetic (Rhinoplasty) surgery take?
It may not always be correct to give a standard duration for all surgeries. The surgery should take as long as necessary to achieve the desired result. The duration of rhinoplasty surgery may vary depending on various factors, such as the complexity of the procedure, the specific techniques used, and the experience of the surgeon. Some factors that may affect the duration of rhinoplasty surgery include:
Scope of Correction: The amount of correction needed on the nose will affect the duration of the surgery. For example, surgeries that involve significant reshaping of the nasal structure or multiple corrections may take longer than procedures that require minor adjustments.
Techniques Used: Different surgical techniques may require different times. For example, conservative or structural rhinoplasty surgeries may take longer than excisional rhinoplasty surgery. Additional Procedures: Sometimes rhinoplasty, septoplasty (to correct a crooked septum), reduction of nasal concha (to improve nasal airflow), or grafting (to the nose) It can be combined with other procedures such as: to add support or volume. Adding these procedures may extend the overall duration of the surgery. Anaesthesia: The type of anaesthesia applied may also affect the duration of the surgery. General anaesthesia is commonly used in rhinoplasty procedures, and the time required for induction of anaesthesia and recovery from anaesthesia will be included in the overall duration of the surgery.
What options do patients have in Rhinoplasty Surgery?
1.Closed Rhinoplasty
In closed rhinoplasty surgery, all incisions are made on the membranes inside the nose. After the surgery, there is no scar left outside the nose. Another advantage of the closed method is that there is less post-operative swelling in the nose and the swelling goes down sooner. It is a method that can be applied to every patient.
2.Open Nose Aesthetics
In Open Rhinoplasty surgeries, an incision is made in the thinnest part of the area between both nostrils. The incision scar will not be visible unless there is an unusual wound healing problem. However, the swelling is more noticeable and goes down slower than the closed technique.
In both techniques, if the nostrils are to be narrowed, an incision is made on the skin on the wings of the nose.
In which patients is Open Rhinoplasty more appropriate?
The open rhinoplasty technique can be applied in any rhinoplasty surgery, but offers significant advantages in certain situations.
Severe deformities: Open rhinoplasty provides better access and visibility to solve complex problems such as crooked septum, saddle noses or severe asymmetry.
Revision rhinoplasty: While correcting the results of previous surgeries, open techniques allow meticulous repair and reconstruction.
Extensive structural changes: Planning and implementing major adjustments to the nasal tip, bridge, or base often benefit from the increased use of the open approach.
Ethnic rhinoplasty: Specific techniques used to sculpt features for different ethnicities can be facilitated by open rhinoplasty.
Can Rhinoplasty be performed with threads?
Yes, rhinoplasty can be performed using thread lift techniques, but this method is used much less in nose shaping than surgical rhinoplasty. Thread lift, also known as thread lift or thread rejuvenation, involves the use of dissolvable stitches (threads) to lift and reposition the skin and underlying tissues of the face or nose in order to achieve a more youthful or aesthetically pleasing appearance.
In the context of rhinoplasty, thread lift techniques are typically used for minor improvements or adjustments rather than extensive nose reshaping. Some of the possible applications of thread lift for nose aesthetics include:
Nose Tip Lift: Thread lift can be used to elevate and define the tip of the nose by placing threads at the tip of the nose and slowly pulling upwards to create a more elegant look.
Nasal Symmetry: Threads can be used to improve symmetry by adjusting the position or shape of nasal structures.
While thread lift techniques offer a non-surgical alternative to rhinoplasty, it is important to remember that they have many limitations compared to surgical rhinoplasty. Thread lifts may provide milder and temporary results, and the degree of improvement that can be achieved with this technique may be limited, especially for patients with more complex nasal problems.
Which type of anesthesia is preferred in rhinoplasty?
The type of anesthesia preferred for rhinoplasty depends on a variety of factors, including:
The complexity of the surgery matters. Simple procedures: Local anesthesia with sedation is often preferred because of faster recovery and less risk of complications. Complex procedures: General anesthesia may be required for longer interventions or extensive structural changes that require deeper access. There are factors associated with the patient. It may be more appropriate for people with serious diseases to be operated on under general anesthesia to allow immediate intervention for their breathing and circulation. Patients with high anxiety may prefer general anesthesia to lose consciousness completely. General anesthesia may be more appropriate for people who have previously operated under local anesthesia and experienced pain complaints.
Local anesthesia with sedation can be performed. Injections numb the surgical area, while sedation relaxes the patient and reduces discomfort. Its advantages can be listed as follows. Shorter recovery time, fewer side effects, less expensive. The disadvantages are that the patient’s consciousness remains a little open; discomfort may be felt depending on the complexity of the procedure.
General anesthesia includes medications that make the patient completely unconscious. Its advantages include providing complete pain control and allowing longer and more complex procedures. Disadvantages are longer healing time, increased potential for side effects, and higher cost.
I think performing rhinoplasty surgery under general anesthesia is beneficial for both surgeons and patients. Generally speaking, in this form of anesthesia, both the respiratory and circulatory systems of the patient are under the control of a safe anesthesiologist during the operation. This takes the burden off the surgeon and allows her to focus entirely on her surgery. It eliminates the distress caused by the patient being in a sedentary and stressful environment for a long time. However, it can be safely used under local anesthesia for minor interventions.
Is it always necessary to intervene in the bones during Rhinoplasty surgery?
It is not always necessary to intervene in the nasal bones during rhinoplasty surgery. If only nasal tip surgery is to be performed, the bones may not be intervened. If there is curvature in the nasal bones, a large hump on the back of the nose, or a wide nasal bone base, intervening in the nasal bones may be necessary for a good result.
Will There Be Bruising and Swelling Around the Eyes After Nose Aesthetic Surgery?
Bruising and swelling around the eyes after rhinoplasty surgery is a common and expected condition. Their extent and severity may vary depending on various factors, but it is important to understand that these are temporary side effects and will subside slowly.
Bruising: Typically occurs within the first 24-48 hours and usually reaches its peak on the second and third day. The color may change from blue to purple to yellow before slowly fading over the next 1-2 weeks.
Swelling: It usually reaches its peak within the first 3-5 days and may take a few weeks to disappear completely. Swelling may be more noticeable in the morning and may improve throughout the day.
Bruising and swelling that may occur under the eyes and around the nose after the surgery may depend on both the patient and the surgical technique used. Generally, edema and bruising should be expected after rhinoplasty in people who have a lot of edema and bruising after trauma. In addition, bleeding-increasing drugs or foods before surgery may increase the bruising after rhinoplasty surgery. These substances may also cause intranasal bleeding. The surgical techniques used are interventions on the nasal bones that increase bruising and swelling after the surgery. Attempts to correct the wide nasal base or the curvature of the nasal bones may increase bruising and swelling after surgery. Open rhinoplasty, where an external incision is made, may cause slightly more significant bruising and swelling than closed rhinoplasty.
Do the intranasal splints placed during rhinoplasty surgery make it difficult to breathe after the surgery and are they difficult to remove?
The splints used in rhinoplasty surgery are usually placed for safety purposes to control bleeding and are removed within 2-3 days after the surgery. The splints placed in septorhinoplasty surgery can be removed after 5-6 days as they are placed to support and maintain the position of the corrected and relocated septum as well as to control bleeding.
The splints we use have passages that keep the airways open. Nasal breathing continues as long as these passages are not blocked. To prevent congestion, the nose should be frequently cleaned with ocean water or saline. Splints are fixed with thin stitches and are easily removed after the stitches are removed.
When should sports be started after Rhinoplasty Surgery?
In order to reduce the risk of bleeding and swelling during the first month, it is recommended not to increase blood pressure and heart rate. In the second month, depending on your recovery and your surgeon’s recommendations, you can begin incorporating low-impact exercises such as jogging, stationary cycling, or yoga. However, avoid activities that involve leaning forward or pressing on the nose. Contact sports with a risk of collision should be avoided, especially in the first 6 months.
How long does it take for the results of rhinoplasty surgery to appear on the nose?
Positive results of rhinoplasty surgery are observed immediately in the early postoperative period. Observing the full permanent result depends on various factors. These may be controllable factors such as the surgical technique used, whether or not to intervene in the bones, adequate rest in an appropriate position after surgery, effective bandaging, or the thickness of the patient’s skin. As skin thickness increases, the time it takes for postoperative tissue swelling to subside becomes longer. The decrease in swelling starts from the root of the nose and progresses downwards on the nose, and the swelling and numbness finally disappear at the tip of the nose. Subtle changes are noticeable starting from 3 months, and the final result occurs within a year and a half.