Rhinoplasty of the nose non-surgical, closed, open, reconstructive, injection, rehabilitation

What to do if the nose is spoiled by the hump, size or imperfection of the nasal cartilage Rhinoplasty will help to solve many problems.

What is rhinoplasty

Rhinoplasty of the nose – surgery in plastic surgery to correct congenital or acquired deformities, shape correction, restoration of parts of the nose, aimed at aesthetic improvements in its appearance.

There are several ways rhinoplasty:

• operative – for small surgical interventions (for example, correction of wings or the tip of the nose);
• by injection or non-surgical method (made to smooth out deformations or imperfections in the form);
• operations of increased complexity to fully restore the appearance and functions of the nose.

Fundamental surgery involves affecting not only the nasal cartilage, but also the frontal bones, so only an experienced specialist should be trusted so as not to fundamentally disrupt respiratory functions and metabolism. Well-performed rhinoplasty allows a person to look more impressive. A favorable period for correction is the age from 20 to 30 years.

Methods of nose surgery

Depending on the planned volume of surgical intervention, nose plastic can be open or closed. Open rhinoplasty is considered a serious intervention in bone, cartilage, soft tissue, and therefore requires a certain skill from the surgeon.

Typically, this method is used for significant bone changes:

• after hitting;
• with curvature;
• when installing transplants.

The surgeon makes an incision between the nostrils and separates the skin from the cartilage. The operating field is ready, then there are manipulations to achieve the goal.

Rhinoplasty of the closed part of the nose is considered an adjustment, accompanied by incisions inside the nasal cavity. In this case, the skin remains unharmed. This method is used to eliminate minor defects, as well as to combat hyperemia of the nasal mucosa.

Closed plastic practically does not give puffiness and complications, but it can complicate the surgeon’s work due to the inconvenient location of the surgical field.

Types of Rhinoplasty

Plastic surgery knows several types of nose defect repair. Which option is most suitable for the patient, the doctor decides, based on the needs of the client, the structure of his nose, the quality of the cartilage and the amount of surgical intervention.

If the adjustment is insignificant, then it can be done by injection. Injection rhinoplasty is one of the safest methods to correct the contours of the nose. It can be performed by an experienced cosmetologist. In this case, injections of fillers (liquid preparations based on hyaluronate) can be used.

The substance fills the cavities that affect the formation of a more perfect and smooth contour of the nostrils, the back of the nose or its tip. The full procedure is carried out 1 time in 1.5-2 years. Another injection method is used, when hormones are introduced under the skin, absorbing protruding formations from fat or connective tissue above the surface.

Reconstructive plastic surgery is aimed at restoring and shaping the nose, which has defects due to damage, diseases that affect the cartilage tissue, as well as congenital imperfections. Such operations are recommended to be done only after the facial disk and skull have fully formed and ceased to grow. Exceptions are only for a number of serious indications.

Laser rhinoplasty is a special type of surgery to combat flaws, which allows manipulations in various parts of the nose:

• in the area of the colummel – to change the shape and position of the skin part between the nostrils;
• at the tip of the nose – correction of the indicated part;
• on the nostrils – adjustment of their shape and size;
• turning a wide nose into a narrower one;
• removal of a certain part of the nasal mucosa (conchotomy) for more free breathing.

There are concepts of primary and secondary (repeated) rhinoplasty. The latter is applied when it is necessary to correct the consequences that arose after the first.

There are several other types of rhinoplasty, but they are resorted to much less often for a number of reasons. For example, plastic using Aptos threads. With their help, the wings of the nose and the nose are pulled through the punctures. After the procedure, there is a high probability of the appearance of scars, breaks of threads.

Indications for surgery

Rhinoplasty of the nose is done for medical or aesthetic reasons.

Medical indications for surgery include:

• difficulty breathing arising from an increase in temperature, swelling of the respiratory tract due to a curved septum of the nose;
• deformation, displacement of the nasal cartilage after injury;
• difficulty breathing with congenital disorders of the nasal cavity;
• cartilage fractures of the nose;
• cartilage failure after certain diseases.

Indications of an aesthetic nature are not mandatory for the operation, unless obvious imbalances are evident.

More often, patients having:

• wide or narrow back of the nose;
• dilated or narrowed nostrils;
• nose “potato”;
• consequences of a burn;
• mild nose bridge;
• snub nose;
• noticeable hump;
• crochet nose.

Contraindications

Those who decided on rhinoplasty need to know about the existing contraindications, these are:

• acute infectious diseases;
• herpes;
• diabetes;
• suspected malignant tumors and the tumors themselves;
• poor blood coagulability;
• cardiovascular disease;
• acute rhinitis;
• pyelonephritis;
• mental health problems;
• period of pregnancy and lactation;
• menstruation period;
• children’s age, if the condition is not a direct threat to health;
• age after 40-45 years.

Pros and cons of surgery

Rhinoplasty of the nose has positive and negative sides.

The positive include:

• the appearance of confidence in his appearance, satisfaction from her;
• getting rid of defects;
• getting rid of snoring;
• getting rid of shortness of breath.

But you must understand that the operation can entail undesirable phenomena:

• spontaneous bleeding;
• decrease in sense of smell;
• postoperative complications;
• infection
• lack of the expected effect.

Nose tip plastic

Modeling of the tip of the nose can be carried out either as a closed method or as an open one. It all depends on the purpose of the operation. As a rule, patients turn to the surgeon if it is necessary to raise the tip of the nose, slightly lower it, align it or make it more elegant.

In the open method, after cutting the skin between the nostrils, the surgeon removes by exfoliation the excess subcutaneous soft tissue or part of the cartilage. When manipulating cartilage tissue, it is necessary to take into account its condition and the degree of cutting off the excess so that the supporting function of the nose is not lost.

Another way of correction involves not clipping, but building through the use of a biotransplant – usually to form a slight elongation or snub-nosed.

With the closed method, the surgeon cuts the mucous layer and creates a shape, freeing the wing-shaped cartilage and applying small ( 4/32 – 6/32 inch) sutures in the right places. The inconvenience is that the doctor does not see exactly where the blood vessels pass and can hurt them.

Nose wings plastic

With the help of plastic wings of the nose eliminate:

• asymmetry of the nostrils – the formation of a new contour by the method chosen by the surgeon;
• dilated nostrils – the narrowing occurs due to the stitching of the wing-shaped cartilage in the area of the columella;
• nostril drooping – the effect is achieved by transplanting tissue from the auricle or nasal septum;
• adjust the length and width of the lateral parts of the nostrils – using methods of internal excision, tissue tightening;
• large sizes of the wings of the nose – a decrease occurs due to partial excision of the tissue.

For these types of plastics, the closed method of surgery under local anesthesia is most often used.

Septoplasty

Septoplasty is aimed at correcting defects of the nasal septum, for example, the displacement of cartilage or nasal bones, which interferes with normal breathing, provoking chronic diseases up to bronchitis, hypoxia and asthma. An operation is performed under general anesthesia and using an open method.

Medicine knows several ways to carry out septoplasty:

1. The main method is submucosal resection, in which the surgeon removes the deformed parts of the cartilage or bone, after having previously released them from the soft tissues.
2. Partial septoplasty involves the removal of a small portion of cartilage. Another option is the removal of the deformed fragment, its alignment by, for example, excision and returning back to the anatomically correct position.
3. The endoscopic method is also used, that is, all actions can be tracked using optical equipment.

In many cases, the method of performing the operation using a laser, rather than a scalpel, is used.

Rhinoseptoplasty

Indications for rhinoseptoplasty may include:

• desire to correct the shape of the nose;
• correction of a deformed nasal septum;
• neoplasms;
• congenital defects of the nose;
• consequences of injuries
• repeated operations.

Medicine distinguishes types of rhinoseptoplasty:

• functional (solves the problems of nasal dysfunctions);
• reconstructive (when restoring the nose after injuries);
• aesthetic (correction of various parts of the nose).

Operations can be performed with general anesthesia and local anesthesia, open or closed method. The methods of plastic surgery are chosen by the surgeon, focusing on the nature of the manipulations.

Reconstruction of the external nose

The operation to restore the external nose is considered one of the most complex, requiring great surgical experience.

Indications for the restoration of the sense of smell are as follows:

• significant damage to the nose as a result of injury;
• congenital malformations;
• deformations after removal of growths and tumors;
• the result of frostbite, burns;
• other causes of destruction of the nose.

Reconstruction is usually carried out using the biomaterial of the patient himself:

• skin of the forehead, temple;
• part of the cartilage from the auricle;
• part of the bone from the rib.

This provides a certain guarantee that the transplanted element will not be rejected. If it is not possible to use the patient’s material, a specially prepared silicone implant is made. Surgical operations are designed to restore all layers, starting from the mucosa and ending with the nose frame itself.

How to use the method: closed or open, – the doctor decides, focusing on the task, but in both cases, general anesthesia is preferable. Reconstruction can last from 1 to several hours. Rehabilitation takes no more than 2 weeks.

Nose hump removal

The removal of the hump is recommended not earlier than 18 years. In the process of plastic surgery, a small incision is made on the nasal bridge, and cartilage or bone tissue protruding above the surface is removed with a special file.

At the discretion of the doctor, cuts on the sides of the nasal slope are possible to give the nose a more aesthetic appearance. At the end of the procedure, the incisions are tightened, sutures are formed, a plaster cast is applied for 2-4 days. The procedure is performed under local or general anesthesia, depending on the complexity of the execution and always using the open method.

Closed Rhinoplasty

This method includes a large number of surgical procedures and can significantly complicate the work of the surgeon, since the procedure is carried out exclusively inside the nasal cavity.

The advantages of this rhinoplasty are that it takes less time than open, the skin on the nose remains intact, and the postoperative period passes without significant edema.

However, as after any surgical intervention, typical complications are possible:

• infection
• bleeding
• internal hematomas;
• unexpected mucosal reactions.

Indications for such an operation may be medical and aesthetic reasons:

• obstructed air passage through the nose;
• injury;
• ugly nose;
• deformation of some part of the organ.

Repeated rhinoplasty, rhinoseptoplasty

Secondary or repeated rhinoplasty is performed if the first operation was unsuccessful and there were certain complications or dissatisfaction with the appearance.

A second operation to correct the results of the previous procedure is possible only after 1 year, after the nose is finally formed, and it will be clearly visible that it is necessary to correct it. Such plastic surgery is performed by the open method and is associated with significant surgical intervention.

To make the correct diagnosis and make the choice of the method of the operation, the surgeon should familiarize himself with photographs of the nose before and after the first operation, and also suggest that the patient do a tomography. It is necessary to be prepared for the fact that the rehabilitation period will be much longer than the first time.

Preparation for surgery

Rhinoplasty of the nose requires prior preparation. The surgeon studies the patient’s health, the state of the future surgical field, discusses the client’s wishes and analyzes the most appropriate correction methods. The patient needs to be examined for cardiovascular diseases, get advice from a neurologist, otolaryngologist.

If plastic is not contraindicated for the patient, then he is offered a day hospital for 10-14 days.

During this period, you must abandon:

• alcoholic beverages;
• heavy, fatty foods;
• smoking

It is necessary to comply with proper nutrition and proper sleep. 2-3 hours before the start of the operation, it is not recommended to drink water and eat food – this may affect the result of the surgery.

Minor defects, changes in the configuration of the tip of the nose are done under local anesthesia. If serious changes and adjustments are required, then general anesthesia is prescribed. In this case, the patient needs to consult with an anesthetist about the tolerability of anesthesia components.

Necessary analyzes

Before the operation, it is necessary to undergo a number of studies.

To do this, are assigned:

• general blood analysis;
• ECG;
• biochemical analysis;
• additional tests as recommended by a physician.

The examination is carried out to understand the general condition of the patient, to determine the rate of blood coagulation, the presence of latent inflammatory processes in the body and their pathogens.

Start of operation and anesthesia

Any surgical operation, including nasal plastic surgery, begins with the treatment of the surgical field with disinfectants. This will reduce the risk of pathogens getting under the skin.

Before surgical procedures, the anesthetist gives the patient local anesthesia (if minor correction is planned) or gives general anesthesia (in complex cases involving cartilage, bone tissue).

As a rule, an operation, if it is an open type, begins with an incision with a scalpel of the skin between the nostrils and the release of cartilage from it. Next are the actions aimed at completing the task. Closed plastic surgery implies the work of a surgeon through the nostrils, without violating the integrity of the skin.

In some cases, additional anesthesia is done to locally disable receptors during general anesthesia.

Stages of rhinoplasty

Rhinoplasty consists of several stages:

• skin disinfection at the incision site;
• anesthesia;
• if necessary, additional local anesthesia to disable receptors;
• an incision is made depending on whether the closed (in the nasal) or open (between the nostrils) method is used;
• correction of defects, irregularities – depending on the task;
• replacement of cartilage with implants, if necessary;
• stitching of surface tissues;

  

• applying a bandage-retainer.

Rehabilitation after surgery: before and after photos

Rhinoplasty of the nose takes from 40 minutes. up to 4 hours. The rehabilitation time takes from 14 to 30 days, depending on the complexity and extent of the surgical intervention.

After the plastic surgery, swelling and hematomas are observed, which are formed due to damaged or burst capillaries. For the nose to take the given shape and the seams to heal, it will take 7-10 days, during which it is necessary to wear a bandage-retainer.

At first, to stop bleeding in the nostrils, it is recommended to insert cotton or gauze swabs. In an operation affecting all the nasal departments, the recovery period is determined at 14-16 days.

To prevent intense blood circulation in the face and the expansion of capillaries, doctors recommend that for 25-30 days avoid visiting the sauna or taking hot baths, any physical activity that provokes facial muscle tension.

Throughout the recovery period, it is recommended to wash in such a way that the nose remains dry, wear clothes that do not need to be worn over the head. The final result can be estimated no earlier than 6 months later.

Consequences, complications of rhinoplasty

Depending on the quality of the operation and the personality of the body, a number of consequences may occur locally:

• decreased skin sensitivity;
• scarring;
• labored breathing;
• complete or partial loss of smell;
• skin defects – stretch marks, loss of elasticity;
• tissue necrosis;
• dark spots;
• lack of de
  sired effect.

Complications after rhinoplasty are conditionally divided into early and unpredictable. The latter can occur unexpectedly due to a specific reaction of the body and affect the condition of cartilage or healing tissues.

Early complications include:

• involuntary lacrimation;
• bleeding;
• severe swelling;
• pronounced hematomas;
• the formation of plugs of the sebaceous glands.

Nutrition after surgery

To prevent edema, experts recommend limiting salt and sugar intake for 1.5-2 months after surgery. It is not advisable to eat sodium glutamate and other food chemistry. For the first 14-16 days, doctors suggest changing the meal schedule – eat 5-6 times a day in small portions. It is believed that this will help better absorption of nutrients.

As for the menu itself, in order to prevent an intense rush of blood to the head and vasodilation, it is necessary to temporarily abandon alcohol, drink hot and spicy foods.

Excluded from the diet:

• oily;
• spicy;
• food that can cause constipation.

Daily meals should consist of:

• porridge;
• soups;
• fruit
• vegetables;
• lean meat, poultry, fish, stewed or steamed.

What swings the drinking regime, then drink water, tea, juices based on the needs of the body, but under control, not forgetting about the possibility of edema.

Rhinoplasty prices in New York, Los Angeles and

The cost of rhinoplasty includes:

• anesthesia;
• the operation itself, taking into account the level of its complexity;
• expendable materials;
• stay in a hospital taking into account his status;
• postoperative medical consultations.

The table shows indicative prices for several main types of rhinoplasty in various cities of USA.

	New York	SPB	Los Angeles	Detroit
Full	170000	100000	150000	70000
Rhinoseptoplasty	230000	100000	100000	100000
Tip	130000	80000	50000	60000
Wings	160000	50000	50000	50000
Repeated	300000	150000	250000	200000

Now, rhinoplasty of the nose is difficult to surprise. People resort to it to solve their problems, both for medical reasons and following the standards of beauty. It is not recommended to neglect the preliminary consultations of specialists, the choice of an experienced surgeon and postoperative rules.

Video about nose rhinoplasty, real stories

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