THE SUBJECTS YOU WONDER ABOUT RHINOPLASTY
IN THE NOSE AESTHETIC SURGERIES (WHICH IS CALLED ‘RHINOPLASTY’) THE MAIN GOAL IS CORRECTING THE SHAPE DEFORMITIES OF THE NOSE AESTHETICALLY AND ELIMINATE THE PROBLEMS CAUSING BREATHING PROBLEMS.
Problems of the nose that require plastic surgery;
The nose is larger or smaller than the face,*
Having an arched appearance,*
Nose surgery with rhinoplasty technique,*
Nose surgery with piezzo technique,*
Depressed or crooked nose,*
Low or deformed nose tip.*
The rough tip of the nose,*
Wide nasal base, etc.
The fact that the nose is incompatible with the face due to its dimensions is the most important reason for aesthetic operation.
Is it possible to achieve the ideal nose with rhinoplasty?
The truth is that; For most plastic surgeons it is "nose surgery to one side other plastic surgeries to another". For patients who will have rhinoplasty for the first time, the worldwide average of satisfaction with rhinoplasty surgeries is around 85%. This means; For fifteen of every hundred patients who have had nose surgery, the result is far from satisfactory. This rate is around 65% in patients who will be operated for the second time, and as the number of surgeries increases this satisfaction rate gradually decreases. If the patients who will undergo surgery for the problem of breathing through the nose are considering a change in aesthetic sense, it is most ideal to have these two surgeries together.
In order to achieve the ideal nose, first of all, we need to determine what the ideal nose is for our patient. Like fingerprints, every face is different. Therefore, the "ideal nose" is different for each face. The expectations of our patients and the shape of the nose in our heads as surgeons should overlap. For this evaluation, we edit the photographs of our patient taken in the studio with Photoshop and make a mutual evaluation on the new version. We conduct a free consultation for approximately one hour with our patient who is considering rhinoplasty. After the functional and aesthetic evaluation, we should discuss and agree with the patient what we can do. In some cases, it may not be possible to make the nose in the person's dream due to the current anatomical condition. But generally, the variety of surgical techniques strengthens our hands in this sense. As long as we agree with our patient about the ideal nose, there is no problem that cannot be solved in experienced hands for the person who decides to have rhinoplasty surgery today. However, as with other plastic surgery surgeries, rhinoplasty cannot solve the problems noted in psychiatric disorders. How should an ideal rhinoplasty be? The ever-increasing concept of naturalness is also valid for the future of Rhinoplasty. For this reason, the nose should not be foreign to the face and should look aesthetically pleasing as an organ in the middle of the face. In social life, it should not be noticed that a person has undergone aesthetic nose surgery unless he/she expresses it himself/herself. Face shape, eyebrow, eye, lip thickness, chin structure, even the size of the person should be proportional and compatible. It should not remain against the face over the years, and should not make the patient regret that he had surgery.
How many techniques are used in rhinoplasty?
Rhinoplasty is a surgery performed with many technical riches due to the diversity of the nose shape and the difference of the personal aesthetic goal. These techniques may vary according to the surgeon's knowledge, skills and experience. Different techniques can be used in line with personal experiences and habits to achieve the same goal. Techniques that are still developing in general can be grouped under the title of "structural rhinoplasty". "Reductive Rhinoplasty", which is based on the removal of tissue from cartilage and bone structures, is no longer preferred except in some cases.
Structural rhinoplasty techniques bring a person's own tissue to the aesthetic and functional goal with the addition of various suturing techniques and/or cartilage grafts (own cartilage tissue) while preserving their own tissue. Operations are performed in two ways, open or closed rhinoplasty. When is closed rhinoplasty preferred? Whether rhinoplasty is open or closed should not be understood as a stand-alone technique. According to the characteristics of the person's nose, the preference is determined by the aesthetic needs and the experience of the surgeon. Except in multifaceted situations, the same techniques can be applied to the same patient with both approaches. Both approaches have advantages and disadvantages. In a closed approach, all surgical maneuvers are performed through the nostrils. Recovery time is marginally shorter due to fewer tissue incisions and separations. In symmetrical noses, nose tip and nose ridge arrangements are a common approach. Closed approaches are complex for the surgeon and more difficult to implement with concomitant techniques and in fact the operative time is longer than open surgery. For this reason, it is not preferred in patients with advanced nasal deformity, lack of tissue support or very problematic secondary (revision) cases.
Which technique do you use for bone intervention in nose surgeries?
I no longer do bone breaking in nose surgeries. I use a technique called the "piezzotome" or "piezzo" technique or rather the device.
What is the piezzo technique?
In the ultrasonic rhinoplasty procedure, which is called piezzotome or piezzo technique, bone cutting is performed with very special devices.
What is the advantage of Piezzo technique (Ultrasonic Rhinoplasty) over the other classical method?
Ultrasonic rhinoplasty (Piezzo Rhinoplasty) that is Piezzotome device works with a sound wave so it only cuts the bone and does not damage the surrounding soft tissue. Therefore, it is thought that there is less swelling and bruising. Even more important advantage is that most people in our society have bone fragments at the base of their noses that block the airways. The base of the nose is very close to the brain and is in close contact with the bones that protect it. Bone fragments causing obstruction in this area were previously cleaned with the help of a hammer and chisel. This situation made the brain tissue vulnerable to traumas that could damage the surrounding cerebral cortex and cause leakage of cerebrospinal fluid. Ultrasonic rhinoplasty (piezzo) brings such a serious risk close to zero.
Is it possible to make bone drilling with Piezzo technique or Ultrasonic rhinoplasty technique?
Yes. File, bone drilling and cutting etc. with piezzo. all operations that need to be done to the bone can be done.
In what situations is the open method used?
The open approach is the method by cutting the skin between both nostrils and removing the nose tip and back skin. It provides a comfortable maneuvering area with a wider surgical field of view. The open approach is preferred especially in patients with high degree of hump (bone or cartilage on the back of the nose) when curved applications are needed (cartilage, bone, soft tissue, etc.), deformed or collapsed and multiple interventions. However, it is always a technique involved in easy or complex cases, according to the surgeon's preference.
Is there an age limit for nose surgery?
Since the development of skull bones and cartilages is completed at the age of 18, it is appropriate to perform the surgery after this age. However, this age limit can be slightly stretched in patients with severe breathing problems.
Can the solution of nasal aesthetics and the situations that cause nasal congestion be in the same surgery?
As stated above, since the chance of success is high in the first operation, it is best to solve both problems in one operation.
Can septum deviation be corrected with plastic surgery?
What we call the septum is the part that divides the nasal cavity in two, consisting of cartilage in the front and bone in the back and covered with a cover called mucous. The deviation of the septum that is the inclination of this cartilage or bone part in the midline of the nose to one side, is one of the causes of breathing disorders. Whichever side has a curvature, the passage on that side is narrowed and causes difficulty in breathing. Nasal concha and septum curvatures can be operated simultaneously with rhinoplasty by a plastic surgery specialist. Sometimes this curvature can be very advanced due to trauma or previous surgery. Sometimes this cartilage may be excessively removed. In this case, the plastic surgeon will have to take cartilage from the ear or rib and restore this area to its natural anatomical structure.
Does removing cartilage from the ear or ribs cause any harm to the body?
It is necessary to make an incision to remove cartilage from both areas. Due to this incision, a small incision of 3-4 cm remains on the back of the ear or on the lower fold of the breast. This may be an advantage for the patient whose ear cartilage is slightly large and whose ear is slightly open. Removing cartilage from the rib or ear does not cause any deficiencies or problems in the body. Of course this area must not have local complications.
Can rhinoplasty be performed with local anesthesia?
It is preferred in very rare cases. Theoretically, every nose surgery can be performed under local anesthesia but this is not a comfortable situation at all. With today's anesthesia technology it is safer and more comfortable to perform these surgeries under general anesthesia.
Can those with sinusitis have aesthetic nose surgery?
In general, patients with chronic sinusitis already have this discomfort due to the inability to breathe easily through the nose. It cannot be expected that this situation will completely improve before it becomes easy to breathe through the nose. Of course, nose surgery can be performed on these patients and it should be done anyway. However, it is not done during the active period of the disease. Acute sinusitis is treated and surgery is performed.
How many hours does rhinoplasty take?
If you have not had surgery before and there is only a shape problem it takes 2.5 - 3 hours on average. This time may vary slightly depending on the difficulty level of the nose surgery. If there is a situation that requires cartilage removal from another region it may take up to 5-6 hours.
Is aesthetic nose surgery a very bleeding surgery?
Aesthetic nose surgeries are not a bleeding operation. In order to make things easier during the operation and to reduce the post-operative bruising and swelling the anesthesia and surgical team require almost zero bleeding and take special precautions for this.
Will there be bleeding from the nose after aesthetic nose surgery?
After aesthetic nose surgery, there may be bleeding in the form of slight drops or leakage which lasts for a few days and gradually becomes lighter. This is a completely normal state.
Will there be scars after aesthetic nose surgery?
If closed surgery is performed, no scars are left. If open surgery is performed, a thin scar of approximately 2-3 mm remains on the skin between both nostrils and this scar gradually disappears within weeks to months and becomes almost invisible. In order to notice this scar, it is necessary to look carefully at a distance of about one span under the nose. If it was necessary to take cartilage from another area during the surgery, there will be an operation scar belonging to that area.
When do swelling and bruises go away after rhinoplasty?
Swelling and bruising that will occur after nose surgeries generally depend on the skin and tissues of the patient. While some of our patients do not have it at all it is a small amount in most of our patients. Very few patients have severe swelling and bruising. This usually happens when advanced nose surgery is required. This swelling disappears in about three days and the bruise disappears in 1 week. For an organ that will be carried in the middle of the face for a lifetime, swelling or bruising that may occur during this period is not something to be obsessed with.
Does the tip of the nose drop after aesthetic nose surgery?
After the surgery performed by advanced surgical techniques and an experienced plastic surgeon, there is no nasal tip drop. The fact that the nasal tip lift due to mild edema immediately after the surgery returns to normal after this situation has passed should not be interpreted as nasal tip drooping.
Will there be asymmetry after rhinoplasty?
As a result of the interventions on the nasal skeleton, the nose regains its new shape. After these intervention there may sometimes be asymmetrical recessions during the healing of that region and these may cause asymmetry in the early period. Very rarely, these asymmetries may require a second surgery. If you give an asymmetry at the beginning these will be corrected with surgery, but if the asymmetry is secondary to a trauma at the age of development and is advanced a zero degree axis in the nose may not be achieved.
Is there any difficulty in breathing through the nose after aesthetic nose surgery?
There might be a small chance. This situation is especially likely to occur in patients who need advanced narrowing of the base of the nose or patients with severe deviation of the axis to one side.
Does the smell in the nose change after aesthetic nose surgery?
Rarely, there may be a temporary or permanent inability to smell from the nose.
Is aesthetic nose surgery different in men and women?
Surgical technique, preoperative and post-operative all procedures are the same but the difference between both genders is the targeted nose shape. While a slightly curved and slightly upturned nose is desired in women, this situation is not desired in men and maneuvers are made accordingly. Otherwise, the man will have a feminine nose and this may disturb the patient.
Is there a difference between performing nose surgery in summer or winter?
Generally, this surgery does not have any season. Both seasons have advantages and disadvantages in terms of comfort. With the effect of the sun and heat in the summer, especially in the region we are in (Antalya Estetik), the nose plaster may disturb the comfort a little. In winter, seasonal diseases may affect patient comfort in the postoperative period. Apart from these, there is no obstacle or difference surgically.
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