The nose is the most striking feature on the face, the most visible and the least disguisable, therefore it has all the elements to be appreciated or hated. The search for the facial harmony has made the Rhinoplasty or nose surgery give a new shape to the nose and to be one of the most common procedures of plastic surgery. The rhinoplasty can reduce or increase the size of the nose, change the shape of the tip or of the bridge, improve the opening of the nostrils or change the angle between the nose and the upper lip. It can also correct a birth defect or an injury, or help improve breathing problems
From what age is this operation convenient?
When the development of short bones that form the face has already completed its maturing. Therefore, it would be from 15-16 years old in women and shortly after, from 17-18 years old, in men.
What preliminary preparation is necessary?
It is important that, apart from a complete medical history of the patient, an exploration of the structure of the skin, bone and cartilage of the nasal pyramid be carried out, as well as the functionality of the same (how it breathes).
The final result of a rhinoplasty focuses on a double result: aesthetic and functional. To know perfectly well the patient‘s wishes in a rhinoplasty is very important so that the operation is entirely satisfactory and the operated nose is well accepted with greater harmony to the face. Nowadays, because of the progress of the surgical techniques and studies on the nose surgery, it has been achieved that the operated nose be totally natural and not noticed in any way that it has undergone surgery.
As in all other operations, pictures of the patient will be taken for the medical history and necessary preoperative testing will be requested.
What kind of anesthesia is necessary?
The best one for this type of operation is a general anesthesia of short duration, since the rhinoplasty does not usually last more than two hours. Therefore the patient, in general, spends a night at the clinic and the next day he is discharged.
How is it carried out?
There is not a type of universal rhinoplasty which meets all the needs of all patients. The nose surgery is designed for each patient depending on his needs. This operation basically involves modifying the bony structures and nasal cartilage to get a new shape to improve facial harmony. This is achieved through two types of techniques, the open and the closed one. In the closed one, the incisions are carried out through the nostrils, while the open (which is mainly performed in more complex cases of nasal asymmetry) is a small incision in the outside on the base of the nose (in the columella).
Through these incisions it is possible to:
- Narrow the tip removing part of the cartilage wings.
- Reduce the back making it straight.
- Narrow the nose.
- Make the tip rise.
- Place cartilage grafts to fill the projection in different areas of the nose.
- Correct the deviated septum.
During surgery, the skin of the nose is separated from its support, composed of bone and cartilage, to be carved in the desired form. Finally, the skin is redistributed on this new support. When the surgery is completed, a splint of plaster or other material helps keep the new form of the nose. The nasal tampons are placed in both holes to stabilize the nasal septum if the rhinoplasty has been associated with septumplasty. If it is a rhinoplasty without surgery of the septum, tampons are not often placed.
Does it leave scars?
It will depend on the technique that has been used to give the new shape. If the incisions are internal through the nostrils, which are the normal procedure, there will be no apparent scar. If it has been necessary to cut the skin in the operation, it is made on the lower part of the nose, in the small column that separates the two nostrils. This area heals very well and what is common is that after a few weeks it is virtually undetectable.
Is the postoperative painful?
No, it isn’t. This operation does not produce, contrary to what it may seem, pain or excessive discomfort. We must take into account that the nose, following the operation, is anchored by a splint and therefore, there is no movement that can cause pain. The greatest discomfort is to breathe through the mouth in the first days, with a very similar feeling when we have a cold.
When can we come back to normal life?
The splint is removed after the seventh day. The bruising and swelling of the eyelids, logically after a rhinoplasty, will gradually disappear over the seven to ten days after the operation. Usually, the patient can go back to his normal life in a week.
It is recommended to apply cold compresses to help reduce the swelling. It is common that during the first days there will be a slight bleeding from the nose. The patient must avoid blowing with force during a week until the tissues heal. It is recommended not to pursue sports like swimming, jogging or gymnastics during two or three weeks.
When can one see the final results?
When the inflammation has lowered, the first results begin to be visible, although a minimal swelling above all in the tip of the nose can last for several months. The improvement is progressive and gradual. No one can make a judgment on the outcome of a rhinoplasty until several months, or even a year, have passed. This is the time that the tissues require to stabilize and for the scars to carry out its maturing process. The intention of the rhinoplasty is that the new nose does not attract attention and is fully integrated into the general context of the face, producing a harmonious and pleasant view, i.e., not to notice that it has been operated. On some occasions, either for serious initial anatomical disturbances, by disorders in the scarring of the tissue, or due to postoperative injuries, etc. , one may not achieve a perfect result (asymmetries, irregularities in the nasal outline, etc. ) being necessary a surgical retouching, in which case it will be performed after six months.