Rhinoplasty surgery is probably among the most challenging (reshaping the bone structures) and most important (being in the middle of the face) plastic surgery operations. There are basically 2 surgical philosophies in rhinoplasty surgeries. The first one is camouflage surgery. In camouflage surgery, nose is reshaped by making minimal changes in the nasal bone and cartilages and causing less damage to the muscles and ligaments. Generally, camouflage surgery is CLOSED rhinoplasty. Closed rhinoplasty is usually used for those undergoing rhinoplasty for the first time and requiring small manipulations.Procedure Videos
CLOSED (SCARLESS) RHINOPLASTY
Nose can be reshaped by making intranasal incisions, as well as the intranasal structures causing shortness of breath can be corrected. Since intranasal incisions are made and the incisions are hidden by using this technique, no postoperative scar forms, at the same time, patient does not need to have sutures removed.
In my opinion, it is surgically a more difficult technique, but the results are better in eligible patients compared the open technique.
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In this technique, nasal bone and cartilages are reshaped by making incisions from the lower part of the nasal tip. This technique is mostly preferred for second nose operations of patients who previously underwent rhinoplasty and did not achieve aesthetically and/or functionally satisfactory result. It can be performed in patient whose bone structures are more shapeless and who are not eligible for closed rhinoplasty.
In my opinion, open rhinoplasty can be performed in patients in whom we cannot achieve the desired result with closed rhinoplasty.
Frequently Asked Questions
Surgical Planning with Patient Before Surgery
Any shape-related and functional (breathing-related) complaints about your nose and your postoperative expectation are evaluated.
Photographs of your nose are taken from different angles and postoperative targetted image of your new nose is shown to you on the computer.
The preoperative and postoperative nose photographs of the patients, whom we previously operated and obtained their consent, are shown.
Breathing condition and intranasal structures are evaluated in detail with the help of an endoscopic device, and if deemed necessary, tomography is performed and intranasal protrusions, enlargement of nasal conchae and septum deviation are determined and these current problems are corrected during the operation.
Preparation for Surgery
- Aspirin and derivative drugs are discontinued one week before the surgery (do not discontinue the drug that you use regularly without consulting your doctor).
- It is recommended that smoking be stopped for some time before and after the surgery.
- There is no problem for female patients to undergo the surgery, if they are on menstrual cycle during that date.
- Do not put on make-up, do not use hair gel, and wear comfortable clothes, leave your jewelry at home while coming to the hospital on the day of operation.
- Nothing should be eaten or drunk 6 hours before the surgery.
- It is necessary to be at the hospital about one hour before the operation.
- When you arrive at your reserved room, you will be given an oral drug that will relax you, if you like.
Rhinoplasty surgeries are performed under general anesthesia. I usually prefer the closed rhinoplasty technique (there will be no scar since no incision is made on the tip of the nose). Nasal structures (cartilage, bone and soft tissue) are reshaped. While reshaping these structures, the priority is to obtain the functional nasal structure, in other words, a beautiful nose through which patients can easily breathe. Nose is treated gently, and droopy nasal tip, extreme elevation, angle between nose and lip, protruding area or missing area on nasal dorsum, deviated septum, tip of the nose and nostrils are corrected and an aesthetic appearance is achieved. Nasal structures that may cause difficulty in breathing (septum deviation and size of nasal concha) are intervened and corrected at the same time during the surgery. In this way, our patients have both an aesthetic nose and a nose through which they can easily breathe. After nose is reshaped as beautiful as possible and after a functional nose through which the patient can easily breathe is created, we attach special tapes on the outer surface of the nose and place a splint that has a special plastic structure and does not leave the nasal skin airless and does not harm it, thanks to the specially designed small holes on itself. These special nasal splints are removed after 5-7 days.
What is more important than the operative time is to create a nose through which the patient can breathe easily and comfortably during the surgery. Therefore, we try hard to create a nose through which the patient can breathe easily and comfortably during the surgery. The operative time may sometimes take 1.5 hours, but it may take 3 hours in surgeries in which we have to take cartilage from another area.
In direct proportion to the operative time of rhinoplasty, our patients are sometimes discharged on the same day and sometimes on the next day. In order to prevent postoperative pain and to make our patients pass through this period more comfortably, local anesthetic (painkiller) injections are administered to the nose and surrounding tissues during the surgery and special masks are worn to reduce postoperative edema. In this way, pain, swelling and bruising rarely arise in the face.
Keeping your head elevated and positioning your face upwards while lying for at least 10 days after the operation are important for swellings to reduce quickly and symmetrically.
When small amounts of intranasal blood leak reduce after the surgery, the splints on the tip of the nose are removed (the next day).
Two days after the operation, you can wash your hair at home as if having your hair washed at the hair salon.
Two different nasal sprays to be used intranasally are prescribed (one of them is used for about 1 week and the other for about 4 weeks).
Two days after the operation, swelling and edema reach the maximum level (depending on the nature of the individual and the technique used) and then they rapidly dissolve.
On the postoperative day 5, the plastic splint and tapes are removed and a tape in skin tone is applied for one more week to accelerate to dissolve your edema.
About 2 days after the operation, you can return to your work depending on your profession, if you protect yourself from the trauma without touching the splint on your nose.
A slight numbness may ocur at the tip of the nose. This decreases and completely recovers within 2-3 months.
Depending on your nose structure, you will be shown how to do a nose massage.
After the operation, glasses with a heavy frame can be worn after 3 months and glasses with a light frame can be worn after a month, while contact lenses can be worn 3 days later.
If you had undergone deviated septum correction and enlarged nasal concha reduction to breathe more easily, you may have nasal obstruction postoperatively; this will recover within 2 months, if you use the nasal sprays to be prescribed to you.
You can start doing mild exercise that will not tire you after 2 weeks and swimming after six weeks.
It takes about 6 months-1 year to get the final shape of the nose.
According to my personal experience, positive changes in the person after rhinoplasty are reflected in the patient’s social life.