Rhinoplasty Surgery

Definition and Purpose

Rhinoplasty (rhinoplasty)is a surgical intervention aimed at restoring the appearance of the nasal structure and, if necessary, respiratory function. This operation involves changes such as reducing or enlarging the size of the nose, removing deformities (for example, correcting the arched nose structure), and reshaping the tip of the nose or nostrils. At the same time, structural problems such as deviation (curved septum), which creates breathing problems, can also be corrected during rhinoplasty. Rhinoplasty is one of the most frequently performed aesthetic surgeries in the world, and thanks to successful results, it helps patients to achieve both balance in facial aesthetics and increase their self-esteem.

How Is Surgery Done?

Rhinoplasty is an operation that is usually performed under general anesthesia and can last about 2-3 hours. The approach of surgery according to the needs of the patient unprotected or closed technique is planned with. Closed rhinoplasty In the method, incisions are made entirely from the inside of the nostrils and there is no visible trace from the outside. Open rhinoplasty In the technique, a small incision is made in the area called the columella that separates the nostrils, so that the surgeon can shape the cartilage and bone structures of the nose with a wider angle of view. Even with the use of the open technique, this incision scar becomes vague after proper healing.

During the operation, the surgeon first gently removes the skin of the nose from the underlying cartilage and bone structure. Then, if the nasal arch is filed in accordance with the changes that the patient wants, it is repositioned by applying controlled fractures (osteotomies) if the bone roof is to be narrowed. The cartilages at the tip of the nose are shaped; if necessary, the tip of the nose can be supported by cartilage grafts taken from the septum or ear. To eliminate the problem of breathing, the curved septum is corrected and can be reduced if there are meat growths (conches) in the nose. All these procedures are carried out meticulously with the aim of ensuring that the nose acquires both the aesthetically desired appearance and functionally comfortable breathing.

After the styling is completed, the skin of the nose is again covered in place, and the incisions are closed with fine stitches. Soft silicone splints can be inserted into the nose to fix the septum and the new shape; these silicones do not completely impede breathing and are usually removed after 5-7 days. Externally, a protective plaster or thermoplastic splint is applied to the back of the nose, which remains in the nose for about a week. At the end of the operation, the patient is taken to the assembly room and awakened from anesthesia. Patients after rhinoplasty surgery may be able to return home the same day, but in some cases it is preferable to stay in the hospital for comfort and safety the first night.

Who is it suitable for?

Rhinoplasty surgery is an ideal option for people who are dissatisfied with the appearance of the nose or who have functional problems and whose health status is suitable for surgery. The groups that can be candidates are:

• What is Disturbed by the Appearance of the Nose: Individuals whose nose is disproportionately large with facial contours, with an arched nose structure, and aesthetic problems such as a low or wide tip of the nose can get the look they want with rhinoplasty.
  
  
• People with Respiratory Problems: Patients suffering from chronic nasal congestion who cannot breathe comfortably through one or both nostrils due to septal deviation (curvature of cartilage in the nose). During rhinoplasty, septoplasty (septum correction) is also performed, achieving both aesthetic and functional improvement.
  
  
• Those with Nose Injury or Deformity: People who have suffered trauma such as a broken nose in the past and as a result developed deformity or breathing difficulties, or those with congenital shape anomalies.
  
  
• Adults who have completed facial development: The minimum age usually recommended for rhinoplasty is late puberty, when facial and nose development is complete (~17 years in women, ~18 years and older in men). Under these ages, aesthetic nose surgery is not preferred, as facial structures are still changing.
  
  
• Those with good overall health and realistic expectations: People who do not have serious chronic health problems, do not have bleeding coagulation problems that will prevent surgery, and who have reasonable expectations of surgery are the most suitable candidates. Rhinoplasty provides a marked improvement in appearance, but the concept of “perfect nose” varies from person to person; it is important that candidates have a realistic and positive view of the outcome.
  
  

Before the operation, candidates must clearly express their wishes by conducting a detailed interview with their surgeon and understand the intended results that the doctor will provide. Thanks to this, the satisfaction rate after surgery will be high.

Possible Risks and Complications

As with any surgical intervention, rhinoplasty surgery has certain risks and the possibility of complications. Fortunately, serious complications are rare in rhinoplasty, and most patients undergo a smooth recovery process. Nevertheless, it is important for patients to be aware of the following possible risks:

• Bleeding: Nosebleeds in the form of slight leakage are normal in the early period after rhinoplasty. But rarely, severe bleeding can occur and require intervention. This risk is low, as bleeding is carefully controlled during surgery.
  
  
• Infection: The risk of infection after nose surgeries is quite low because the nose is a multi-vascular area, healing is usually rapid. Preventive antibiotics are prescribed after the operation so that infection does not develop. If it still occurs, it may be necessary to clear it with antibiotic treatment or, if necessary, a minor surgical intervention.
  
  
• Difficulty breathing: After surgery, breathing may become difficult in the first weeks due to edema (swelling) and crusting in the nose. This condition is temporary and breathing becomes easier as the nasal passages are cleaned. Very rarely, permanent breathing problems can occur as a result of excessive correction of the nasal structures during surgery (for example, removal of excess cartilage). Experienced surgeons pay great attention to maintaining the functional structure when performing aesthetic correction.
  
  
• Septum Perforation: Although there is a very low probability, the formation of holes (perforation) in the cartilage wall in the septum can occur. This condition can lead to problems such as nosebleeds in dry air or breathing with whistling sounds. Small perforations usually do not cause problems, while large perforations can be repaired with additional surgical interventions.
  
  
• Risks Associated with Anesthesia: As with any surgery performed under general anesthesia, an allergic reaction, respiratory distress or other complications due to anesthesia drugs can occur, although very rarely. This risk is minimized by performing anesthesia evaluation and necessary tests before surgery.
  
  
• Dissatisfaction with the aesthetic result: After rhinoplasty, it is difficult to assess the result before the swelling in the nose is complete, especially in the first months. The vast majority of patients are satisfied after the final nose shape is seated, but in some cases there may be slight differences between expectations and outcome. It may be difficult to achieve the desired result in patients with very poor nasal structure or thick skin structure. Rarely, revision (a second correction) surgery may be required.
  
  
• Sensory and Sensitive Changes: There may be a temporary feeling of numbness in the nose and upper lip areas after surgery. This resolves within a few weeks, depending on the healing of the nerve endings. There may also be a temporary decrease in the sense of smell; as the innervation heals, the sense of smell returns to normal.
  
  

Most of these risks are minimal, and the complication rate is minimal in operations performed by an experienced otolaryngologist or plastic surgeon in a fully equipped hospital. Your surgeon will take all the necessary measures for you and will also inform you about the management of problems that may occur after surgery.

Healing Process

After rhinoplasty surgery, recovery progresses gradually, and it takes time for the full result to appear. Silicone splints inserted into the nose at the end of surgery and a splint on the nose are usually removed by your doctor at the end of the first 1 week. This first week is the period when bruises and swelling are most noticeable on your face, especially under the eyes. Many patients feel well enough to return to their daily lives within 7-10 days after surgery, but the time to return to work depends on how quickly the person recovers and the physical requirements of the job. Those who do desk work can work at the end of a week, while those working in jobs that require physical exertion may have to wait a few weeks.

The first two weeks: Bruises around the eyes and swelling on the face noticeably decrease in the first 10-14 days. During this period, it is recommended to protect your nose from blows, refrain from heavy exercise and rest with your head held high. Saline sprays (serum physiological) can be used to soften the crusts in the nose. Touching the nose and sneezing strongly should be avoided unless your doctor indicates otherwise. Activities such as light walks can be done from the second week.

Between 1-3 Months: A month after surgery, the nose begins to regain its new shape with its general outline; most of the swelling has passed, but slight edema may still remain, especially in areas such as the tip of the nose. During this period, people usually have a natural appearance that is too natural to notice that you have had a rhinoplasty. If you wear glasses, you should continue to use lenses instead of glasses until your doctor's approval (usually 4-6 weeks) to avoid putting weight on the nose. Towards the third month, the nose softens and the stiffness felt when performing mimicry decreases. For sports that require physical contact, it is usually recommended to wait at least 2-3 months.

Long Term: The full results of rhinoplasty require patience. In people with thin skin, the tissues of the nose completely heal from the inside, get used to their new position and take their final shape 6-12 months, if in people with thick skin 12-24 months can last. During this time, there may be very small changes in the shape of the nose; usually the people around you will not notice these changes. The edema that remains after the first months is at the level that only you can feel. As a result, at the end of a year, the targeted final appearance of rhinoplasty surgery is revealed. In the recovery process, it is very important to go to the doctor's check-ups at the indicated intervals, apply them if recommendations such as nasal massage have been given, and consult the physician in case of possible problems.

Nose Aesthetics at Central Hospital Istanbul

Central Hospital Istanbul aims to offer its patients the best results both aesthetically and functionally with plastic surgeons and otolaryngologists specializing in rhinoplasty. Before surgery, nose and face analysis of our patients is carried out in detail and possible surgical results are shared with the patient using digital imaging and simulation methods. In this way, the patient's expectations and the surgeon's predictions are aligned and a personalized surgical plan is created.

In rhinoplasty operations performed in our hospital, modern techniques of world standards are applied. In necessary cases piezoelectric surgery Bone interventions using ultrasonic bone shaping methods such as those are performed with precision and damage to soft tissues is minimized. This contributes to less swelling and bruising after surgery. All operations are performed in sterile operating room conditions and under the supervision of an experienced anesthesiologist team.

After rhinoplasty, all the necessary support is provided for our patients to have a comfortable recovery process. At the end of the surgery, our nurses provide detailed information on the care of silicone splints inserted into the nose and splint on the nose. After discharge, checks are also of great importance: periodic examinations such as removal of splints and splints in the first week, and checks in the first month and third month, the patient's state of recovery is evaluated. With early intervention in the event of any setbacks, problems are solved without growth.

Central Hospital Istanbul aims not only to achieve a beautiful nose appearance in rhinoplasty surgeries, but also to achieve a healthy nose in which the patient can breathe comfortably. Our expert team listens to the wishes of our patients and reveals results in accordance with the natural and facial structure with the latest surgical techniques. Patients who choose our hospital for rhinoplasty have the comfort of knowing that they are supported by confidence and a friendly face, starting before surgery and until the end of the recovery process.

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