Rhinoplasty (nasal surgery) is the correction, restoration, correction of the structures of the nose using plastic surgery techniques. Used for medical and aesthetic reasons.
Despite its widespread use, rhinoplasty surgeries are still considered to be one of the most difficult.
Rhinoplasty has been done for thousands of years. Old manuscripts attest to the successful experience of such procedures long before our era.
Medicine is way ahead of ancient doctors, and modern rhinoplasty is more of a cosmetic procedure than a medical necessity.
Indications for a nose job
Any plastic surgery is a complex creative process that combines the solution of aesthetic problems with the maintenance or restoration of certain functional features of the organ (in this case nasal breathing).
Thus, a nose correction can be carried out for therapeutic and aesthetic purposes. The optimal age for performing is 25-35 years.
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 tissue development) or compensatory curvature of the nasal septum;
- pronounced injury or complete lack 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, such defects in children can lead to chronic oxygen starvation of the brain, which leads not only to their physical, but also to mental disability and affects their mental development and behavioral responses. Therefore, rhinoplasty can also be performed on children under the age of 18.
More than 60% of the reasons for a nose job are the patient's desire to improve the shape of the nose in order to achieve complete harmony in its appearance. Plastic surgery services are becoming increasingly popular. Aesthetic indications for a nose job are divided into two broad groups:
- objective - these are disproportionate and unattractive sizes or shapes of the nose;
- subjective or psychological: there are no specific criteria for judging beauty, every person has their own established stereotype and therefore may simply not like their nose for personal reasons.
These reasons often affect the professional and personal relationships of people, lead to dissatisfaction complexes and one's own inferiority, especially in the female environment, lead to social maladjustment.
Aesthetic rhinoplasty is indicated in cases where:
- disproportionate size of the nose in relation to the entire face - too large or, conversely, too small;
- congenital or acquired malformations;
- Curvature of the nasal septum;
- dilated nostrils, humps;
- forked, lowered or too high, asymmetrical tip, as well as their non-coincidence with the height of the bridge of the nose;
- Saddle shape;
- Aesthetically unsatisfactory result of the previous operation.
In many cases, medical and aesthetic indications are the same and result from the same anatomical defects.
Types of Rhinoplasty
According to the pursued goal and the technique of performing the surgical intervention, rhinoplasty is divided into:
- Reconstructive, the purpose of which is to restore anatomical disorders due to improper intrauterine development, traumatic injuries or diseases.
- Aesthetics - correction of existing defects.
According to the same criteria, there are several types of rhinoplasty:
- Reduction or enlargement of the nose.
- Backrest alignment - correcting a lowering of the saddle or eliminating a hump.
- Correction of aesthetic imperfections in the tip.
- Septum correction (septoplasty).
- Post-traumatic reconstruction of the structure.
All types of operations are divided into:
- primary;
- secondary;
- repeated.
Access techniques
The following techniques are used for rhinoplasty, depending on the access options:
- Closed nose job,where incisions can be made in the nasal cavity. The closed access is divided into marginal (along the inner surfaces of the nostrils), transseptal, inter- and transchondral. After the incision, the soft tissues are separated (separated) from the cartilage and bones that make up the frame, allowing you to freely perform the necessary manipulations. Closed rhinoplasty is less traumatic than open rhinoplasty and eliminates artery damage and tissue malnutrition, and post-operative scars are completely invisible because they are located in the nasal cavity. It is most commonly used, especially for aesthetic rhinoplasty.
- Open nose job- The incision runs along the columella (the part of the skin of the fold between the nostrils) and on the nostrils where they meet the lip. The technique is used in cases when the task cannot be solved in any other (closed) way. It allows you to lift up soft tissues and cartilage, gain adequate access to the inner 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 nasal deformity with malformations such as "cleft lip" or a hard cleft palate; Reconstruction with grafts. The disadvantage of open rhinoplasty is the formation of a noticeable postoperative scar and the forced damage to the columella arteries, which leads to significant and long-lasting postoperative tissue edema.
Rhinoplasty of any kind is performed under one of the types of general anesthesia and usually takes 1-2 hours. Sometimes their duration can reach three or more hours.
How is a nose job done?
The process is carried out in the following order:
- Correction of the nasal septum is carried out;
- if necessary, the nasal shells are reduced;
- the nasal hump is corrected when a uniform profile is required;
- Bones are dissected and displaced to narrow the nasal pyramid;
- erects the nose;
- Tip correction.
Revision rhinoplasty
Another rhinoplasty can be considered if surgery has already taken place in this area. The final nasal formation after plastic surgery occurs in six months - 1 year. This period is ideal for the reoperation. It is carried out when:
- State of impossibility to achieve the goal in one phase;
- unsatisfactory results of the primary operation;
- the need to correct problems that remain after the primary rhinoplasty.
According to global statistics, 25-30% of patients who have had a primary rhinoplasty need a second corrective operation. This is considered normal. It usually lasts no more than half an hour and is performed under local anesthesia. Corrective revision nose correction allows you to correct scarred defects and bring the shape of the nose to an aesthetic result that will satisfy the surgeon and the needs of the patient.
A repeated rhinoplasty is much more difficult if the primary or unfavorable course of the rehabilitation phase is poorly carried out, which often depends on the individual circumstances of the organism and the complications. Such operations require a deeper investigation and preparation. According to one of the options, they represent a full-fledged plastic, but usually turn out to be much more complicated and time-consuming. Small mistakes in repeated plastic interventions can lead to a definitive form disruption, not only of the tip, for example, but also to severe deformation of the entire nose.
Complications and preparation for surgery
Rhinoplasty is considered to be 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 the operation (bleeding, skin cracks, tearing of the mucosal cartilage flap, violation of the integrity of the bone pyramid, fracture of the bone site, etc. ) and postoperative.
Possible complications after a nose job:
- functional - atrophic rhinitis, difficulty breathing through the nose, loss of smell, temporary or permanent decrease or complete loss of skin sensitivity of the nose and upper lip;
- aesthetic - no change or deterioration of previous defects;
- psychological - patient dissatisfaction with the results of plastic surgery;
- infectious - prolonged swelling and inflammation, suppuration;
- Pigmentation of the nasal skin, formation of a vascular system, adhesions of the mucous membrane and rough scars;
- recurrent nosebleeds and soft tissue or cartilage necrosis.
The preparation consists of:
- Consultation with a plastic surgeon, during which the technical possibilities for 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), EKG.
- Carrying out (if necessary) special studies - pictures of the paranasal sinuses, endoscopic examination of the nasal cavity to identify accompanying anomalies and pathological changes.
- Computer simulation that enables the patient to compare the initial condition of the nose with the results of a future rhinoplasty.
- Consultations with a therapist and specialized specialist (for chronic diseases).
- Examination by an anesthetist after all examinations.
- Refusal two weeks before the operation to take drugs that affect the processes of blood clotting - acetylsalicylic acid and its analogues, anticoagulants.
- Withdrawal from sedatives and sleeping pills on the day of intervention.
Contraindications and Rehabilitation
Absolute contraindications for rhinoplasty:
- the presence of chronic systemic diseases in severe forms (endocrine, cardiovascular, pulmonary);
- acute infectious diseases;
- Bleeding disorders;
- Days of menstruation.
Basic recovery from rhinoplasty takes up to 3 weeks. Despite this, the deadline for the full end of the rehabilitation period is determined by the doctor when assessing the results and is 6-12 months. During this time, certain restrictions must be observed.
1-1, 5 weeks after the procedure, the plaster cast and the sutures are removed. Do not wash with hot water or take hot baths for the first two weeks as bleeding, bruising, and swelling may occur and spread to the entire face and neck. It is necessary to sleep only on your back in an elevated position, which will make breathing easier and reduce swelling. It is advisable to wear a face mask in dusty places. Bending over and lifting weights should be avoided.
Also, you must stop wearing glasses and wearing tight or heavy hats within 3 months. You can not visit the pool and sunbathing for 3 months. In hot weather and in the sun, an umbrella or wide-brimmed hat is recommended.
When planning options for rhinoplasty surgery, a skilled surgeon adheres to the principles of three types of constraints: constraints set by the surgeon himself; restrictions imposed by the patient; Limitations associated with the patient's condition and the anatomical features of his nose.
price
The cost of the operation depends on the complexity of the correction.
credentials
Review of a woman
"I've always had complexes about the shape of my nose. It was too long, with a bump and the tip of my nose seemed to fork. I decided to have a rhinoplasty last year. If I had done it sooner, my life would probably be better now. They removed all imperfections. They even restored the septum, the defect of which I wasn't even aware of. My nose is perfect, just like me. "
Review of a man
"After breaking my nose several times, my nasal septum shifted. I could not breathe normally, I snored heavily at night. The diagnosis showed temporary holding of my breath during sleep. The nose looked ugly, it was shifted to the side. I have "to do a rhinoplasty to straighten my nose and get rid of the problems associated with the displacement of the septum. I did this. I am happy with the result. Now my nose is normal, as it was before the fractures. She is always breathing 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 knowledgeable surgeon and make sure that you do not have any contraindications to the procedure.