The nose is the aesthetic center of the face and certainly the most challenging and detailed plastic surgery in which the surgeon combines refined technical knowledge with the art of shaping extremely delicate structures. As fundamental to the harmony and beauty of the face, any difference in its shape and size changes not only the nose, but all facial aesthetics.
The nose has a large anatomical variation between individuals and races, both in skin thickness, in size of the cartilage and nasal bones. Thus, the result changes a lot between different patients, since the intention is to preserve facial symmetry characteristics and avoid artificial results. The central objective of rhinoplasty, therefore, is to correct the disproportion of the nose, either at its tip or in the bony region (called the nasal dorsum, where the “bony callus” of the nose is located), making it more harmonious with the rest of the nose, face, enhancing beauty and facial aesthetics.
Combining aesthetic deformities, surgeries also aims to correct patient's respiratory functions, such as septoplasty in septum deviations. Thus, the nose is treated as a whole, always remembering its main function, which is to preserve a good quality breath to the patient.
Local anesthesia with sedation or general anesthesia.
In rhinoplasty, the plastic surgeon has the option of performing the treatment through internal scars or through a small scar located at the junction between the nose and upper lip (called the columella). There are indications for both types of surgery, which will be thoroughly explained during the medical consultation. From this incision, the surgeon has access to all the structures he wants to modify in the nose, be it the nasal septum, the tip cartilage or the nasal bones. At the end of the surgery, if a nasal bone fracture has been performed, a bandage will be applied to the upper part of the nose containing a stiffened plastic called aquaplast. Its function is similar to the plaster used in fractures and remains in the nose for 7 to 10 days, during which much of the healing of the nasal bones occurs.
In general, if it is necessary to use gauze inside the nostrils after surgery, they will be removed within 24 hours before discharge. Thus, the patient is discharged breathing normally through the nose, and may have little difficulty due to swelling in the internal region of the nose. If stitches are used on the outside of the nose, they will be removed on the 5th day after surgery. The internal points do not need to be removed, as the wires used are absorbed by the body. Check the following illustrations for anatomical details of the nose and the steps of the surgery.
Generally from 90 to 120 minutes. In case the septoplasty is done in association with the rhinoplasty, the surgery can last a little bit longer.
Length of hospital stay:
Generally 24 hours.
After rhinoplasty, the patient gets the “aquaplast” dressing for 7 to 10 days. After its removal, it remains with a skin-colored tape over the nose (micropore) for another seven days.
Edema and bruising around the nose are common and completely regress within 21 days. During this period, strict sun protection is recommended, using sunscreen and avoiding sun exposure. In the nose, the edema gradually disappears, and around the 3rd month after surgery at least 80% of it is absorbed. Around the 6th month there is practically no more edema and the result will be very close to the end. Up to 1 year, small changes may still occur, such as decreased edema and improved nasal tip shape.
For two months after surgery, physical activities that require physical contact, such as soccer, basketball or wrestling, should be avoided, as in some cases a fracture of the nasal bones is performed and trauma can lead to dislocation of the bones and leave the nose deviated.
The most common possible complications in rhinoplasty are transient, such as:
- Postoperative bleeding;
- Occurrence of hematoma, surgical infection and nasal obstruction;
- Anesthetic complications;
Poorly performed rhinoplasty can also cause breathing difficulty; nasal obstruction; severe tip deviations; facial disfigurements.
The final result of rhinoplasty, as in all cosmetic surgeries, will depend on the reaction of the patient's body and zeal with pre and postoperative indications.
- Fasting at least 8 hours before surgery, including water, avoiding drinks and overeating on the days preceding the procedure;
- Smokingshould be stopped15 days before surgery;
- Do not apply products on the face beforesurgery,just cleanse the face with mild soap;
- Communicate changes in health status on the eve of surgery;
- Do not wear dark colored nail polish on the day of surgery and avoid wearing jewelry and watches;
- Attend surgery with a companion.
- Provide postoperative azure, finemicropore, cotton swabs, saline, and procedural gloves.
The definitive result of rhinoplasty will be obtained between 6 months and 1 year after surgery. However, we can say that after two months the result will be very close to the end, with the rest of the period gradually decreasing edema and improving the shape of nasal structures, giving the nose an increasingly natural and harmonious result.
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