Natural, Compatible With The Face, Unbuffered Rhinoplasty
Rhinoplasty surgery is one of the most frequently performed surgeries in our day. In general, we have a patient portfolio with broad and hook nose due to the racial and genetic characteristics of our country. So, one of the most important surgeries that we, as plastic surgeons, are interested is the rhinoplasty surgery.
Rhinoplasty surgery is performed not only with the purpose of reducing or enlarging sizes of the nose, also for reshaping the tip of the nose, removing the hump on the upper part of the nose, and correcting the relation and angulation between the upper lip and the nose and/or the angle between the nose and the forehead. In some cases, it may be required to add tissue, cartilage in order to correct the appearance of the nose. One or all of these changes is performed with one operation. Since we evaluate the nose as a whole in general, it is necessary to make touches to all elements although small.
Rhinoplasty aims alongside of correcting the appearance in other words the aesthetics of the nose, correcting breathing functions of the naso-respiratory structure, also correcting the psychological expectancy, mood of the patient.
Besides the rhinoplasty surgery is a plastic surgery of correcting internal and external shape of the nose, it will also provide correcting curvature in the nose, correcting the concha hypertrophies called nasal conchae, and also a beautification, improvement in the external part of the nose. Especially this situation, in other words correcting the intranasal curvatures in the course of the same operation is extremely important. The cartilages to be obtained from here are used in the tip, front, skeleton parts of the nose in the purpose of aesthetics and support. Consequently, fixing inside and outside of the nose with different surgeries has the meaning that cartilage source to be on our hand goes to waste.
Rhinoplasty surgery is the main surgery depending the most knowledge, skill, foresight, preparation and experience of the plastic surgeon among all of the aesthetic cosmetic surgical procedures. In the rhinoplasty surgery, both functional and aesthetic external appearance will be fixed. Nose is the most apparent and the most glaring organ in the middle of the face. For this reason, the rhinoplasty surgery to be made should be performed in extremely careful and experienced hands.
A plastic surgeon should try to understand the psychological state of the patient, listen his/her expectation and desires, explain what may be lived after surgery, explain in detail that the ideal result to be obtained in consequence of the surgery is not that in the patient’s head or in any picture, it is the result plastic surgeon can obtain, tell that this is a surgery, and the complications which may occur within and after the surgery to the patient who wants to have rhinoplasty surgery, comes to get examined in the course of the first meeting and examination.
Bone, cartilage and skin structures of the nose, nasal skin thickness, skin fattiness rate of each person show difference from each other. Of course the application and techniques to be performed in the operation will also be different. Consequently, the result emerged after surgery will also be different in each patient and also have personal characteristics. Still the most important factor in rhinoplasty planning is to make different nose planning and design for each nose, each person and perform the surgery. A nose that is compatible with the person’s facial features, suits his/her own face, is not criticized by the others, with natural appearance, is not understood by everyone that it’s being made, befitting the face is a successful result from the point of both the surgeon and the patient.
I make computer nose design in the course of pre-interview with my patients desiring rhinoplasty surgery. Even if the design made does not show the result completely, at least I provide the patient to have idea about the nose shape that can be.
Still it can be looked at the previously performed patient surgery photos, before-after photos; and this creates preliminary information for the patient before rhinoplasty.
Nose surgeries, which are same in all patients, upturned as much as its nostrils are seen from the outside, unnatural, without support, are not performed any longer as before or I do not prefer absolutely.
Rhinoplasty surgery is an operation should be performed under general anesthesia preferably. This is necessary for the doctor to be at ease in the course of surgery. However, if there is only nasal septum deviation, this can be performed under local anesthesia.
I’m using the technique of open rhinoplasty or open nose job plastic surgery in all of my surgeries. The cuts in nose job are made from the inside of wings of the nose and worked from the inside. In the open rhinoplasty there is additionally a small cut under the nose tip. With this technique, all of the structures in the nose, cartilage and bone anatomy are evaluated clearly, by seeing cartilages to be taken off and cartilages to be left, the surgery is maintained, many applications, which cannot be performed with the closed technique especially related to the nose tip and providing the nasal support, can be performed with the open rhinoplasty.
Because only the cartilages that taken off are observed in the closed rhinoplasty, because cartilages supporting the nose tip and sutures are used in lesser extent, I perform my operations with the open rhinoplasty technique. Cuts that are made in such a technique, provide entrance door for the surgeon to cut, trim, remove, reshape the bone and cartilages, and manoeuvre in the purpose of changing the external appearance.
In the nose jobone of the questions patients ask frequently is the matter of whether the bones will be broken or filed. What if we say its name is trimming, filing, cutting; ultimately an application will also be made to the bones. I remove the hump in the upper part of the nose by trimming or filing, but afterwards I definitely activate the bones by cutting from the sides or breaking, and recreate the nasal roof.
Following the surgery a splint made of plaster is applied in the nose to protect bone and cartilages in the new position. In our day, white plaster is left no longer in a large extent. I’m using splints called thermal splint in my nose jobs.
In the technique called unbuffered rhinoplasty, there is need neither tall, nor spongy buffers as before. However, I don’t use buffer in my cases, I apply unbuffered rhinoplasty. In the unbuffered rhinoplasty surgery, internal part of the nose is sutured longitudinally with a special suture technique, thus the need of putting buffer goes away.
Rhinoplasty surgeries take two hours in average. In the course of the operation, with the long acting local anesthetic applied under the nose skin, the patients do not feel any pain after surgery. Some swelling and bruises under eyes; the swelling and bruises that become at the most in the day after surgery completely disappear within a week in general.
Contrary to what is believed, rhinoplasty is a painless surgery of which post-surgical period is very easy for the patient. Splint is completely removed in the 7th day after the operation. At the end of 7 days the patient will be healed and there will be swelling on the nose and face. Even if these swelling get over in a large extent 1 month later, the ultimate healing will finish in 1 year.
After rhinoplasty in the early period, in other words after 1 month the nose tip becomes a hard structure, the nose skin becomes attached a little to the nasal bone. Even sometimes a slight loss of sensation may be in the nose tip. This situation is extremely normal; the nose will become softer in 3 months. Swelling in the bone will be reduced, and after 1 year the final state of rhinoplasty will show up. Consequently, this time should be waited to come to any decision or conclusion.
Rhinoplasty prices change depending upon the nose structure, shape, existence of breathing problem, curvature, if an operation was had or not before (revision rhinoplasty),), and the hospital to be selected. You should come to get examined to learn the rhinoplasty price. Private and state insurances do not cover this surgery.
Non-Surgical Nose Job
In fact, there is no completely non-surgical nose job. But, by using fillers in hollownesses on the back of the nose, slight hump, making the nose tip explicit, arrangements can be made in temporary shape of the nose. The patients who don’t want, abstain from having rhinoplasty, or want to camouflage a deformity formed previously prefer this application. Depending on time and type of the fillers, there are fillers that may last about 6-8 months or 1.5 year.