Surgery to reduce the nose: wings, tip, how to do, photo before and after

The most demanded of plastic surgeries are those that are aimed at changing the shape, reducing size, as well as correcting defects of the nose resulting from injuries or diseases. They are combined under the general name of rhinoplasty. According to statistics, these are some of the safest plastic surgeries.

Indications

Patients resort to this operation for many reasons, which are divided into physiological (difficulties with breathing) and aesthetic (improvement of appearance).

The operation to reduce the nose is performed according to the following indications:

• disproportionately long nose;
• large nostrils;
• Aquiline nose;
• the tip of the nose is too thick or pointed;
• saddle-shaped nose;
• a change in the shape of the nose due to injuries or injuries;
• inherited defects in the shape of the nose;
• low back of the nose;
• there is a bulge in front of the tip of the nose;
• asymmetry of the nasal septum;
• difficulty or almost impossible breathing through the nose as a result of fused or twisted septa or another cause

Contraindications

An operation to reduce the nose should be performed after the examination to identify contraindications that may complicate the course of the operation or affect the final result of rhinoplasty.

Surgery to reduce the nose has the following contraindications:

• age less than 18 years, since the shape and structure of the nose until the age of 18 is still being formed;
• atherosclerosis;
• diabetes;
• viral diseases (HIV, hepatitis C, herpes in acute form);
• inflammation of the skin of the nose;
• infectious diseases in acute forms;
• mentally unhealthy patient;
• diseases associated with poor blood coagulability and impaired heart function;
• inflammation of the nasal, frontal sinuses;
• diseases of the oral mucosa.

Operations to change the shape or size of the nose are performed by two methods: closed or open. Which one will be selected depends on the type of operation and tasks.

Open method

Plastic surgery to change the shape or reduce the size of the nose is most often performed by an open method. The essence of this method is to perform an incision at the edge of the wing cartilage and an incision along the columella. When the surgeon made the incisions, the skin is taken to the bridge of the nose, thereby opening up access to the bone-cartilage tissue for further action on the change.

The main advantages of open rhinoplasty:

• Since this is an external operation, the surgeon has the ability to visually control the execution of the work, making it easier to make changes or adjustments in the process.
• The fabrics do not turn out and do not stretch during the intervention, this makes it possible to put the fabrics in their place and distort without distortion without undesirable shape changes.
• Even with severe defects in the anatomical structure of the nose, grafts of complex shape can be installed.
• Achieving perfect nose symmetry after surgery.

Open rhinoplasty has disadvantages:

• Longer rehabilitation period due to high tissue trauma.
• Cutting of the columellar arteries leads to a violation of the nutritional processes of the skin of the nose in the operating period.

Private method

Closed rhinoplasty is also widespread, since it makes it possible to achieve the desired result without visible signs of surgical intervention.

The main distinguishing feature of this method is minimal tissue damage, incisions are made inside the nose, and the columella is not damaged.

The main advantages of a closed methodology:

• minimal tissue trauma and a short rehabilitation period;
• lack of visible traces of the operation;
• since the stitching of cuts is performed by self-absorbable threads, there is no need to remove the seams;
• high predictability of the result;
• the integrity of blood vessels provides normal nutrition of tissues and skin of the nose.

Disadvantages of closed rhinoplasty:

• The surgeon must be highly qualified and have extensive experience, since the operation is performed almost blindly.
• Operations performed by a closed method do not make it possible to solve all problems of aesthetic and physiological nature.
• It is difficult to achieve symmetry, especially if the skin is thick.

The technique and type of operation is determined by an experienced surgeon, as a result of which the desired result is achieved.

Varieties of plastics

The type of necessary plastic surgery on the nose is determined by the tasks and goals of the surgical intervention.

Hump removal

Rhinoplasty for hump removal is performed by two methods: surgical and non-surgical.

Non-surgical nose surgery

This is a kind of nasal contouring using injection. Biodegradable preparations are used as injection fillers: their basis is collagen and hyaluronic acid. Silicone is also used in such rhinoplasty, which refers to biodegradable drugs.

Recently, autologous fillers are increasingly being used. In this case, the nose is adjusted by injecting the patient’s fat cells. This type of plastic is called lipofilling.

Nasal Surgery

The surgical method is implemented through rhinoplasty. Intervention is carried out under the influence of general anesthesia. The surgeon makes incisions inside the nasal openings, exfoliates the tissue to get to the hump itself.

If necessary, bone tissue is cut off and cartilage is removed. After removing excess tissue, the surgeon fixes the tissue in a new position. To consolidate the result and to prevent side effects, plaster is fixed on the nose for 10
days, and tampons are inserted into the nostrils.

Wing reduction

The operation to reduce the wings of the nose is carried out quickly. The surgeon does all the work in 20-25 minutes. The operation can be performed under general and local anesthesia. The specialist is guided by the amount of work, age, and health of the patient, and also takes into account the wishes of the client himself.

The reduction of the wings of the nose is carried out as follows: lateral wedge-shaped incisions are made on the base, excess tissue is removed, and then the edges are sutured. If it was decided not only to reduce the nostrils, but also the wings of the nose, then the incisions are made in the form of an oval or sickle. At the end of the procedure, a plaster cast is applied to the tip of the nose, and tampons are inserted into the nostrils.

Reducing the height of the nose

In the case of a high nose bridge, an operation is performed, during which part of the bone (nasion) is removed with special tools through incisions in the soft tissues of the nose. As a result, the nose becomes lower.

Length cutting

The operation to reduce the length can be carried out open and closed method. It all depends on the amount of work. The surgeon cuts soft tissue to allow access to bone and cartilage. Part of the cartilage and bone is removed; if necessary, the bone is only partially cut off.

Backrest narrowing

Narrowing of the nasal bridge is performed during surgery with a controlled fracture of the nasal bones (osteotomy). The surgeon moves the bones closer to each other, thereby reducing the width of the back of the nose.

Tip reduction

Carrying out the operation by a closed method, the surgeon makes incisions inside the nose, removes part of the supporting cartilage. To achieve a narrow tip of the nose, the doctor applies stitches as needed to raise or tilt the cartilage.

Open surgery opens up more possibilities and simplifies the work, but the rehabilitation period is significantly lengthened.

Preparation for surgery

Before surgery to reduce the nose (two weeks), you need to undergo a standard medical examination.

For a complete check of the state of health, it is necessary to pass tests:

• blood (general and biochemical);
• blood on prothrombin;
• urine
• blood for checking the Rh factor and blood group;
• for acute viral diseases (HIV and hepatitis C).

Also required to do:

• ECG;
• tomography of the paranasal sinuses;
• pregnancy test for women;
• ultrasound diagnostics (not in all cases).

  

In addition to passing standard tests, additional examinations should be carried out, if necessary, in order to maximize the health status and determine all contraindications. The doctor must conduct tests for allergic reactions and study the medical history.

Immediately before rhinoplasty, you should consult with a surgeon, discuss all the nuances of a future nose surgery, and clearly and as deeply as possible describe the desired result.

On the eve of the operation, it is recommended:

• stop taking anticoagulant drugs two weeks before surgery (blood thinning drugs) to avoid bleeding;
• eat only light and quickly digestible food (salads, fruits and dairy products) – the day before plastics;
• stop eating food and liquids 6 hours before surgery;
• stop drinking alcohol and tobacco a week before rhinoplasty.

On the eve of surgery, you need to meet with an anesthetist to determine the method of anesthesia, check the patient for an allergic reaction to anesthesia, and make sure there are no contraindications. Examination and verification should be thorough, since rhinoplasty is performed under general anesthesia.

Procedure

Based on the wishes of the patient, the degree of reduction of the nose (in whole or in separate parts) and the nature of the incisions, the surgeon determines the technique of the operation. Immediately before the plastic surgery, he makes a marking of future incisions and discusses with the patient all the nuances of the operation and the desired result.

Stages of rhinoplasty:

1. Anesthesia.
2. Incision. Depending on the tasks and methodology of the operation, the incisions are made inside the nose (closed) or outside (open). In the latter case, the surgeon cuts the columella (a strip of tissue separating the nostrils). Through the cuts, the soft tissues of the nose are removed, and access to the cartilage and bone tissue is opened.
3. Nose reduction. The surgeon removes part of the cartilage and bone tissue. If necessary, removes part of the back of the nose to reduce it.
4. The hump of the nose. Part of the bone tissue (directly the hump) is removed with a special rasp.
5. Correction of the width of the nostrils. The surgeon makes incisions and removes excess parts of soft tissues, and also distributes the wings of the nose closer to the midline.
6. Correction of the nasal septum. If necessary, the specialist straightens the nasal septum, which will ensure the normal physiological functioning of the nose.
7. Closure of cuts. Upon completion of all actions to reduce and adjust the size of the nose, tissue and skin are put in place and sutures are performed.
8. Fixation. Special tires are applied and tubes are inserted to maintain the nose during the healing period. A special sticker of gypsum or pyroxylin (collodin) is applied to the nose, it will retain the shape of the nose.

Rehabilitation

The rehabilitation period after surgery to adjust and reduce the size of the nose is divided into 4 stages.  The first stage lasts the first week after rhinoplasty. This is the most difficult stage, because pain is felt in the early days, you need to constantly take antibiotics to avoid infection.

Dressings, gypsum pads and tampons in the nostrils make it impossible to breathe through the nose. There is no way to go to work, do housework. Inconvenient to observe personal hygiene. Bruising, bruising and swelling of the tissues are pronounced on the face.

The next stage lasts two weeks after the first stage of rehabilitation. At the beginning of this stage, the doctor removes dressings and plaster, removes tampons, removes some stitches. The nose is washed with a special solution to remove blood clots and mucus from the cavity.

This greatly facilitates breathing. The swelling of the tissues is significantly reduced, the bruises almost disappear, but the nose remains swollen and deformed. During the first two stages, it is advisable to sleep only on the back so as not to damage the nose. It is forbidden to lift weights, bend over, eat hot food, be in places with high temperature.

The third stage lasts up to 3 months after surgery. Swelling of the nose becomes almost invisible, but it is not yet fully formed. Slightly swollen wings and the tip of the nose are observed.

The fourth stage lasts from 3 months after rhinoplasty to one year. The period of complete rehabilitation depends on the characteristics of the patient’s body and on the amount of work done to reduce the nose. About a year later, the nose will fully form and the result of the operation will be visible.

Possible complications

The result of the operation is influenced by many factors, ranging from the professionalism of the surgeon to the patient’s activities during the rehabilitation period.

All sorts of complications may occur after surgery on the nose:

1. The surgeon can cause damage to the nasal bone, cartilage, or skin. If a mistake was made in the operation, repeated surgical intervention will be required to repair the damage.
2. Divergence of seams. This depends not only on the professionalism of the doctor, but also on the patient’s body, as well as on caring for himself during the rehabilitation period.
3. Numbness. In the first days after surgery, numbness and loss of sensation of the nose are observed, as the surgeon made incisions that damaged the nerve endings. This is a temporary phenomenon.
4. Hematomas and swelling of tissues. This is a natural phenomenon, since soft tissue was damaged during plastic surgery. If the operation was carried out for a long time and many changes were made, then edema can make breathing difficult. An experienced surgeon will prescribe medications that will facilitate the rehabilitation period.
5. Infection This is extremely rare. May be due to insufficient disinfection of instruments and skin of the patient before rhinoplasty. A timely detected infection is successfully neutralized by antibiotics.
6. Tissue necrosis. As a result of surgery, blood vessels are damaged, and blood stops flowing to the skin, bone or cartilage. This causes tissue death. In this case, a second operation is performed under local anesthesia to remove excess skin, bone or cartilage. A long healing period can also lead to necrosis.

To avoid or reduce the likelihood of postoperative complications, you should adhere to several rules:

• do not smoke or drink alcohol before and after surgery;
• do not take drugs that reduce blood coagulability;
• do not succumb to stress, monitor the state of health, avoid pressure drops;
• protect your nose from damage;
• Eat a healthy and balanced diet.

During the operation to reduce the nose, you can change the length and width of the nose, remove the hump. Despite the fact that this operation is one of the safest, complications are possible after rhinoplasty.

Rhinoplasty Video

Photos of rhinoplasty before and after: