Rhinoplasty (plastic nose) is the correction, restoration, correction of the structures of the nose using plastic surgery techniques. Used for medical and aesthetic reasons.
Despite its prevalence, nose correction surgeries are still considered one of the most difficult.
Nose repair surgeries have been performed for thousands of years. Ancient manuscripts testify to the successful experience of such procedures long before our era.
Medicine has come a long way compared to ancient doctors, and modern rhinoplasty is more of a cosmetic procedure than a medical necessity.
Rhinoplasty indications
Each plastic surgery is a complex creative process that combines the issues of solving aesthetic problems with the preservation or restoration of specific functional characteristics of the organ (in this case, it is nasal breathing).
Therefore, rhinoplasty can be performed for therapeutic and aesthetic purposes. The optimal age to do it is 25 to 35 years old.
The medical indications are:
- congenital deformity of the nasal septum;
- polyps and hypertrophy of the turbinates;
- traumatic injuries and post-traumatic changes in bones, cartilage, physiological (due to uneven development of tissues) or compensatory curvature of the nasal septum;
- Pronounced violation or complete absence of the possibility of nasal breathing.
Changes in the correct anatomical structure of the nose are very often the cause of functional disorders and pathological conditions: shortness of breath, atrophy or hypertrophy of the nasal mucosa, rhinosinusitis, otitis media, frequent respiratory diseases, night snoring.
In addition, in children, such defects can cause a chronic lack of oxygen in the brain, which leads not only to their physical, but also mental retardation, and affects their mental development and behavioral reactions. Therefore, rhinoplasty can also be performed on children under the age of 18.
More than 60% of the reason for rhinoplasty is the desire of the patient to improve the shape of the nose to achieve a complete harmony of the appearance of it. Plastic surgeon services are becoming more and more popular. The aesthetic indications for rhinoplasty are divided into two large groups:
- Target: These are disproportionate and unattractive sizes or shapes of the nose;
- subjective or psychological: there are no specific criteria for assessing beauty, each person has their own established stereotype and, therefore, simply for personal reasons, you may not like her nose.
These reasons usually affect people's professional and personal relationships, give rise to dissatisfaction complexes and their own inferiority, especially in the female sphere, leads to social maladjustment.
Rhinoplasty for aesthetic purposes is indicated in cases where there are:
- disproportionate size of the nose in relation to the entire face - too large or, conversely, too small;
- congenital or acquired deformities;
- curvature of the nasal septum;
- dilated nostrils, hump;
- forked tip, lowered or too high, asymmetrical, as well as its mismatch with the height of the nasal dorsum;
- saddle shape;
- aesthetically unsatisfactory result of the previous operation.
In many cases, the medical and aesthetic indications are the same and are the result of the same anatomical defects.
Types of rhinoplasty
According to the objective pursued and the technique of performing the surgical intervention, rhinoplasty is divided into:
- Reconstructive, whose purpose is to restore anatomical disorders resulting from inadequate intrauterine development, injuries or traumatic diseases.
- Aesthetics: correction of existing deficiencies.
According to the same criteria, there are several types of rhinoplasty:
- Reduction or enlargement of the nose.
- Backrest alignment: correction of saddle depression or elimination of a hump.
- Correction of aesthetic imperfections of the tip.
- Septum correction (septoplasty).
- Post-traumatic reconstruction of the structure.
All types of operations are subdivided into:
- primary;
- secondary;
- repeated.
Access techniques
When performing rhinoplasty, depending on the access options, the following techniques are used:
- Closed rhinoplasty,in which incisions can be made in the nasal cavity. Closed access is subdivided into marginal (along the inner surfaces of the wings of the nose), transseptal, interchondral, and transchondral. After the incision, the soft tissues are separated (separated) from the cartilage and bones that form the framework, allowing you to freely perform the necessary manipulations. Closed rhinoplasty is less traumatic than open rhinoplasty and eliminates arterial damage and tissue malnutrition, and postoperative scars are completely invisible, since they are located in the nasal cavity. It is used most often, especially for cosmetic rhinoplasty.
- Open rhinoplasty- The incision passes along the columella (the skin part of the fold between the nasal openings) and on the wings of the nose at its junction with the lip. The technique is used in cases that do not allow the task to be carried out in another way (closed). It allows you to lift soft tissues and cartilage upward, gain sufficient access to the internal parts of the nose, and perform manipulations under constant visual control. Open rhinoplasty is necessary to correct particularly serious changes and technically complex and significant operations: pronounced deformity of the nose, especially with lateral displacement; combination of deformity of the nose with malformations such as "cleft lip" or cleft hard palate; reconstruction using grafts. The disadvantage of open rhinoplasty is the formation of a noticeable postoperative scar, as well as forced damage to the arteries of the columella, resulting in significant and long-lasting postoperative tissue edema.
Rhinoplasty of any type is performed under one of the types of general anesthesia and usually lasts between 1 and 2 hours. Sometimes its duration can reach three or more hours.
How is rhinoplasty performed?
The operation is carried out in the following sequence:
- correction of the nasal septum is performed;
- if necessary, the shells of the nose are reduced;
- the nasal hump is corrected if it is necessary to form a uniform profile;
- the bones are dissected and moved to narrow the pyramid of the nose;
- straighten the nose;
- tip correction.
Revision rhinoplasty
Replasty of the nose is considered if there has already been a surgical intervention in this area. The final formation of the nose after plastic surgery occurs in six months - 1 year. This period is optimal for reoperation. It is done when:
- condition of impossibility of achieving the goal in one stage;
- unsatisfactory results of the primary operation;
- the need to correct problems that remain after primary rhinoplasty.
According to world statistics, 25-30% of patients who underwent a primary rhinoplasty require a second corrective surgery. This is considered normal. It usually lasts no more than half an hour and is performed under local anesthesia. Corrective revision rhinoplasty allows you to correct scarring deficiencies and bring the shape of the nose to an aesthetic result that will meet the needs of the surgeon and the patient.
It is much more difficult to perform a repeat rhinoplasty in cases of primary or unfavorable course of the poorly performed rehabilitation period, which often depends on the individual characteristics of the organism and complications. Such operations require a more thorough examination and a more thorough preparation. They represent a complete plastic according to one of the options, but, as a rule, they turn out to be much more complicated and time-consuming. Minor defects during repeated plastic surgery can lead to a final disruption of the shape, not only, for example, of the tip, but also a pronounced deformation of the entire nose.
Complications and preparation for surgery.
Noseplasty is considered one of the most difficult plastic surgeries, the outcome of which largely depends on the skill and experience of the surgeon. Complications occur in 4-15% of cases. They can be during surgery (bleeding, skin breaks, tear of the muco-cartilaginous flap, violation of the integrity of the bone pyramid, fracture of the bone site, etc. ) and postoperative.
Possible complications after rhinoplasty:
- functional: atrophic rhinitis, nasal breathing difficulties, loss of smell, temporary or permanent decrease or complete loss of sensation of the skin of the nose and upper lip;
- aesthetics: no changes or worsening of the previous deficiencies;
- psychological - dissatisfaction of the patient with the results of plastic surgery;
- infectious - prolonged swelling and inflammation, suppuration;
- pigmentation of the skin of the nose, formation of vasculature, adhesions of the mucous membrane and rough scars;
- Recurrent nosebleeds and cartilage or soft tissue necrosis.
The preparation consists of:
- Consultation with a plastic surgeon, during which the technical possibilities of fulfilling the patient's wishes are determined.
- Conducting general studies: clinical and biochemical blood tests, blood clotting test (coagulogram), general urinalysis, tests for hepatitis, HIV, syphilis (RW), ECG.
- Carrying out (if necessary) special studies: imaging of the paranasal sinuses, endoscopic examination of the nasal cavity to identify concomitant abnormalities and pathological changes.
- Computer simulation that allows the patient to compare the initial state of the nose with the results of a future rhinoplasty.
- Specialized therapist and specialist consultations (in the presence of chronic diseases).
- Examination by an anesthesiologist after all examinations.
- I refuse two weeks before the operation to take drugs that affect the blood clotting processes - acetylsalicylic acid and its analogues, anticoagulants.
- Stop taking sedatives and sleeping pills on the day of the intervention.
Contraindications and rehabilitation.
Absolute contraindications for rhinoplasty:
- the presence of any chronic systemic disease in a severe form (endocrine, cardiovascular, pulmonary);
- acute infectious diseases;
- blood clotting disorders;
- days of menstruation.
The basic recovery from rhinoplasty lasts up to 3 weeks. However, however, the time frame for the full end of the rehabilitation period, when the results are evaluated, is determined by the doctor and is 6-12 months. During this time, certain restrictions must be observed.
After 1-1, 5 weeks after the intervention, the cast and sutures are removed. During the first two weeks, do not wash with hot water or bathe in hot water, as bleeding, bruising, and swelling may appear and spread throughout the face and neck. You need to sleep only on your back in an elevated position, which helps make breathing easier and reduces swelling. In dusty places, it is advisable to wear a face shield. Bending and lifting weights should be avoided.
Also, within 3 months, you should stop wearing glasses and wear tight or heavy hats. You cannot visit the pool and sunbathe for 3 months. In hot climates and in the sun, a wide-brimmed umbrella or hat is recommended.
When planning rhinoplasty options, an experienced surgeon adheres to the principles of three types of restrictions: restrictions determined by the surgeon himself; restrictions imposed by the patient; restrictions that are associated with the patient's condition and the anatomical characteristics of his nose.
Price
The cost of the operation depends on the complexity of the correction.
Testimonials
Review of a woman
"I have always had complexes about the shape of my nose. It was too long, with a hump and the tip of the nose seemed to fork. Last year I decided to have a rhinoplasty. If I had done it before, then my life would be now, probably better. They removed all the imperfections. They even restored the septum, whose defect I did not even know about. My nose is perfect, like me. "
One Man Review
"After I broke my nose several times, my nasal septum moved. I couldn't breathe normally, I snored a lot at night. Diagnostics showed temporarily holding my breath while sleeping. The nose looked ugly, it was displaced to one side. I have a rhinoplasty to straighten my nose and get rid of the problems associated with the displacement of the septum. I did it. I am happy with the result. Now my nose is normal, as before the fractures. I always breathe and I no longer snore. "
Rhinoplasty is not always a whim, but most of the time it is justified by an objective need. It is important to choose a competent surgeon and make sure that you have no contraindications for the procedure.