RHINOPLASTY

RHINOPLASTY

Rhinoplasty is the most common aesthetic surgical procedure lately. The reason for rhinoplasty is mostly Airway problems. This surgery can be performed both for aesthetic outcome and health issues.

There are multiple variations in the anatomy of nasal cavity and paranasal sinuses. The nasal Airway is mostly compromised or completely blocked because of these variations. These anatomical variations cannot be altered with medical Therapies and the only solution for these problems is surgery. It is a complicated process for one to make the desicion of having such an operation. Mostly patients do a long period of researchment about clinics, doctors and hospitals.

It is a mostly hard to find a reliable doctor. It is so important for the patient to trust Clinic especially when he or she is going to choose the clinic in a different country.

FREQUENTLY ASKED QUESTIONS ABOUT RHINOPLASTY

Which clinic or which doctor?

Patients mostly decide the operation according to the images on social media posts. Most clinics and doctors run their own Instagram accounts to share their results. These images may be reliable to an extent.

And some patients are referred to the doctor from other patients they know in real life. This is the most common way of deciding which doctor to have the operation. 

Can i talk to my doctor before i fly?

Yes. We provide online consultations via whatsapp videocall, zoom or Skype.

You can send us your pictures before the consultation and the surgeon will make a surgical plan which would help through the operation. And you can make an appointment for an online consultation and talk directly to your surgeon.

When do I get the final result after rhinoplasty?

It takes approximately about 1 year after rhinoplasty for the patient to get the final result on the face.  Bone healing process takes about 2 months. During this 2 months period, one should avoid all kind of pressure or trauma to the face since the nasal bones are still flexible and the any kind of external force May alter the Surgical result. A number of skin changes occur after this operation indeed. We usually observe that the skin gets thinner due to the healing process which takes like 6 months. And lastly the patient should wait until the swelling is totally gone and that is a 1 year time period. After all the edema and swelling has gone, the final result of the operation can be visible.

Is there an appropriate season for having rhinoplasty surgery?

Some say that having rhinoplasty in summer might have bad effects on the result. I don’t agree with that. Rhinoplasty is a surgical procedure which is made in the operation theater and it can be done in Siberia or it can be done in Dubai. Season or humidity or temperature doesn’t have any effect on the surgical result. 

Can I have nose filler instead of rhinoplasty and can I get the same result? 

Hyaluronic acid fillers are very commonly applied by Medical estheticians. They have very successful applications on  the face and sometimes they are Magic. I’d rather not say the same on the nose. Those patients who don’t want surgery maybe a candidate for nose fillers. I usually offer surgical rhinoplasty to those who have never had a nosejob before because I dont think the nose fillers give the same results as a rhinoplasty. I more oftenly do nose fillers after an unsatisfying rhinoplasty for only fixing problems. Especially for those patients who are not satisfied with their surgical result and dont want revision surgeries. For primary rhinoplasty i do nose fillers in a a very limited number of patients  especially in some distinct areas on the nose like Radix or dorsum. I prefer not to inject fillers around the tip area. 

Will I have bruising after rhinoplasty? How long does the bruise take? 

Bruising has become very uncommon after technological advancements in rhinoplasty. But we still see bruising sometimes. Bruising is because of the introoperative bleeding.

When can I start gym after rhinoplasty surgery? 

We recommend all our patients to wait until 2 months after rhinoplasty surgery before starting any kind of heavy exercises. Heavy exercises are those which increase the heart rate over 100  beats per minute. (for example : swimming, weight lifting, bodybuilding, running, football, tennis) This kind of situation prolongs the edema and swelling after the rhinoplasty surgery. Our patients can do light walks after 1 months. 

When can I swim after rhinoplasty?

You can swim in a swimming pool or see after 1.5 months after rhinoplasty surgery 

Which is better? Open or closed technique? 

There is no significant difference in the results of open and close technique rhinoplasties. The healing time is similar, the operation time is similar, and there’s no evident scar after 1 year after open rhinoplasty. I performed only closed rhinoplasties for almost 3 years and I finally came to the decision that some patients need to be operated open technique and some patients need to be operated in closed technique. 

In open technique rhinoplasty, the skin between the two nostrils is cut and the nasal skin is dissected through this incision. Nasal cartilages are reached. Desired changes on the nasal cartilages and bones are made in this way.

In closed technique rhinoplasty, there is no incision on the columellar skin between the two nostrils. Desired changes on the nasal bones and cartilages are made through the nostrils. The incisions are hidden within the nostrils. The advantage of closed rhinoplasty is that there is no visible skin incision and therefore no scars are left after the operation. Another advantage is the preservation of vessels and nerves passing under the skin. Especially in the skin area between the two nostrils called columella, there are critical arteries and veins feeding the tip of the nose. Since these vessels are not damaged in closed technique rhinoplasty, the recovery is faster.

Will my nasal tip fall down 1 year after surgery? 

According to the studies there are some changes in the shape of the surgical results after one year. But that is never supposed to be described as a falling down. An appropriate rhinoplasty result should be permanent and reliable for years. We are supporting the tip region with cartilage crafts strongly and tightly secured to the nasal septum. And that’s the best way to preserve the nasal projection and definition in practice currently.

Precautions After Rhinoplasty Surgery

WE advise our patients to avoid eating and drinking 4 more hours after surgery. This situation is because of general anesthesia. The gastrointestinal tract is affected by the anesthetic medications. Patient is observed for one night at the hospital released yet the day after. Sometimes the patient can be released the same day if she wants to. Nurses taking care of the patients if he stays in the hospital.  Antibiotics painkillers antihistamines are given to the patient in prescription.  The patient learns how to use the medication the ice application from the nurses when she is released from the hospital intranasal splints are placed in both nasal cavities and cast on the skin of the nose by the time of the release. Nasal packings are going to be removed after 5 days and the cast is going to be removed at the first week. On the 7th day, we control the patient in our Clinic and remove the cast and put bandages on the nose. The bandages are going to stay for one more week and be removed one week later.

The patient is advised to keep the bandages and the cast dry (away from water) for 15 days in total. And also laying position is important in this time period. One has to keep his or her nose away from any kind of pressures and trauma. We recommend  2 or 3 days of bed rest after the release. And we also recommend ice application for 10 minutes of every hour in the first week following the operation.  Swelling and bruising is possible on the nose and face and we recommend topical ointment for these bruises. Bruises usually start to recover on the 4th and the 5th day. The nasal packing cause variable levels of nasal obstruction feeling and we recommend different intranasal sprays or solution treatments for this reason.

After the 14th day of the surgery all the peckings and the cast and the bandages are going to be removed and the patient is going to be instructed to massage for the bones and skin. Massage application is individual. It can be instructed face to face during the control visit or video chat ( especially for Foreigners) 

Routine control dates are :

– 7th and 15th days, 

– 1,3,6 th months 

– 1st year 

Controls are going to be done via videocalls for Patients coming from countries other than turkey

Ultrasonic Rhinoplasty

In recent years, the use of technological developments in the field of medicine has become widespread. The piezo device, which is also used during rhinoplasty, provides significant comfort to patients and surgeons. Piezoelectric devices are used in many fields of medicine. The use of these devices, which have the ability to vibrate at very high frequencies, during shaping of bones and hard tissues has increased the comfort of patients and doctors in branches such as orthopedics, dentistry, neurosurgery.

Piezo device offers the opportunity to make very precise and accurate cuts on the bone . The damage to the underlying tissues is minimal while doing this. In this way, it causes less bleeding and trauma. Piezo ultrasonic devices used in rhinoplasty generally provide :

• shorter operation time,
• shorter recovery time,
• less bleedng during the surgery
• less bruising after surgery
• safer surgery,
• more predictable aesthetic result

Peservation Rhinoplasty

European and Caucasian people mostly have characteristically bone and cartilage structures are well-developed, there are large arched noses. It is the process of reducing the high birdged noses that we mostly do in our surgical practice. We mostly aim to lower the dorsal height by doing this. In this way, the roof of the nose is straightened.

Normally, the bone and cartilage structure that forms the roof of the nose pyramid is cut and removed from the nose. So, after the nasal hump is removed, the nasal bones remain on the sides and the roof becomes open. In order to close the roof, cartilage grafts are harvested from the inner nasal cartilages (quadrangular cartilage) of the nose and added to the roof of so that the roof is repaired. Consequently the side walls are cut and displaced inwards. This technique is called classical hump resection technique which the bony part overlynig the nose s totally removed. The bone and cartilage structure on the roof of the nose is very important in terms of aesthetics. It is techniquely very difficult to recreate the same original natural dorsal aesthetic appearance and structure after the bridge has been removed. It does not replace the original nasal roof, even if it is done very succesfully.

Today, the frequency of the use of PRESERVATION RHINOPLASTY technique is increasing as an alternative to the classical hump resection technique among rhinoplasty surgeons. In preservation rhinoplasty, the nasal dorsal height is lowered without removing the dorsal nasal roof – the bones and cartilages forming the roof of the nose.

In the classical hump resection technique, the roof of the nose is completely cut off and removed. The remaining sidewalls under the dome are brought closer to each other and a new roof is constructed, and the height of the nose is shortened.

In the preservation rhinoplasty technique, the roof of theose nose is kept in place and bone fragments are removed from the sidewalls close to the base ground floor, thus shortening the height of the nose.