Rhinoplasty and rhinoseptoplasty:
interventions to solve aesthetic and functional defects of the nose
Rhinoplasty is one of the most requested cosmetic surgery interventions ever. It allows the correction of defects of the shape (hump, twisted or deviated nose) or of the excessive dimension of the back, of the tip (drooping, asymmetrical, globose, hypertrophic) of the shape and size of the nostrils.
In some cases it may be necessary to correct and improve the result of a previous operation which, performed by inexperienced hands, did not meet the patient’s expectations: the operation to be performed will be a secondary rhinoplasty operation.
Rhinoseptoplasty and septoplasty
Often, in addition to aesthetic corrections, functional corrections on the septum and hypertrophic turbinates are also necessary. In these cases the interventions to be performed are respectively a septoplasty and a rhinoseptoplasty.
How do you decide on the changes to be made to the nose with rhinoplasty?
Thanks to the advances in cosmetic surgery, modern rhinoplasty allows for much more natural results than those of years ago: the operation in fact eliminates the specific defects of the nose without upsetting its shape.
Before the rhinoplasty operation, the surgeon examines the nose and evaluates its internal parts, i.e. the nasal cavities, to assess the presence of deviations of the septum, hypertrophy of the turbinates). Then he takes profile photographs , of three quarters, frontal and axial with which he analyzes together with the patient all the characteristics and defects of the nose. Together, doctor and patient plan the corrections to be made to remove all unwanted aspects.
To maintain a pleasant harmony of the nose with the rest of the face and profile, the surgeon must take into account the racial elements of the individual, the characteristics of his features and the shape of the rest of the face such as that of the forehead and chin, the color of the hair, eyes and skin.
The expert cosmetic surgeon analyzes with the patient all the details of the corrections to be performed , advising and guiding him with the utmost attention in the delicate moment of planning the rhinoplasty surgery.
Is the preview of rhinoplasty results reliable?
Some people want to see on the computer the shape that their nose will have after rhinoplasty in order to understand what the final result will be like, however it is important to remember that there is no certainty about it. It is good to be wary of those who show that the nose can be changed with ease, moreover it is not certain that what has been created with the photo editing software can be achieved with the real operating skills of the surgeon , if he is not equipped with great experience.
To understand how the nose can change, the surgeon must explain what changes must be made to each single element that makes up the nasal pyramid, show pre and post-operative photos of patients with the same problems and also show the actual result to be obtained . It is from these images that you can really see if the surgeon really knows what he says.
From what age is it possible to undergo a rhinoplasty
The nasal structures complete their growth towards the age of 15 for women and towards the age of 16 for men, so it is possible to carry out rhinoplasty or rhinoseptoplasty starting from this age , especially if there are functional problems. However, you must first make sure that the young patient is fully aware of undergoing the operation.
Very often rhinoplasty is requested by young adults who have a clear understanding of the situation of their nose and the corrections they wish to make, but not only. Sometimes rhinoplasty is also requested by elderly people to correct an aesthetic defect of the nose , always poorly tolerated during the course of life but never accepted or, in other cases, to eliminate the inevitable signs of aging that also appear on the nose, such as the tip that increases in size and tends to go downwards.
How rhinoplasty surgery takes place
Rhinoplasty and rhinoseptoplasty take place inside the nasal cavities, through the nostrils. The operation consists in modifying the shape of the bones and cartilages that make up the rigid structure of the nose .
First of all, the skin is freed from cartilage from the inside, but the most important moment is represented by the small and delicate millimeter changes that are performed on the cartilages of the back, tip and bones to change their shape.
At the end of the rhinoplasty operation, the skin, thanks to its plasticity and elasticity, “rests” on the new nose and adjusts itself to it . At the end of the surgery, two small soft pads are placed inside the nostrils, which are very easy to remove because they are covered with a greasy ointment that does not make them adhere to the mucous membranes. The swabs will then be removed the following morning.
Once discharged, the patient will return home with a small rigid plate on the bridge of the nose fixed with a plaster . This will be removed after 1 week and for another 7 days only a paper patch will remain on the nose. 2 weeks after surgery, the nose will be completely free .
The post surgery
After a rhinoplasty or a rhinoseptoplasty it is rare that complications can occur , such as a partial correction of the defect, or that the healing of the tissues of the nose can occur unevenly and symmetrically in both parts.
It is also rare for small irregularities to emerge at a distance from the surgery or respiratory function deficits : these problems are infrequent and in any case correctable with a possible small retouch. In experienced hands, complications are rare and usually minor.
It may surprise you, but after rhinoplasty or rhinoseptoplasty, you usually don’t feel any pain . Immediately after the operation, the nose and cheeks have swelling which, in most cases, is greatly reduced in a couple of weeks.
Prof. Bracaglia will remove the nasal swabs the morning following the surgery, before discharge . A light but effective protective dressing will remain on the nose for 7 days.
The limited daily activities can be resumed within 2 or 3 days, while it is advisable to wait at least 1 month before putting on the glasses . After 3 weeks you will be able to gradually return to sun exposure.
What kind of anesthesia is used
The rhinoplasty operation, like that of complete rhinoseptoplasty, usually takes place under general anesthesia with 1 day of hospitalization , but, in the case in which the rhinoplasty is limited to one element of the nose (for example the tip only) it is also possible to carry out the operation under local anesthesia, without hospitalization or with sedation, in day hospital.
Closed rhinoplasty or an open rhinoplasty? The differences.
Open rhinoplasty and closed rhinoplasty are distinguished
for the access route by which the structures of the nose are reached .
It is the surgeon who plans from time to time which is the most effective approach to best solve cartilage or bone defects in the nose. Using the open or closed technique is therefore not a rigid choice, but it depends on the individual case.
With closed rhinoplasty, the structures of the nose can be reached via an internal access route to the nose, while if open rhinoplasty is used, only a tiny incision of about 3mm will be made, below the subsept, in an invisible point that allows you to make effective changes and get some changes with greater precision, especially of the cartilage portion of the nose and tip.
The surgery that corrects the errors of a previous rhinoplasty
It may happen that some patients who have undergone a previous rhinoplasty are not satisfied with the result obtained and that they find defects. In these cases it is necessary to intervene with a secondary rhinoplasty .
Defects can be caused by:
- Removal performed irregularly or asymmetrically between the two sides of the nose
- Excessive or insufficient removal of cartilage or bone structures
In the event that the first surgeon has made excess excisions , secondary rhinoplasty will have to reintegrate the cartilage or bone tissue removed in excess . For this purpose, specific techniques of reconstructive and aesthetic plastic surgery are used.
In the event that the surgeon has limited himself to making an insufficient correction of the aesthetic and functional defects of the nose , secondary rhinoplasty will have to complete a rhinoplasty that has only been partially sketched and never done right.
Whatever the starting situation, the correction of rhinoplasty must always and in any case be preceded by a meticulous evaluation of each single defect .
How secondary rhinoplasty takes place
Secondary rhinoplasty is an operation that aims not only to recover the compromised aesthetic aspect but also to restore correct breathing . The operation therefore requires a careful and precise preoperative assessment of damage to the bone and cartilage structure of the nose.
The nose scaffold is made up of numerous cartilages and bones that connect and fit together to form the structure of the nose itself. Surgical techniques may involve the use of cartilage autotransplants taken from the same patient .
Secondary rhinoplasty often has a painless post-operative course, but with recovery times a little longer than those of a primary rhinoplasty . The experience and skill of the plastic surgeon expert in nose surgery is able to achieve very good results from both an aesthetic and functional point of view.
Do you have questions about rhinoplasty?
Read here first.
The tampons are usually removed the morning following the surgery, before discharge.
No. Nasal swabs are soaked in grease which makes their removal easy and painless.
At the end of the surgery, the nose is completely asleep thanks to a local anesthetic that removes all sensation for many hours after the surgery. At the end of its effect, the sensations you have are extremely modest and not painful.
Yes, the improvements obtained in recent years by surgical techniques have been very relevant for the wide possibilities achieved. The rhinoplasty of the past was basically limited to removing excess tissues, while today modern rhinoplasty offers many more possibilities. In addition to the techniques to remove excess tissues, there are also those that allow you to integrate the deficient structures of the nasal pyramid to obtain very pleasant, natural and stable results over time.
Rhinoplasty can be done all year round. However, in the first 3-4 weeks after surgery, it is advisable to avoid exposure to intense sun.
It is very important that the modifications chosen respect the somatic characteristics of the patient and his biotype: only in this way will the nose look as natural as possible.
Resolve the aesthetic and functional defects of the nose
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