Rhinoplasty

Is the surgical procedure that modify the aesthetic aspect of the nose. Depending on its initial form, the presence or not of a hump, nose length, nasal lobe shape, etc., the procedure may involve  changes of the osseous and / or the cartilaginous skeleton.

For the surgery is preferable general anesthesia, for both patient and surgeon comfort. Depending on the complexity of changes required, the procedure may be done using thae"opened" or "closed" method.. Opened method rises the skin from the bony-cartilaginous skeleton and shape "sight" nose. Closed method is used in relatively simple cases in which lobule require minimal changes.

Postoperatively swelling of the nose and adjacent areas is inevitable, accompanied by bruising (bruises) suborbitary sometimes, especially when a fracture of the nasal bones was needed. A metal splint designed to fix fractured bones in their new position will be carried on the nose a week after the operation.

Swelling and bruising persists about 7-10 days after surgery, but they will decrease progressively . The result can be partially evaluated approx. 2-3 months after surgery, and the final one year after.

If the breathing problems coexists , it is possible that exists septum deviation that required evaluation by a physician ENT, who previously or simultaneously will solve this problem. Outpatient surgery can be done if a simple operation without general anesthesia (intravenous potentiated local anesthesia only) and require hospitalization for one day, in more complicated cases.

Aesthetic and reconstructive surgery of the nose (rhinoplasty or rhinoseptoplasty) can not only improve the appearance of the nose and breathing but can correct septal deformities. Rhinoplasty can increase or decrease the size of the nose, narrow nostrils or nasolabial angle turn. This surgery can correct birth defects, nasal trauma and respiratory problems.

Cosmetic surgery can have an impact on physical and mental health by increasing self-esteem and self-confidence, thus removing depression and inferiority complexes. Reshape nose can change the whole facial expression. Nasal surgery is one of the most challenging procedures in plastic surgery.

Depending on the initial appearance of the nose, surgery can correct only osseous skeleton, cartilage or both as it follows:

• Surgery involving reshaping the cartilage or "sculpture" cartilage without involving nasal bone portion are carried off in a closed method, without external scars or open, in cases where the changes required are more complex. The operation is completed by mounting a nasal and post nasal splints.
• Surgery on soft tissue and bone involve a more complex operation that requires attention in maintaining dimensional scale that approaches the aesthetic ideal. The operation is carried off, no external scars, or open, with a small scar at the columella base. At the end a metal splint and intranasally mesh is necessary.

There is no universal type of rhinoplasty that covers the needs of all patients. However, this procedure can be individualized, taking into account the wishes of patients. Rhinoplasty can be performed simultaneously with internal nasal surgery, if we want to improve the patient's respiratory system. The best candidate for rhinoplasty is patient seeking an improvement in nasal appearance, not perfection. In addition, realistic patient's wishes are important, good stability and good mental health are all important characteristics of patients who require a rhinoplasty.

Preparation

The operation requires no special preparation, but the surgery can not take place under the conditions of the inflamation of the nasal mucous membrane or an face and nose acne. Medications containing aspirin or other drugs that may increase the risk of bleeding (aspirin, Acilpirin, Anopirin, Brufen, ETC.) will be stoped 3 weeks before surgery. You must not eat, drink and smoke the night before surgery. The nose should be carefully cleaned before surgery.

Operation

Simple correction of nasal soft tissue is performed under local anesthesia, complete nasal correction, including the nasal bone is performed under general anesthesia. Soft tissue correction performed under local anesthesia does not require hospitalization, while the surgery performed under general anesthesia requires hospitalization for 1day.

Anesthesia

The general anesthesia is prefered, both for patient and surgeon comfort, technical

Besides improving nasal appearance it is also important to improve respiratory function. On the other hand, the final result should not be unnatural

The surgery is performed through small incisions inside the nose. This should be adapted so that it can:

• Narrow the tip of the nose by excision of portions of cartilage that make up the lobule
• Reduce nasal dorsal arch or curve
• Narrow the nose
• Peak nose to be more heads- Post cartilage grafts to fill in or correct some parts of nasal
• Correct nasal deviations

Postoperative procedures

At the end of surgery we will place a splint that will be held for 7 days. The nose will be meshed for two days. A week later, nasal splint is removed, taking care to avoid further trauma that may lead to deformation of the nose. In 10 days postoperative bruising and swelling will fade, but a degree of swelling can persist for another 1-6 months, observing the final outcome at 6 months or 1 year. Three weeks later can initiate dorsal nasal massage, watching the doctor's instructions.

Article written by Silviu Marinescu M.D. PhD