Corrective plastic surgery of the external nose and nasal septum
The size and shape of the nose play a key role in facial aesthetics. Corrective surgery of the cartilaginous and/or bony nose (rhinoplasty) is a procedure to improve the appearance of the external nose, correct imperfections, reduce its size and improve the proportion of the nose to the rest of the face.
The most common features of the nose that a plastic surgeon can modify during surgery include:
- size of the nose and its proportion to the rest of the face,
- width of the dorsum and tip of the nose,
- width and position of the nose wings,
- profile of the nasal dorsum, in particular presence of a hump or sunken nose,
- shape of the tip of the nose, which may be large, excessively rounded, drooping, curved or pointed,
- angle between the nose and the upper lip,
- asymmetry within the external nose and septum.
Why is it worth it?
Rhinoplasty at Ambroziak Clinic renders a long lasting, aesthetic effect and is associated with easy convalescence. A wide range of possibilities as to selecting the nose aspect to be corrected gives the patient a perspective to choose how exactly they want their nose to look. The best surgeons in Poland, operating at Ambroziak Clinic, have vast experience which guarantees that the surgery will be performed flawlessly and the effect will be spectacular.
What do you need to know?
How often repeat
Change in the appearance of the nose is noticeable immediately after removal of the dressings. The final result of the surgery can be evaluated at the earliest 3-6 months after the procedure (among other things, because of persistence of tissue swelling for the first weeks), while long-term results of the surgery depend largely on the patient's compliance with postoperative recommendations and occurrence of other processes in the body, including changes in body shape and weight, changes associated with aging.
Rhinoplasty takes 3-3.5 hours and is performed under general anaesthesia. In addition, local anaesthesia is used to reduce pain and bleeding. Two surgical accesses to the nasal structures are possible: closed and open ones, and the decision to choose one depends on the type of nasal deformity and the surgeon's preference. Open surgery allows the plastic surgeon to better visualise individual nasal structures, assess them accurately and model them precisely. This approach is recommended in cases of complex defects involving both cartilaginous and bony parts of the nose, in patients after surgical correction of cleft palate and in cases of reoperation. The skin surgical incision runs through the narrowest part of the nasal pillar (between the nostrils) and only leaves a small, hardly visible scar. Closed nose surgery, from a cut in the nasal vestibule, is feasible if the only nasal features modified are an isolated nasal bridge hump or minor imperfections of the tip or wings of the nose. In the case of an open rhinoplasty, the first step is to dissect the soft tissues covering the nose. Once the cartilaginous and bony scaffolding of the nose is visualised, various modifications of the shape of individual structures are possible in order to achieve the desired effect: modelling of the nasal cartilages to achieve a desired shape; strengthening the support of the nasal structures using cartilage taken from the nasal septum (spreader graft). Less commonly, defects, irregularities or lack of support of the nasal structures need to be treated with cartilage taken from other parts of the body (e.g. from the auricle or from the rib); in case of a nasal hump, the plastic surgeon performs trimming or scarification (grinding); nose tip modeling can be performed by trimming the cartilages to the desired shape, placing sutures to approximate the larger wing cartilages or using cartilage grafts; a procedure often performed during corrective rhinoplasty is osteotomy (controlled fracture of the nasal bone). The purpose is to restore correct alignment of the nose and to narrow its lateral walls; after modelling the cartilaginous and bony nose and performing a thorough haemostasis, the nasal covering is restored and small incisions are sutured. Sutures on the nasal column are made with a thin thread and usually require removal within 7-10 days after the surgery. Setons - fabric strips with ointment, or plastic stabilisers are placed into the nasal passages on both sides to hold the nasal structures in position after the surgery and to prevent bleeding. The final stage of the operation is placement of a plaster dressing, which is designed (especially after osteotomy) to stabilise the nasal structures, assist in shrinking the skin and plays a very important role in shaping the final aesthetic effect of the surgery.
RECOMMENDATIONS FOR THE PATIENT AFTER RHINOPLASTY 1. Someone you trust needs to drive you home and take care of you for 1-2 days. 2. Throughout the recovery period, eat a balanced diet with plenty of liquids. 3. Only take the medicines prescribed by the doctor. Do not take aspirin or medicines causing blood coagulation disorders or bleeding. 4. Do not drink alcohol for 3 weeks after the surgery. 5. Do not smoke or stay nearby smokers until the end of the healing process. Physical activity 1. Start walking as soon as possible, as this will reduce swelling and the possibility of blood clot formation. 2. Do not drive a car while taking strong analgesics. 3. Avoid physical activity causing increased blood pressure, including bending forward, lifting and stretching. 4. Avoid physical exercise for 2 months after the surgery. 5. Do not return to work sooner than approximately 14 days after the surgery. Indications concerning the wound 1. You can take a shower no sooner than 24 hours after the surgery. 2. It is advisable to place the head on at least 2 pillows to reduce swelling to a minimum. The use of cooling dressings around the eyes for the first 48 hours will reduce swelling and bruising that normally occurs after the surgery. 3. Do not make the thermoplastic splint on your nose wet or put pressure on it. Change the dressing under your nose each time the dressing becomes wet. 4. The dressing on the bridge of the nose must remain in place for approximately 10 days after the surgery and may only be removed at the Clinic. 5. Do not blow your nose too forcefully for at least 8 weeks after the nose surgery. Try not to sneeze; if unavoidable, try to do it with your mouth open. 6. Do not lower your head below the level of your heart. 7. Avoid foods that require long chewing. For 2 weeks avoid foods which require intensive lip movements while eating, e.g. apples, corncobs etc. 8. Brush your teeth with a soft toothbrush only. 9. Avoid long telephone conversations for at least 10-14 days after the surgery. 10. Do not smile and avoid mimic facial movements for 1 week after the operation. 11. Do not wash your hair for 1 week. Keep the dressing on your nose dry and clean. 12. Wear cloths with buttons or a zipper at the front or back. Avoid clothes which you need to pull over your head. 13. Avoid exposing the scar to sunlight for at least 12 months after the surgery. Always apply high factor sunscreen if sunlight exposure is unavoidable. 14. Do not wear glasses or sunglasses for at least 4 weeks after the surgery. 15. Contact lenses may be worn 2-3 days after the surgery. 16. After removal of the dressing from the nose, the nasal bridge may be gently washed with soap, a delicate cream and make-up may be applied. 17. Avoid intensive physical exercise for 1 month after the surgery. 18. Avoid constipations. 19. Apply Sulfarinol drops 3 times per day and spray seawater to assist in clearing nasal secretions.
Recommendations after the corrective nasal surgery include: Cool dressings on the eye area to reduce swelling, placing the head high on pillows. Limiting major physical efforts, including lifting heavy objects for the first 2 weeks. Failure to do so involves the risk of bleeding and the need for revision surgery. A sparing lifestyle ought to be pursued for at least 6 weeks. The nose should not be blown forcefully for at least 8 weeks after the operation. Use of spray seawater may be helpful in clearing nasal secretions. If the patient uses intranasal medications on a long-term basis, return to their use after the surgery must be agreed with the attending plastic surgeon. Setons/stabilisers in the nasal passages are maintained for approximately 2 days after the surgery and are only removed by the doctor at the Clinic. If fitted, a plaster dressing over the nose should be maintained for 7-10 days after the surgery. Wetting of the dressing should be avoided. Removal of the plaster cast can only be performed by a doctor at the Clinic. Removal of skin sutures in the case of open surgery takes place on the 7th-10th day after the procedure. The patient should not wear glasses, including sunglasses, for at least 1 month after the surgery. Smoking and inhaling tobacco smoke should be avoided for at least 6 weeks before surgery and throughout the healing period. The patient should not sunbathe the skin of the operated area for 6 weeks after surgery, use high photoprotection (SPF 30-50).
No, rhinoplasty is performed under general anaesthesia, as a result of which it is painless. Recovery after the surgery [urwane zdanie]
Rhinoplasty results are permanent.
No, correction rhinoplasty is a one-time surgery.
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