NOSE AESTHETIC SURGERY Rhinoplasty
The procedure performed in nose aesthetics (rhinoplasty) is to reshape the nose by changing the structure of cartilage and bones. In order to create a more aesthetic nose shape, it is sometimes necessary to cut the bones and cartilages, and sometimes to complete the missing parts and change their shape.
It would be right to accept rhinoplasty or aesthetic nose surgery as the most difficult and unknowns of plastic surgery.
WHY AESTHETIC NOSE SURGERY IS HARD
Aesthetic nose surgery is difficult because the nose is like a closed box and you have to do this surgery from only one side of this box. There are many uncertainties in this surgery because the bones and cartilages that make up the structure of the nose are found independently of each other but as a whole and may behave differently during the healing period. Therefore, this is the plastic surgery performed most frequently after revision, namely a second correction surgery. It is considered normal for a world-class surgeon to have to revise one out of every 10 cases.
On the other hand, when this surgery is done well, it gives very good results.
Rhinoplasty surgery can be done in two ways as open and closed technique.
In closed technique, all cuts are made in the nose. The surgeon completes the surgery by working from within. In the open technique, a 3-4 mm cut is made at the tip of the nose and the tip of the nose is opened.
The difference between the two techniques is related to the surgeon’s mastery of the operation. The closed technique made from the tip of the nose is more like surgery in a bottle. If you only plan to get something out of the bottle, it will not be a problem, but if you want to make a model of a ship inside, your job is difficult. In the open technique, the surgeon can see the structures remaining in the front 2/3 of the nose.
Which technique is better is always a matter of debate among the doctors who perform this surgery, and no decision has been made on this issue.
As you can see from my descriptions above, my preference is mostly for open technique. The most important reason for this is that I do not believe that a fine work that is blinded and does not forgive such mistakes can be a good result without seeing it. It is something that even closed technique advocates cannot object, that many surgical maneuvers are only possible with open technique, and corrections that cannot be imagined with closed technique are possible with open technique. I believe that the possibility of revision decreases after open surgeries.
The biggest handicap of the open technique is leaving a scar at the tip of the nose. But this scar becomes almost indistinct after a well-performed surgery and remains under the nose. Many patients forget this scar after surgery.
Consult and trust your doctor anyway. Every surgeon will get the best results with the methods he knows and believes best. The above are just my personal views.
I SEE VERY BAD SURGERIES, AM I WILL BE THAT?
I also see unnatural, very small “operated noses” that look like nostrils from the front. I explained on a separate page how you can understand a poorly performed nose surgery. Remember that the outcome of the surgery depends entirely on the techniques used by the surgeon, his skill and what he wants to do.
Giving an upturned nose shape by only shrinking the nose creates an unnatural result. In modern techniques, only the locations, positions and shapes of the tissues are changed, almost without removing anything.
If you examine this shape, you can see one of the common aesthetic mistakes. This is a common method in old techniques. In the past, the starting point was taken as low as possible by shrinking the nose to show the nose upright. Thus, an illusion is created as if the nose was up, but the result would not be natural. Starting the nose where it should be, from where it should be, that is, almost at the level of the pupils and giving the whole shape accordingly.
How can I see what kind of nose I will have after the surgery?
There are computer programs prepared for this purpose. Your doctor will likely give you an idea with one of these. However, with these programs, a real surgery planning and measurement cannot be made and they can only give a general idea. If your doctor is using one of the new measurement-based techniques, he or she will want to make measurements on your pictures. For this, it will either hold a ruler in your hand while taking your photo and measure it accordingly or print the picture in real size. I calculate the golden ratio and ideal face profile by making fine measurements before the surgery. As a result of my calculations, I draw a profile picture with my hand. Click here for detailed information on profile work.
COMPLICATIONS AND PROBLEMS:
The risk of blood in every surgery may be more serious in rhinoplasty. Especially if non-aesthetic procedures are to be performed in the nose to remove nasal congestion, which must be done if necessary, the possibility of unwanted bleeding increases. It is an organ that contains medium-sized vessels in the nose. However, such bleeding usually does not reach dangerous levels and can be stopped with simple tampons.
After surgery, adhesions called synechiae may develop in your airways and these can make your breathing more difficult than before surgery. This is usually easy to treat, but a second surgical intervention may be required.
Very rarely, a hole may occur in the structure called “septum” that forms the middle of the nose. This is usually not a problem, but it may rarely cause a sound while breathing. It is difficult to treat and requires reoperation.
It can be said that the infection is almost not in the nose. This organ, which has a strong blood supply, is very resistant to inflammation. If an infection develops after this surgery, you can enter the medical literature.
But no one will be surprised if you experience these postoperative aesthetic problems, deformities, or do not like your nose shape. Therefore, the most common complication of this surgery is aesthetic.