The operation of rhinoplasty is carried out to reshape the bone and cartilaginous structure of the nose: in this way, it gives it more harmonious proportions, but the aesthetic purposes can never be separated from the functional ones. In any case, this intervention is much less invasive than in the past and even post-surgical recovery is faster, thanks to new hyaluronic acid treatments.
When it comes to rhinoplasty, the widespread belief is that it is an intervention aimed in most cases only at improving one aspect of the nose, but the main objective of the intervention, for the Clinical Lus Fly, must always be the one to respect and to improve respiratory function, in perfect harmony with an aesthetic refinement: a harmonious and natural nose, with correct proportions and angles, will also be able to work optimally.
The operation of rhinoplasty is planned according to the problem to be solved:
- Septoplasty: surgery that corrects functional problems that hinder respiratory activity, in which the surgeon works only at the level of the septum;
- Rhinoseptoplasty: surgery that corrects the volume and shape of the nose, but also functional problems, therefore the surgeon will operate either on the nasal pyramid or on the septum, or in limited areas such as the tip of the nose or the nostrils, the pyramid, the columella;
- Increased rhinoplasty: it is less required and it is applied to patients who need to increase the volume of the nose following a nasal trauma with consequent reabsorption of the cartilages.
Preparation for rhinoplasty surgery
During the preliminary visit, the patient will express his aesthetic needs and our surgeon will have the task of evaluating the bony structures, the septum, the mucous membranes, the respiratory function, skin and appendages, profile and relationships of the facial structures. Only in this way our doctor will be able to provide exhaustive and precise information on the success of the intervention and the results that can be obtained.
Computerized programs will also be used, in order to provide the patient with an idea very close to the reality of the final result of his intervention.
It is also important to evaluate the thickness of the skin which could limit interventions at the level of the tip: a thick skin does not allow to obtain a very thin nose tip. Then, our doctors will explain the methods of intervention, the post-operative course, the examinations and investigations to be carried out before proceeding with the operation.
The surgeon will also investigate any pathologies the patient is suffering from, and the familiarity with hereditary diseases.
The exams needed before the nose surgery
Before the surgery, it is essential to perform a computed tomography (CT) scan of the paranasal sinuses, through which all anatomical structures that condition good breathing can be correctly evaluated. Hematochemical and instrumental tests will also be required, such as an electrocardiogram, chest x-ray, abstaining from the use of anti-inflammatory drugs that reduces the healing time and increase the risk of bleeding.
Furthermore, it will be necessary to suspend or at least reduce the smoke, which limits the vascularization of the tissues and hinders healing. Contraindications to the intervention are: colds or influences contracted in the days before the operation, menstruation.
Nose plastic surgery: the days of surgery
The operation to rebuild the nose is performed under general anesthesia and only the very small corrections will be made under local anesthesia and it can be done in two ways:
- Closed rhinoplasty: with access from the nostrils, it provides the making of small incisions inside the nose with which the surgeon has the possibility to intervene on bones and cartilage by modifying the structure of the skeleton.
- Open rhinoplasty: it is more invasive than the "closed" technique and it is reserved for more complex corrections. Open rhinoplasty is performed by engraving from the outside the cartilage segment that separates the nostrils (columella). In this way it is possible for the surgeon to control the outcome of the intervention more directly.
The operation has an average duration of one hour, but it can range from a minimum of half an hour to a maximum of 2/3 hours, and in most cases it is required at lease a night of hospitalization.
The phases after rhinoplasty
At the end of the operation, internal stitches are applied, as well as semi-rigid supports on the back of the nose that will allow the tissues to reshape, and a patch at the tip. They will be removed after about a week, while the swabs to the nostrils will be removed after 24 hours.
The edema, that is the swelling and the ecchymoses caused by the operation, can be located both at the level of the nose and of the periocular area and cheeks, and it can last on average about ten days. In this period, the patient can go back to work, always avoiding strain, sudden movements and excessive temperature changes, as well as wearing glasses. The use of contact lenses is recommended. The resumption of intense physical activity can usually take place within 2/3 weeks.
Bone and cartilage healing usually takes 7/8 days during which the nose is protected by a stiff brace; after this period another ten days are needed for the recovery of the normal functionality of the nasal mucosa.
It is known that hyaluronic acid is a substance normally present in our tissues, essential for their elasticity; the precious characteristic of administration through nebulisations is that of making their availability immediately at the level of the nasal mucosa. To regain full respiratory well-being, 15/20 days of daily nebulisations are usually enough, starting from the third day after surgery.