Rhinoplasty is the name given to surgeries that reshape all anatomical areas of the nose. It is performed due to complaints such as nasal obstruction, nasal deformity, recurrent headaches, and sinusitis. Fractures, bending, incorrect healing, overlapping tissues, and deformities in soft tissues that develop in cartilage and bone structures after trauma or due to the anatomical structure of the nose can cause deformities in the shape of the nose inside and outside, including bone and cartilage protrusions, curvatures, and asymmetries on the nose bridge.
TYPES OF RHINOPLASTY SURGERY
Functional Rhinoplasty is performed to improve the nasal breathing and olfactory
functions, while the procedures performed to correct and change the appearance of
the nose are called Esthetic Rhinoplasty.
We use different names to describe the surgery performed, such as Primary
Rhinoplasty if it is performed for the first time, Revision Rhinoplasty if it is
performed multiple times, Ethnic Rhinoplasty if it is performed to change the shape
of the nose due to the person's genetic structure, and Tip Rhinoplasty if it is
performed only on the nose tip. "
SURGERY
It is usually performed under general anesthesia. Local anesthesia can be used if a
very small anatomical area is to be treated. It should be performed in fully
equipped hospitals and operating rooms. Depending on the procedures to be performed,
it takes about 2-3 hours on average, but in cases requiring special procedures such
as "grafts", it can take up to 6 hours.
There are two main approaches, namely "closed" and "open". In the "Closed
Rhinoplasty" approach, there is no incision on the skin. Incisions are made inside
the nose and under the nostrils. In the "Open Rhinoplasty" approach, there is an
incision site on the skin under the tip of the nose. The choice of approach in the
surgery depends on the surgeon's experience and the procedures to be performed. If
major changes will be made to the nasal septum, bone and cartilage structures, and
cartilage pieces called "grafts" will be placed, the "open technique" must be
preferred. The "closed" approach can be used for limited and small procedures.
The techniques and tools used by each surgeon may vary depending on the school they
trained in. A skilled surgeon can achieve successful results with the methods and
tools they are experienced in using."
At what age is it performed?
The earliest age for rhinoplasty surgery varies depending on individual differences. It can be performed after the age of 18-21 when bone growth is completed. However, for rhinoplasty performed for aesthetic purposes, I recommend that the person has reached a level of decision-making maturity because there will be a permanent change in their facial appearance. There is no limit for older ages as long as there is no contraindication to anesthesia or any other surgery.
HOW IS PREOPERATIVE PREPARATION DONE?
The patient's medical history, personal information, and any known illnesses and
medications must be known by the physician. Blood-thinning medications may be
replaced with different medications prior to surgery. Birth control pills can
increase blood clotting. Additionally, herbal teas and medications used before
surgery such as green tea can increase bleeding. It is also important to report the
use of cigarettes, alcohol, and other recreational substances.
For anesthesia preparation before surgery, the anesthesiologist performs an
examination and some tests. If there is a condition that prevents surgery or makes
it risky, it is identified after these tests. Sometimes surgery may need to be
postponed for a while. Preoperative evaluation of the patient is therefore
important.
HOW IS IT AFTER THE SURGERY?
After the surgery is completed, a "Septum Silicone Splint (Stent)" is placed in each
nostril, and a nasal cast (Plastic Ateli/Termal Splint/Hermal Cast) is placed on the
bridge of the nose. Depending on the case, the nasal splints are removed between the
2nd and 7th days, and the nasal cast is removed between the 7th and 10th days.
Swelling and bruising around the eyes are expected after the surgery. The amount of
swelling and bruising varies depending on the person's skin and tissue structure and
the surgical technique used. Applying cold compresses or ice to the nose area
immediately after surgery can help reduce swelling. Regular ice application every 30
minutes for 10-20 minutes for 3-4 days is very important and effective. There may be
bloody nasal discharge in the first few days. Nasal sprays and gels that prevent
crusting and speed up healing can be used. Antibiotic ointment can be used to
prevent infection in the stitches at the tip of the nose. After removing the nasal
cast, the skin is cleaned. Heavy exercise should be avoided for 2 months after the
surgery, and walking is recommended instead. Wearing glasses and exposure to
sunlight are prohibited for 3 months after the surgery.
It takes 6 months for the swelling of the nose skin to completely resolve and 1 year
for complete healing.
The earliest revision surgery can be performed after 1 year has passed.