Rhinoplasty is a separate area of plastic surgery for the correction of congenital or acquired nasal defects. With the help of rhinoplasty it is possible to solve the problems of nasal breathing, correct the external consequences of injuries, and also correct the appearance according to aesthetic indications.
For many people unhappy with the shape of their own nose, a rhinoplasty can be a lifesaver. If the nose does not correspond to the ideal, it is possible to correct its contours with the help of rhinoplasty. This is an operation that allows you to change the shape and position without affecting the body's functions. And in some cases, with its help, the performance of the nose also improves. Depending on the defect, the tip can be made narrower, sharpened, raised. Rhinoplasty is able to correct the shape of its inner part - the septum. The changes in the cartilage tissue lead to improvements in the organ's appearance and functionality.
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Indications for the procedure
Plastic correction of the nose is indicated for the following problems with it:
Aesthetic indications
Aesthetics, as mentioned above, mainly affects the parameters of beauty. That is, this desire to correct the shape or length of the nose. The most important requirements that the patient brings with him are:
- hump removal;
- non-standard shape of the tip of the nose;
- desire to lower or raise the tip;
- change in distance between upper lip and nose;
- narrowing of the bridge of the nose;
- changing the size of the nostrils;
- changing the size of the nose;
- nasal alignment;
- Elimination of the crooked partition, its alignment.
Medical indications
There are also direct medical indications for rhinoplasty..Typically, such operations are assigned when received:
- injuries;
- burns;
- fractures of the nasal bones;
- frostbite.
That is, according to medical indicators, problems caused by artificial means are mainly solved. There are exceptions of the congenital type, but in such cases they are referred for rhinoplasty only if the anatomical structure worsens the respiratory function and causes problems of a different nature. Note that shortness of breath in children is associated with a number of consequences - from a lack of oxygen in the brain to developmental delays. Therefore, timely treatment of the patient plays an important role in medical cases. Thus, not only defects are eliminated, but also many negative consequences are prevented.
The presence of nasal defects is determined by the surgeon with the help of special measurements, the results of which are compared with average statistics. Patients with body dysmorphic disorder (a mental disorder in which a person is overly concerned about a minor defect or feature of their body) need to see a mental health professional.
Rhinoplasty is only performed by adults for aesthetic reasons, as the body must be fully formed at the time of the operation.
Contraindications to rhinoplasty are:
- diseases of the cardiovascular system, liver and kidneys;
- diabetes mellitus;
- mental and oncological diseases;
- blood clotting disorder.
It is also not recommended to perform operations on people over 40 years old, in whom the ability to regenerate tissues is significantly reduced.
Types of rhinoplasty
There are many types of rhinoplasty, each designed to solve a specific problem and can affect different tissue types. Which operation to perform depends on the existing defect.
Rhinoplastyaims to reduce the width of the nostrils. Subtle scars may remain at the base of the nose after surgery. The operation is performed both for aesthetic reasons and to reduce possible swelling of the nose after further surgery in this area. Often the patients are representatives of the Negroid and Mongolian races.
Removal of the nasal hump.A large number of patients come to fix the annoying hump on their nose. The surgery consists of removing some of the bone and cartilage and straightening the back of the respiratory organ. The surgeon must show high accuracy in determining the location of the incisions, their optimal number and size. All this is necessary in order not to leave unnecessary scars on the dermis.
Rhinoplasty. The most complex type of rhinoplasty, which can radically change the patient's appearance, but requires great experience from the surgeon. Corrects hooking, upward movement, axis misalignment and other external defects of the nasal tip.
Columella correction. Columella is the skin part of the nasal septum, actually it is a bridge between the nostrils. It can be too wide or too narrow, indented or prominent. You can fix the error with the help of operational fix.
Correction of the shape of the nose. Give the bridge of the nose the right shape - smooth the hump, align the axis. Affects bone and cartilage tissue.
nose contouring. Non-surgical method of correcting small external nasal defects through injections of hyaluronic acid.
septorhinoplasty. Correcting the curvature of the nasal septum to facilitate nasal breathing and solve the problem of snoring.
conchotomy(including lasers). Partial or complete removal of the hypertrophied turbinate mucosa in the case of problems with nasal breathing.
electrocoagulation. Gentle action of electric current on the nasal mucosa with mild hypertrophy of the turbinates.
Augmentative rhinoplasty. This type of rhinoplasty aims to correct nasal defects by enlarging the nasal skeleton (usually in secondary rhinoplasty).
grafting. Transplantation of the patient's own cartilage to create the desired nose shape. Cartilage can be harvested from the nasal septum, the pinna, or the rib.
Laser Rhinoplasty. A laser is used as an instrument instead of a scalpel, making the operation less traumatic.
Reconstructive rhinoplasty. Required to correct the results of previous operations.
Methods of rhinoplasty
In plastic surgery there are open, closed and non-surgical nose jobs. Each of them is used for specific purposes.
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The method of rhinoplasty is chosen during a personal consultation after a visual examination. The decisive factor is the degree of deformation, the presence of a respiratory function disorder and your wishes.
Open rhinoplasty
In this technique, an incision is made at the narrowest part of the middle part of the nose, after which the remaining skin over the cartilage is detached and lifted. After the necessary cartilage is exposed, the problems that have arisen with the nose are solved. One year after the open rhinoplasty, scars (fibrosis) form, the stability of the result depends on this, which is also influenced by the chosen technique and the skill of the surgeon.
The open type of rhinoplasty provides free access to the septum, which can first be corrected or removed, and then, after the deformity has been eliminated, returned and fixed to the bone with sutures. It allows the internal and external valve to be swapped out, which could cause breathing problems.
This technique allows to improve the aesthetic appearance of the nose, but at the same time it is precise and cannot harm the patient.
Closed Rhinoplasty
She suggests that the incisions are made inside the nose, post-healed scars are not visible. During the operation, the arteries supplying the tip of the nose are not damaged - the main advantage of this type of rhinoplasty. Because of this, the recovery and healing of the nose is much faster than after applying an open view.
But with this technique there is one big minus - the inaccuracy of the surgical intervention. During the operation, it is difficult to control each phase of its implementation, which is why it is difficult to predict its effectiveness.
Performing a closed rhinoplasty requires a certain experience of the doctor, it is better to entrust it to an experienced nose surgeon who has had more than one successful operation of this type.
The closed rhinoplasty has several versions that differ in the access points, so it can take place:
- through cartilaginous tissue such performance is considered symmetrical;
- in the lower wings of the nose - this method is used when there is no need to make changes in the bridge of the nose;
- through the nasal septum, in most cases the method is used specifically to correct it.
- between cartilage - the method is applicable to local interventions on the bridge of the nose.
non-surgical method
Non-surgical rhinoplasty is performed without a single incision and primarily resolves minor cosmetic defects. For example, smooth the sharp tip of the nose, the corners of the nostrils or eliminate asymmetries.
Features of rehabilitation
Laser rhinoplasty, hyaluronic acid injections and fillers reduce rehabilitation time to a minimum. Operative methods leave moderate swelling of the nose and eye area, which subsides by the time the cast is removed on the 7th day. A plaster cast may be required for up to ten days. After the operation, special silicone splints are inserted into the sinuses, which are removed a day later. This approach allows the patient to breathe through their nose right after the surgery. The course of rehabilitation largely depends on the age of the patient and the individual characteristics of his body. After the splints are removed and the cast removed, you need to visit a doctor regularly to monitor healing. It is not recommended to play sports, visit the swimming pool and wear glasses in the first three weeks after the operation. Food that is too cold or too warm should be avoided in order not to provoke a nosebleed in the first three days. If you are planning a rhinoplasty, it is best to take at least half a month off.
Complications after rhinoplasty
Complications after rhinoplasty can be classified as follows:
- esthetic,
- functional,
- mentally.
The last point is a bit apart, it follows from the two previous ones. However, sometimes it is given special attention, since it can proceed in a complex form, which depends on the level of the main complication and the psyche of each individual person. Likewise, functional complications in point 1 (aesthetics) can leave their mark, since all functional disorders also have external manifestations.
frequency of occurrence
Complications occur throughout the surgical and rehabilitation period. They can be divided into 4 periods:
- Severe blood loss occurs more frequently directly during the operation,
- Immediately after the operation
- During the recovery period
- At the end of the rehabilitation period.
Complications include bleeding, severe scarring, adhesions, bone damage, airway obstruction, bruising, and swelling.
The expected and inevitable complications pass in 2 weeks. The danger is "unexpected" complications:
- Infection,
- tissue necrosis (skin, cartilage, bones),
- Seam divergence (easily eliminated).
But serious complications are also possible:
- Infection, such cases are extremely rare, 2%.
- Sepsis requiring medical attention
- Toxic Shock Syndrome. It is caused by the bacterium Staphylococcus aureus. Manifested by fever, vomiting, lowering blood pressure. The syndrome occurs extremely rarely and is observed in 0. 016% of cases.
- The divergence of the seams is fraught with the formation of a scar, but more often it has no consequences,
- persistent edema,
- tissue death,
- deformation,
- bulging,
- dorsal cyst,
- Mental Complications.