Rhinoplasty (Dr.-Greek ῥίς, r. Ῥινός - nose + πλαστική - plastic) is a correction of congenital or acquired deformities of the nose, as well as a complete restoration of the missing nose.
ANATOMY-AGE ASPECTS OF INDICATIONS TO RHINOPLASTY.
If the nose defects were congenital, rhinoplasty can be performed from the age of 18, although the final formation of the nose ends on average by the age of 20 (the formation of the nose bone is about 16-18 years old, and the cartilaginous tissue approximately 20 years). The optimal age for rhinoplasty is from 20 to 35 years.
According to the type of surgical intervention, all methods of rhinoplasty are divided into the following:
Closed rhinoplasty is the most popular and often used method of correction, since after the operation scars are not visible. When the nose is plastically closed, all manipulations and incisions occur inside the nose.
Passes through one of the possible accesses (through cartilage, interchip, marginal combined).
The surgeon separates the skin of the nose of the nasal bones and cartilage that make up the skeleton of the nose. After that, the doctor can easily change their shape, remove excess cartilage or bone, increase the volume to achieve the desired shape. For example, to slightly narrow the nose, the surgeon can remove the cartilage in the region of the back of the nose. Removing the protruding parts of the bones of the nose is carried out with the help of a special tool - a chisel. After the surgeon has changed the shape of the bones of the nose and cartilage, he sews back the incision of the soft tissues. With closed rhinoplasty, the surgeon does not make a columella cut. After closed nose plastics, an external nasal splint is placed
Open rhinoplasty - in comparison with the closed method is used less, but is indispensable in complex surgical interventions. Open rhinoplasty is performed through a cut in the area of the vertical septum between the nostrils (columella), which after surgery is sutured and becomes invisible over time.
Do not be afraid of scars after open rhinoplasty! In the hands of an experienced surgeon, traces after plastics of the nose will not be completely visible.
Non-operative nose plastic is used with a slight correction, and the nose shape change is achieved with the help of special fillers (fillers) based on hyaluronic acid, hormonal preparations and Aptos filaments. The result may persist for 10-12 months, and after resorption of the drugs, a second correction is required.
It should be noted that non-surgical rhinoplasty is not a complete alternative to traditional rhinoplasty. With its help, only small defects can be corrected. Among all patients who turn to plastic surgeons for the purpose of rhinoplasty, only 5-7% of the correction can be performed by one of the non-surgical methods.
In addition, our clinic uses rhinoplasty with a laser, the difference of which is that instead of the usual cut with a scalpel, an azure beam is used. Laser rhinoplasty of the nose also has undeniable advantages, which include:
After a nose injury, two problems arise: nasal breathing is disrupted and the shape of the nose changes.
It should be noted that in case of trauma, at the early stage of healing (the first 10 days) without surgery, outpatiently, the original location of the back of the nose is restored (with lateral mixing, bending). The ability to restore impaired nasal breathing and in other cases of change in shape is established upon examination.
If the injury was serious, the nose is reconstructed with the restoration of both external and internal structures. Often, internal operations on the nose are performed by patients after repeatedly undergoing rhinoplasty operations.
The surgical intervention is necessary after the trauma, which can be accompanied by the violation of nasal breathing (curvature of the nasal septum). It is desirable to perform the operation in one stage - to restore the physiology of respiration (submucosal resection of the nasal septum) and to change the shape of the nose (actually aesthetic rhinoplasty).
Since this intervention seriously changes the external image of patients, we recommend that, before carrying out rhinoplasty, the question should be studied maximally and comprehensively.
There are times when a person has a perfectly normal nose without any functional and aesthetic defects, but it seems to him that surgery is needed. In such cases, the patient may have such diseases as dysmorphophobia and dysmorphomania, and he does not need an operative intervention, but the help of a psychologist and / or a psychiatrist.
Having conducted special measurements, the surgeon can tell whether a person has nose defects, or it is not observed. In plastic surgery, there are average statistical parameters of the size and shape of the nose, as well as its harmonious arrangement with respect to the eyes, forehead, ears, lips and chin.
Before surgery, it is also recommended to rest as much as possible, do not smoke, do not consume alcohol and any medications without the knowledge of the doctor. On consultation with a plastic surgeon, it is recommended that you carefully discuss the alleged external appearance of the nose after the operation.
After carrying out rhinoplasty, as a rule, there is a strong swelling of the nose and in the eye area. After the operation, a special bandage should be worn for at least 7-10 days if an osteotomy was performed or an implant of the back was installed. Swelling partially passes through 10-20 days. The preliminary result is estimated after 6 months, the final result in 12 months.
As a rule, the operation of rhinoplasty is accompanied by the installation of intranasal cotton-gauze tampons, which in turn causes discomfort and headaches in patients, since for some time the patient has to breathe through the mouth if the surgeon deems it necessary to leave tampons in the nose for up to three days.
But modern technologies used by us - intranasal air silicon splint (intranasal air silicon splint) and external plastic forming splinters (nasal termo splint) make it possible for our patients to feel much comfortable during the postoperative period - it does not give the patient painful sensations and is completely painless.
The healing time depends largely on the individual characteristics of the organism and the patient's age, so the doctor can only name the approximate duration of rehabilitation. After removing the splints, you must visit the doctor with the frequency indicated for inspection.
After rhinoplasty, it is recommended to limit physical activity. Since in the first weeks the nose is still weak and it is easy to injure, it is recommended that you do not wear glasses for a while. In order not to provoke nasal bleeding, it is recommended to exclude too hot and too cold food from food.
The decision on rhinoplasty is taken individually. And it will not necessarily be approved by others, so the patient should be prepared for the unexpected reaction of friends and relatives. After all, not only the shape of one nose will undergo changes, but also the appearance as a whole. It may happen that relatives will spit out the grievance because of the loss of characteristic family or ethnic features. But often even the closest people do not notice the big changes after the surgery because the nose shape is acquired by the patient and the surgeon for a rather long time, and the swelling of the tissues formed after the operation masks the effect. It should also be noted that the changes in the nose obtained during the operation are not inherited, since plastic does not affect genetics, but gives only an external effect. The full course of postoperative rehabilitation lasts up to 6-8 months. That is why the final result of rhinoplasty should be assessed no earlier than the deadline.
In order to speed up the recovery, we strongly advise to follow recommendations after rhinoplasty, which include:
Patients who decided to do rhinoplasty should not choose between the length of the rehabilitation period and the choice of the scope of the operation. Many are afraid to do full rhinoplasty with osteotomy, choosing only correction of the tip of the nose, but only an excellent result should be chosen. After all, such defects as severe fractures or trauma to the nose can be eliminated only with the help of full rhinoplasty.