The nose has paramount importance from both aesthetic and functional aspects, as it’s located in the middle of the human face and is the beginning of the airway to our respiratory system.
An ideal nose must breathe perfectly, and should look elegant in harmony with the other aesthetic units of the face such as the mouth, chin, forehead, eyes and cheeks.
Due to genetic features of the individual or previous trauma, the nose may look distorted or different from its desired shape. A nose that is disharmonious with the rest of the face is one of the major factors that interfere with overall facial aesthetics. This is the main reason that makes rhinoplasty the most popular aesthetic surgery procedure. Little “touches” to the nose can lead to significant improvements in general appearance of the face. The crucial point is to make these changes in a parallel direction to the current facial architecture, without giving an artificial feeling. The classic “done nose” image is quite apart from the current understanding of nose aesthetics. Natural look and good breathing are the main issues of modern aesthetic rhinoplasty.
Every face, therefore every nose are different from each other. That’s why personal planning has a key importance. For a succesful rhinoplasty, the first step is to make up a balance between what the patient wants, and what the surgeon can give; by discussing these issues face-to-face. The surgeon will make up his operative plan according to the common decisions made together with the patient. After the necessary blood tests, the operation is performed under general anesthesia, and the follow-up period starts afterwards. Not always, but frequently some bruising and swelling will be present immediately after the operation. This problem is solved spontaneously within 5 to 10 days, but the nose needs almost a year to gain its final shape.
Being a very popular and mediatic topic, there is a public pollution of knowledge about rhinoplasty. Here, the only thing one should know is that every nose has its own needs. These needs make up the details of the operation to be performed. It is almost impossible to decide the details of the operation without making a face-to-face consultation with the surgeon.
Rhinoplasty Explained: Everything You Need to Know About Nose Reshaping Surgery
Understanding Rhinoplasty: The Goals and Benefits of Nose Reshaping Surgery
Rhinoplasty, which is popularly known as a “nose job,” can be performed for either cosmetic or medical reasons, and it helps changing the shape of the patient’s nose which also involves changing the size or function of the nose by altering bone, cartilage.
Reasons for Undergoing Rhinoplasty
People choose rhinoplasty for various reasons:
Cosmetic Enhancement: To enhance the aesthetic look of the nose by making it more harmonious with other facial features.
Functional Correction: To treat breathing problems resulting from structural abnormalities in the nose, such as a deviated septum.
Repair After Injury: After an injury, to restore the shape and function of the nose.
Types of Rhinoplasty
Rhinoplasty techniques vary depending on the desired outcome:
Open Rhinoplasty: Involves making an incision on the columella (the tissue between your nostrils). This allows greater access to nasal structure for surgeon.
Closed Rhinoplasty: Involves incisions inside the nostrils, leaving less scarring visible.
Revision Rhinoplasty: For the correction or improvement of results after a previous nose surgery.
Latest Trends and Innovations in Nose Surgery
Minimally Invasive Techniques like Preservation Rhinoplasty
Personalized Grafting Materials
Non-Surgical Rhinoplasty(Use of Dermal Fillers)
Improved Revision Rhinoplasty Techniques
Is Rhinoplasty Procedure Right For Me?
Candidacy for Rhinoplasty: The Ideal Candidates and Key Considerations
Rhinoplasty, commonly referred to as nose surgery, is a popular cosmetic procedure however, not everyone is an ideal candidate for this surgery. Analyzing if the patient should go through rhinoplasty surgery or not depends on both psychological and physical factors such as having a good health and realistic expectations. Also, a clear understanding of the procedure’s limitations is a must. With the right preparation and mindset, rhinoplasty can be a life-changing procedure for many patients.
Who is an Ideal Candidate for Nose Surgery?
Physical Health: An ideal candidate for rhinoplasty should be in good health in general. This means no significant medical conditions that can impair healing or increase surgery risks.
Mature Nasal Structure: The nose should be fully developed anatomically. This means the patient should be at least 18 years old.
Cosmetic Goals: Patients who are seeking to go through rhinoplasty should have realistic expectations regarding the outcome. They should seek improvement, not perfection. Because perfect nose, doesn’t exist.
Functional Issues: Patients who have trouble breathing due to a deviated septum are also good candidates. However, if they have issues about their sinuses or polyps, they should refer to an ENT surgeon, not a plastic surgeon.
Psychological Aspects:
Understanding the limitations of rhinoplasty is essential. The goal is to enhance facial harmony and not to achieve the perfect nose.
Candidates should be mentally stable. Those with body dysmorphic disorder or unrealistic expectations may not be suitable for surgery.
The decision of having a rhinoplasty surgery should be personally motivated, without external pressure.
Physical Aspects:
The nasal structure should be fully developed.
The patient shouldn’t have any significant health issues that can cause trouble post surgery.
The thickness of the nasal skin can affect the outcome as well. Thick skin may hide subtle changes, while thin skin may show minor imperfections.
The possibility of encountering a complication increases in revision cases, it might complicate the procedure.
Customizing Your Rhinoplasty: Meeting the specific needs and targets of each unique patient
Having a nose job doesn’t work for everyone. Because each patient’s facial features are different and unique. It’s a team effort between the patient and the surgeon, There are many details to be covered from the very beginning of the patient’s research to the technique being used during surgery. One shouldn’t forget that, the rhinoplasty surgery changes the shape of the nose but it also indirectly effects all the facial features by being in harmony with one another. Therefore, the result should fit the rest of the face.
There are a few key points explained below to make one’s rhinoplasty journey personal;
Comprehensive Consultation: The path to a personalized nose job begins with a detailed face to face conversation with your plastic surgeon. During your consultation, the surgeon will analyze your facial anatomy and features and listen to the patient’s concerns and desires. The surgeon should guide the patient towards realistic expectations and should explain the process in detail. The surgeon should aim to end up with a nose shape which matches the facial features of that specific patient
Technique Selection: Either it’s open or closed rhinoplasty technique, the kind of approach is decided by the surgeon according to what that patient’s nasal structure and what they really need.
Aesthetic&Functional Goals: A rhinoplasty procedure can help changing the size and the shape of the nose, whether its removing the hump on the nose or creating a better definition. The rhinoplasty surgery can also provide improvement in breathing depending on the problem. If the nose is tilted towards one side, the axis of the nose can be brought to midline and can be made straight.
The Importance of Having Realistic Expectations in Rhinoplasty
It’s important to have real expectations when thinking about getting a nose job. This is key for the procedure to have a successful outcome. It’s about making a fair choice between the changes you want and what can be safely done with surgery. A good nose job is one that not only improves the nasal shape but it should fit with the patient’s other facial features. Patients should have an honest conversation with their surgeons and should be mentally prepared for the healing stage of the surgery.
Remember, the key to being satisfied with surgery is having good expectations and knowing what changes one can expect from a nose surgery. It’s important to know the limits of that patient’s specific nasal structure. As, every nose has a unique shape, there’s a limit to how much it can be changed safely.
Another point that should be taken into consideration is the healing time. Each patient has their own healing pace. And, this can be affected by skin thickness, age and general health. It’s important to know that results can change based on how your body heals after surgery.
It is crucial to set realistic goals such as;
-The aim of nose surgery should be to form a nose that blends well with other facial parts, not just going for the perfect or the popular look.
It’s important to make the nose look better but we should also think about how it functions. Sometimes, trying to get a specific appearance may hurt how well the nose works.
Being mentally ready in your mind about how you might look different.
It can take up to a year for the final shape of the nose to fully come out. Being patient during this process is very important.
Setting unrealistic goals can cause;
People who expect too much from surgery may be disappointed, even if the operation is done well.
Unrealistic hopes can cause mental problems after surgery, especially if what happens isn’t how the patient imagined it.
Setting unrealistic goals can cause more than one surgery, which might be harder and less likely to give success.
The patient can avoid these issues by having a thorough consultation with his/her surgeon and also educating oneself about the risks, complications and limitations of the surgery.
The Rhinoplasty Procedure: A Step-by-Step Guide
Before the Rhinoplasty Surgery
Preparing for rhinoplasty is a comprehensive process that requires careful planning. The initial consultation sets the tone for a successful procedure, while the pre-surgery tests ensure patient’s safety. Following the do’s and don’ts list before surgery is crucial for a smooth procedure and recovery. Remember, the key to a successful rhinoplasty lies not only in the skill of the surgeon but also in the patient’s mindset and preparation.
Initial Consultation&Pre-Surgery Tests:
The first step of journey to rhinoplasty is the initial consultation with a qualified plastic surgeon. This is very important for establishing a clear understanding of the patient’s goals and expectations. During the consultation, the surgeon will evaluate the patient’s medical history, current health status, and any medications they are taking. An examination of the nose’s structure, skin quality, and facial balance will be performed to determine the most suitable technique. The surgeon will explain the procedure’s risks, healing time, and will help setting realistic expectations for the outcome. Patients should clearly mention their desires and concerns regarding their nose’s appearance or function.
Before scheduling the surgery, patients will undergo several pre-operative tests to ensure they are suitable for the procedure. These tests will include, complete blood count(cbc), coagulation profile(pt, aptt, INR), basic biochemistry(liver and kidney functions), electrolytes, infectious disease profile(hbs-ag), anti-hcv, anti-hiv.
Preparing for Rhinoplasty Surgery:
Patients should follow these guidelines for a successful rhinoplasty process and smooth recovery.
The patient should have a healthy, balanced diet and should stay hydrated starting a few weeks before the surgery.
The patient should stop smoking at least 10 days before the surgery. But the earlier the patient quits, the better. Because, smoking can delay the healing process.
The patient should stop consuming alcoholic beverages and green tea at least one week before the surgery.
The patient should stop taking aspirin, tablets containing acetyl salycilic acid or other anticoagulants, herbal supplements and vitamin E at least one week before the surgery.
The patient will stop eating and drinking 6 hours before the surgery.
During the Rhinoplasty Surgery
The rhinoplasty surgical procedure is a delicate operation that requires precision and skill. Understanding the steps involved, from the types of incision to the reshaping of the nasal structure and all other aspects of the surgery like its risks and complications helps preparing the patients for the process. Here is a comprehensive breakdown of the rhinoplasty surgical process, types of anesthesia being used, insight of what actually happens during a rhinoplasty surgery;
The rhinoplasty procedure is performed under general anesthesia so the patient is put to sleep. Throughout the procedure, the patient’s vital signs, including heart rate, blood pressure, and oxygen levels, are closely monitored for safety.
The surgeon begins the rhinoplasty surgery with incisions around the nose, there are 2 types of incisions:
Open Rhinoplasty: There would be an incision on the collumella, this technique is generally preferred in complex cases like revision rhinoplasty. The open rhinoplasty can delay the patient’s healing process, so for standard cases, it is not commonly preferred. But, it creates a better vision of the surgical area.
Closed Rhinoplasty: The incisions are hidden in the nose, there will be no external scars. This accelerates the healing process and causes minimal to trauma to the bone and cartilages in the nose. This is also a more advanced technique that is why the surgeon should be very qualified as the surgical area sight is less visible.
Following, the surgeon will start to reshape the nasal structure. Reshaping involves preserving the natural bone and cartilage structures of the nose as much as possible in contrary to traditional rhinoplasty. So, the bone and cartilages are not removed but reshaped minimally. This will help the nose bridge to be lower and the tip of the nose to be more defined. This is called closed preservation rhinoplasty technique. The nose is exposed to minimal trauma and ligaments are preserved, this leads to a faster healing process and more natural results. Another point to be discussed is, if the patient has a deviated septum, it can be straightened to improve breathing.
After the nose is reshaped, the incisions are closed. And, finally the surgeon will observe the nose closely if any minor touches will be needed or not and ensures the desired shape is achieved.
The surgical team works delicately to maintain the patient’s comfort and safety during the operation. Measures are taken to minimize bleeding and a sterile environment to prevent infection is ensured.
After the Rhinoplasty Surgery
The recovery period of rhinoplasty surgery plays an equally important role in achieving the desired outcome as much as the surgery itself. Rhinoplasty recovery process requires patience and knowing what to expect during the healing period. How to handle to healing period effects the recovery process immensely.
The Recovery Process: What to Expect in the First Few Weeks vs. 1 Year
First 24 Hours: Post-surgery, patients often experience dizziness from anesthesia, swelling, and discomfort. The nose will have splints inside and will be packed with an outer cast. Very mild pain or headache can be experienced. Feeling congested is normal. The facial swelling and bruising will start to increase. Head should be elevated in a higher position while sleeping.
3rd post-op day: The inner splints are removed. The patient might feel less congested. The facial swelling and bruising will start to decrease. The patient can start going out but should be easy on themselves.
7th post-op day: The outer cast will be removed but the nose will be taped again to prevent swelling. The facial bruising will be mostly gone but facial swelling will continue to exist but will gradually dissolve.
10th post-op day: The patient can return to their daily activities and return to work. But should avoid exercising.
14th post-op day: The bruising will be completely faded, the facial swelling will be mostly gone but the nose will continue to look swelled.
1st post-op month: The patient can start sleeping on the sides. Facial swelling will be completely subsided. The nose will settle in its place but might still look a bit upturned. The patient can start with easy cardio exercises, jogging, swimming, pilates, but no heavy lifting. And, this is still not the final result.
3rd post-op month: The nose will start looking like the end result and the healing will slow down but will continue. Minor swelling around the tip might still exist.
1 year post-op: The final shape of the nose will show itself once one year of healing process is complete.
**Avoiding sun exposure will provide a better healing process. Therefore, the patient should always wear sunscreen and use hats especially in the first few months post rhinoplasty surgery.
Risks, Complications, and Recovery in Rhinoplasty
Rhinoplasty does have life-changing results, but it’s important not to forget learning about its risks and complications. The patient should be well prepared before going into a detailed surgery like rhinoplasty and learn all its aspects. The recovery stage after rhinoplasty requires patience, careful attention, and obeying your surgeon’s instructions. Remember, every individual’s recovery process is unique, and the key to a successful outcome lies in being patient&calm.
Bleeding and Infection: Like any operation, there is a risk of bleeding and infection. To prevent these risks, it’s crucial to choose a board certified plastic surgeon. Having a safe and hygenic operation environment is significant. The key here is to use antibiotics during and after the surgery.
Anesthesia Risks: General anesthesia, which is often used during rhinoplasty has its own risks. Patients should research the hospital and its anesthesiology team before proceeding with their surgeon.
Nasal Septal Perforation: This is a rare situation but it happens when a small hole appears in the nasal septum. Proceeding with a board certified plastic surgeon, this problem can often be prevented. But when it occures, further surgery might be needed for correction.
Unsatisfactory Aesthetic Results: Sometimes, the result might not be what the patient hopes for. This can happen because of miscommunication and/or technique being used during surgery. It’s important to speak openly to the surgeon before the surgery.
Difficulty Breathing: After rhinoplasty surgery, some patients might have trouble breathing because of the change in their nasal structure. Discussing that patient’s unique nasal structure function wise might help eliminating this risk.
Prolonged Swelling and Scarring: Sometimes, swelling and scarring can be hard to get rid of. This is normal even if it happens more in certain cases. Obeying the surgeon’s instructions can help make these problems smaller. Only in open nose job surgery, the patient will encounter scars on the outside of the nose, which generally happens during revision nose jobs.
Tips for Faster Recovery for Rhinoplasty
Following your surgeon’s post-operative instructions is a must for a successful recovery.
Your head should be elevated while resting during the first month post surgery.
Applying cold compresses (not directly on the nose) can help to reduce swelling and bruising.
Having a balanced diet and staying well-hydrated provides a faster healing.
Refrain from aggressive physical activities and exercises for at least 6 weeks post- surgery.
Avoid wearing glasses for the first 2 months post rhinoplasty surgery. Use SPF sunscreen and avoid direct sun exposure using hats.
Avoid smoking and drinking alcohol as they will delay the healing process and can impair the skin quality.
Attend all the check up appointments will help ensuring the nose to heal properly.
It’s important to have patience and not to rush to judgment about the success of their surgery because the end results is reached 1 year after the surgery.
Adopt a gentle approach to cleaning your face and nose. Harsh scrubbing can irritate the area.
Avoid causing trauma to the nose. Even after you’ve fully healed, it’s important to be cautious. Avoid activities that might be risky like contact sports, unless you’re wearing protective gear.
If you have allergies that cause nasal congestion and frequent sneezing, managing them is essential. Consult your surgeon about this issue.
High stress levels can impair your overall health. It is important to be calm during the recovery process for easy healing.
FAQ About Rhinoplasty
Who is a Good Candidate for Rhinoplasty?
Ideal candidates for rhinoplasty are individuals who are in good general health, have completed facial growth, and have realistic expectations about the outcomes.
What is the Difference Between Open and Closed Rhinoplasty?
Open Rhinoplasty: Involves a small incision on the columella (the tissue between the nostrils) for more comprehensive access to the nasal structure. It’s typically used for more complex modifications.
Closed Rhinoplasty: All incisions are made within the nostrils, resulting in no visible external scarring. This approach is often chosen for less extensive alterations.
How Long Does the Surgery Take?
Rhinoplasty usually takes between one to three hours, depending on the complexity of the procedure and whether it’s a primary surgery or a revision case.
What is the Recovery Process Like?
First Week: Swelling, bruising, and discomfort, with a nasal splint in place.
First Month: Major swelling decreases, and most patients can return to work and normal activities.
Long-Term: Complete healing with final results may take up to a year, especially for the resolution of minor swelling.
Will I Have Scarring After Rhinoplasty?
In closed rhinoplasty, all incisions are inside the nostrils, so there are no visible scars. In open rhinoplasty, a small scar on the columella will be seen.
Can Rhinoplasty Improve Breathing?
Yes, rhinoplasty can improve breathing by addressing structural issues such as a deviated septum.
How Do I Choose the Right Surgeon?
Selecting a qualified plastic surgeon is crucial. Look for board certification, specialized training in facial plastic surgery, experience in rhinoplasty, and a portfolio of before-and- after photos. It’s also important to have good and clear communication with your surgeon.
How Much Does Rhinoplasty Cost?
The cost of rhinoplasty varies depending on the surgeon’s experience, geographic location, and the specific needs of the procedure. Consult our sales team to get more precise information.
Is Rhinoplasty Painful?
Patients typically experience mild discomfort, which can be managed with prescribed pain medication. This generally doesn’t last longer than couple of days depending on the patient.
Myths About Rhinoplasty
Myth 1: Rhinoplasty only corrects aesthetic concerns.
Fact: Yes, it is true that rhinoplasty is performed for aesthetic reasons but it is also performed for functional reasons like breathing difficulty too. For example, if you have a deviated septum issue, it can be corrected via rhinoplasty surgery.
Myth 2: Rhinoplasty surgery outcomes are always fake
Fact: Recently, the aim of rhinoplasty is to form a natural looking nose, if this wasn’t the case, new advanced techniques wouldn’t have been improved. For instance, preservation rhinoplasty is one of the newest techniques to be developed. This technique helps preserving the existing bones and cartilages as much as possible without breaking the bone. As the natural nasal anatomy is preserved, the results look natural.
Myth 3: The recovery process is extremely painful
Fact: Due to the newly developed techniques, patients don’t even feel pain no more, they mostly feel discomfort and congestion which wears off in a couple of days.
Myth 4: Rhinoplasty leaves noticeable scars
Fact: In primary rhinoplasty cases, most surgeons use closed rhinoplasty technique. In this technique, the incisions are made inside the nose, leaving no external scars. Revision cases might require an open technique as the case might be complex. In such cases, the scar will be right under the columella and will become very faded after 1 year of healing process is complete.
Myth 5: Rhinoplasty is only for young people
Fact: When it comes to rhinoplasty, there is actually no age limit if the patient’s overall health is in good condition. There’s no upper age limit for rhinoplasty as long as the patient is in good overall health.
Myth 6: Any nose shape is possible with rhinoplasty
Fact: Each face is unique and each nasal anatomy is different, this means rhinoplasty is not a one size fits all type of surgery. Each skin type, bone structure is different. The rhinoplasty result should be in harmony with the other elements of the face, this means if a type of nose fits someone, it doesn’t specifically mean that it will fit you.
Myth 7: Rhinoplasty results are instantly visible
Fact: The final result of rhinoplasty takes place once the healing process is complete and the healing takes time. Some facial swelling and most of the bruising will be gone by 10 days. But, the nasal swelling will only start to subside one month post surgery and towards the 3rd month, some of the nasal swelling will be subsided. The healing process will slow down after the 3rd month but will gradually continue.
Myth 8: Any plastic surgeon can perform rhinoplasty
Fact: It important to pick a plastic surgeon who specializes in facial plastic surgery. Because the body consists of many different parts and each part has its own complexity. That is why, the patient should pick surgeons who especially has a training and expertise in the field that they request to have surgery. Because the surgeon will have more experience and skill towards that part of the body. So, while planning your rhinoplasty, it is important to choose a board certified facial plastic surgeon.
How to make the right choice?
Going through a rhinoplasty surgery is not a decision that is taken lightly. It involves weighing your options and understanding the potential risk and complications as well. Here below are the key factors while deciding on choosing your plastic surgeon.
Rhinoplasty Techniques: Knowing the difference between open and closed rhinoplasty helps when discussing your options with the surgeon. It is important to listen to your surgeon about what would suit your face.
Potential Risks and Complications: Awareness of the risks help you prepare for the surgery.
Recovery and Maintenance: Preparing yourself for the recovery period is a big part of the process and it helps easing the journey.
Visual Evidence: It would help you to have a better understanding of the process to see other patient’s before&after case photos and research past patients’ reviews.
Personal Research: It is important to invest your time in researching the surgeon you choose to proceed with and the hospital, the anesthesiologist they work with etc.
Consultation: Having a detailed face to face consultation before the surgery is a must. You should discuss your desires and should have an honest conversation with your surgeon about what can be achieved and what not.
Financial and Emotional Consideration: It is important to have a support system before the surgery and be prepared for the financial investment you will be making.
How to Get in Touch for a Consultation
Whether you’re in the early stages of thinking about getting a nose job or ready to take the next step, having a range of resources is important. And this all starts with scheduling a consultation.
Finding a Qualified Surgeon: Search on EBOPRAS or ISAP website for European Board Certified Plastic Surgeons who specializes in rhinoplasty. Check the surgeon’s credentials and patient reviews before booking your consultation.
Scheduling a Consultation: As you figure out your list of plastic surgeons, contact each surgeon’s sales team and get an online evaluation. Ask as much questions as possible to the person of contact and see their responses.
What to Expect During a Consultation: The surgeon will do a physical examination of your nose and discuss possible outcomes and hear your medical background. Use this time wisely about what to expect during the recovery, what would suit your face and explanation of the surgical procedure.
Virtual Consultations: Most likely, you will be travelling from abroad so you can request an online video consultation with your surgeon before flying out for surgery.
When ready, having a consultation with a qualified plaastic surgeon will provide tailored insight about your specific surgery. Dr. Metin Kerem is 20 year experienced plastic surgeon who gives the utmost care to listening his patients and surgical excellence. For more information and details contact us.