RHINOPLASTY

Although the nose is located immediately in the middle of the face, it is in reality the organ we want to attract the least attention to. The ideal situation when we look at a person’s face is to notice the eyes and the expression, the mouth and the general look of the face succeeding them. When the nose draws attention by being too small or too big, incompatible with facial proportions, the perception of beauty forming in our brain starts to send error signals and we think that the face we are looking at is bad-looking. The nose is also our respiratory organ, in addition to its appearance, its function is very important as well.

Aesthetically an unpleasant nose considerably damages its owner’s self-esteem. Rhinoplasty, commonly called a nose job, is the most often performed cosmetic surgery. Rhinoplasty can make your nose bigger, smaller, change the shape of its tip or bridge, narrow your nostrils or change the angle between the nose and upper lip. It can also correct deformities whether they are congenital or due to injury, or treat respiratory problems. It can make your nose more harmonious with your facial proportions, increasing your self-esteem and admiration.

Before you decide to have an operation, ask yourself why you want to have this operation and what you expect from the rhinoplasty surgery, think carefully and discuss the reasons with your surgeon. The ideal candidates for rhinoplasty aren’t the patients who expect perfection, but the ones who want to improve their appearance.

Many surgeons prefer to postpone this operation until the end of puberty. This waiting period for prepubescent girls is around the ages of 14-15, and for boys a little later. To make sure the decision is made by the patient and not the family, it is important to take in consideration their social and psychological compatibility.

BEFORE THE OPERATION

A good communication with your doctor is essential and very important. During the first consultation, your surgeon will ask about the way you want your nose to look like; she will then examine your nose and your facial structure and explain the possible outcomes. The shape of your nasal bones and cartilage, shape of your face, thickness of your skin, your age and your expectations will be the essential topics.

You should make sure to provide any useful information to your surgeon; past operations or any nasal treatment, allergies or respiratory difficulties if any, medications and your smoking habits should be disclosed. Especially your expectations and the results of the surgery should be discussed so please do not hesitate to ask your surgeon should you have any questions and/or concerns regarding the operation.

OPERATION

In most cases, your doctor will suggest general anesthesia, with the exception of cases not involving the nasal bone, where local anesthesia combined with sedation may be suggested. The operation will be performed in hospital environment.

Generally, rhinoplasty surgery takes approximately 1 hour. During the operation, the skin of the nose will be detached from bone and cartilage of the nasal roof. The remodeling procedure varies upon the existing problem of the nose and the technique used by the surgeon. Finally, the skin will be placed on the reconstructed roof.

Most of the surgeons who have adequate experience perform this surgery from inside of the nose (closed technique). In this case, the recovery is faster and there is no visible scar. My first choice is this technique. Rarely and especially for complicated cases, the open technique may be suggested: A small incision is be made on the vertical tissue (called columella) separating the nostrils and the skin is lifted, making it possible to work from this area.

When the surgery is completed, a thermoplastic splint will be placed on the nose to help preserve its new shape. Tampons placed inside the nose will be taken out the next day.

POST-OPERATIVE PERIOD

Post-op period is generally comfortable. Most of the patients do not complain of nose pain, although mild headache may occur. Cold compress application on the first day and keeping the head up while resting should be planned.

You will notice the bruising and swelling around your eyes to be most significant 2 or 3 days later; cold compress application will decrease the swelling. Most of the bruising (contusion) and swelling will disappear during the first week. Very slight swelling noticed only by you and your surgeon will persist for a few months.

During the first days after the operation, a minor leakage may occur from the nostrils and you may feel a slight congestion. At the end of the first week, the splint on the nose will be taken out. At the end of the second week, plasters will be removed, completely exposing the nose.

Most of the patients who undergo a rhinoplasty can get up and walk within two days and can return to school or to (not physically tiring) work a week later. Notwithstanding, it will be a few weeks before you return to daily life completely. Generally, it will be suggested that you avoid intense exercise (running, swimming, working out, sex – any movement that can raise your blood pressure) for 2 to 3 weeks, that you protect your nose from impact or hits for 8 weeks, avoid rubbing and sunlight. For a few weeks, hot water should be avoided while washing your face or hair, as well as the hair dryer.

You can use contact lenses when needed, but situation is different for glasses. After the splint is removed, the bridge and nose pads of glasses should not touch the nasal bone until your nose heals completely, two months later.

It is easy to forget that you will look better when your face is swollen after the operation. Most of the patients do not feel well after the surgery, this is an understandable and very normal situation. Another group of patients is sure that the stage would pass. Your nose will look better and better every day and your morale will increase with time. A week or two later, you will no longer look like you just had a surgery. However, healing is a slow and gradual process.

Very minimal swelling, especially at the tip of the nose, will possibly persist for months. The real results of a rhinoplasty surgery will show at the end of the first year.

You may first receive unexpected reactions from your friends and family. They may say they do not see any difference or, especially if you changed a feature they perceived as familial or ethnic, they may be a bit offended. If this happens, try to remember why you decided to have this surgery in the first place. If you reached your goal and are happy, your surgery is considered successful.

When performed by an experienced plastic surgeon, complications (undesirable results) are rare and generally unimportant. Despite all the measures, there is always a possibility of complication. As rhinoplasty is performed from the inside, there will be no visible scar. However when an open technique is used, or when large nostrils need to be narrowed, thin, small scars will stay on the base of the nose but they are generally not noticeable.

In about 1 in 20 cases, an additional surgery may be necessary (to correct a small deformity, for example). It is impossible to foresee these situations and it may happen to any patient, even to those whose surgery is done by the most experienced and skilled surgeons. The corrective surgery is generally a more limited and simple procedure.

In conclusion, rhinoplasty (nose job) is a pleasing operation increasing the individual’s self-esteem and contributing to their beauty, with a low complication rate when performed by experienced plastic surgeons.