Aesthetic Nose Surgery

Aesthetic nose surgery (rhinoplasty) or nose reshaping surgery is the most common type of plastic surgery. Aesthetic nose surgery can make your nose smaller or larger, change the shape of the tip or the bridge of your nose, narrow the width of your nostrils, or change the angle between your nose and upper lip. It can also correct congenital or injury-related deformities or relieve certain breathing problems.

When is aesthetic nose surgery useful? How is it done? And what can you expect as a result?

Please consult your doctor if there is anything you do not understand.

Patients Eligible for Aesthetic Nose Surgery

Aesthetic nose surgery can improve your appearance and increase your self-confidence. However, this does not mean that the surgery will change your appearance to match the face that you’ve dreamed of or that other people will treat you differently after the surgery. Before deciding on the surgery, ask yourself and think carefully why you want to have the surgery and what you expect from it, and discuss these with your surgeon. The most suitable patients for aesthetic nose surgery are not those who seek perfection, but those who expect a beautification and improvement in their appearance.

Many surgeons prefer to postpone surgery until adolescents have completed their development. This waiting period is around 16 years for young girls and 17 years for boys. It is important to consider the social and mental harmony of young people in order to make sure that the decision for surgery is made by the patient, not the family.

Risks

If aesthetic nose surgery is performed by an experienced plastic surgeon, complications are rare and usually minor. Regardless, there is always a possibility of complications. These include infection, nosebleeds, or reaction to anesthesia. Small capillaries that are cracked after surgery may appear as very fine red spots on the surface of the skin. Since aesthetic nose surgery is performed through the nose, there is no visible scarring. However, if the open technique is used or if large nostrils need to be narrowed, the very small and fine scars left on the nasal base are usually too insignificant to be seen.

About one in every 30-40 cases may require a second surgery (i.e. to correct a minor deformity). It is not possible to predict these cases precisely. The second corrective surgery is usually a simpler and less extensive surgery.

Planning Your Surgery

Good communication between you and your doctor is essential and very important. During the first consultation, the surgeon will ask you what you would like your nose to look like. He will examine the structure of your nose and face and explain the options available to you. The structure of your nasal bones and cartilages, the shape of your face, the thickness of your skin, your age and your expectations are the main topics of discussion.

Your surgeon will explain to you the anesthesia and the surgery technique he will use, the hospital where the surgery will be performed, the risks, costs and other options, if any. Health insurance policies do not cover this purely aesthetic surgery. However, if the surgery is performed to correct a respiratory problem or a significant post-traumatic deformity, it may be covered by the insurance policy.

You should be sure to tell your surgeon about any previous nose surgery or nasal treatment, even if it was many years ago, and if you have any allergies or breathing difficulties, use any medications, or smoke. In particular, do not hesitate to ask your surgeon any questions you may have about your expectations about the surgery and the results of the surgery.

Preparation for Surgery

Your surgeon will give you instructions on how to prepare for surgery, including eating and drinking, smoking, which vitamins and medications to take or avoid, and washing your face. Following these instructions will help you to have a more comfortable surgery. While getting prepared, do not forget to arrange for someone to take you home after the surgery and, if necessary, to help you go out after a few days.

Place of Surgery

Aesthetic nose surgery can be done in a surgical center or hospital. Most of the time, the surgery does not require a long stay in the hospital, and usually outpatient follow-up is done. However, complex surgeries may require hospitalization.

Type of Anesthesia to be Administered

Aesthetic nose surgery can be performed under local or general anesthesia, depending on the significance of the surgery to be performed and the preference of you and your surgeon. Local anesthesia usually involves administration of a mild sedation. The nose and surrounding area will be numb, you will be awake during the surgery, but you will have a comfortable and painless operation. In case of general anesthesia, you will sleep throughout the surgery.

Your Surgery

Aesthetic nose surgery usually takes an hour or two. The reshaping process of the nose will vary depending on the problem present in the nose and the technique applied by the surgeon.

Aesthetic nose surgery is done in two methods: 1- Open or 2- Closed. The Closed Method is done completely through the nose. There is no incision in the columella. It is preferred in in patients with no complications and whose nasal tip does not require much intervention. The Open Method is preferred especially in patients with complications, aquiline nasal structure, wide nose tips and thick skin. A small incision is made on the vertical tissue band (columella) separating the nostrils.

When the surgery is completed, a splint will be applied over the nose to help the nose maintain its new shape. In order to stabilize the septum, which is the partition that separates the two airways in the nose, pads or soft plastic instruments can be placed inside the nose.

After the Surgery

During the first 24 hours after your surgery, your face will feel swollen, ordinarily, you will not feel pain in your nose, but you may have a mild headache. You can take any discomfort under control with the pain medication prescribed by your surgeon. Plan to lie in bed with your head elevated for the first day except for bathroom trips.

You will notice that the bruising and swelling around your eyes will become most noticeable after 2 or 3 days. Cold compresses will reduce this swelling and help you feel a little better.

Most of the swelling and bruising will disappear within the first week or longer (some swelling that is not noticeable to anyone but you and your surgeon will remain for several months).

During the first few days after surgery, there will usually be a very slight leak from the nostrils, and you may feel a slight congestion in your nose for several weeks.

Your surgeon will ask you not to blow your nose for a week or longer during the healing period of the tissues. If there is a pad in the nose, it will be removed after a few days and you will feel much more comfortable. Towards the end of the first or sometimes the second week, all dressings and the splint on your nose will be removed.

Return to Normal

Most patients who have undergone aesthetic nose surgery get up and walk around within two days and can return to school or work that is not very tiring after a week.

However, it will take a few weeks before you can fully return to your daily life. Your surgeon will provide more detailed explanations about returning to your normal life. Generally, you will be told to avoid strenuous activities (running, swimming, gymnastics, any movement that will raise your blood pressure) for two to three weeks, protect your nose from impacts or bumps for 8 weeks, and avoid rubbing your nose and burning it in the sun. Be gentle and careful when washing your face and hair or putting on makeup.

You can wear your contact lenses when needed, but it is different with glasses. After the splint on your nose is removed, the nose pads of the glasses should not sit on the back of your nose until it is completely healed, i.e. for 2-3 months.

Your doctor will call you for frequent checkups during the month after surgery to check the progress of your recovery. Do not hesitate to call your doctor if you have any unusual complaints in between these checkups or any questions about what you should or should not do.

Your New Look

When your face is swollen and bruised in the days following the surgery, it is easy to forget that you will look better and become more beautiful. After plastic surgery, some patients feel unwell for a while, which is quite normal and understandable. A group of patients, on the other hand, are sure that this phase will pass. Day after day, your nose will start to look better and your morale will increase gradually. After a week or two, you will no longer look like you have just had surgery. However, recovery is still a slow and gradual process.

Some swelling, especially at the tip of the nose, may persist for months. The real result of the aesthetic nose surgery will reveal itself over a period of a year or two.

At first, you may get some unexpected reactions from family or friends. They may say they do not see a change in your nose. Or they may be a little offended, especially if you have changed something they see as a family or ethnic trait. If this happens, try to remember why you decided to have this surgery in the first place. If you have reached your goal, your surgery has also been successful.

Post-operative Care Guide

The healing process after your nose surgery requires time and patience. Your active participation in post-operative care is as important as the surgery itself.

Please follow the suggestions listed below. Do not hesitate to ask your doctor if there is anything you do not understand.

• After the surgery, you may not be able to breathe through your nose due to the pads inside your nose. During this period, you should breathe through your mouth. Your doctor will determine the length of time the pads will stay in your nose.
• It is important to get enough fluids. Sipping fruit juice, water and soft drinks will help alleviate dry mouth caused by breathing through your mouth. Do not use straws. Eat soft, easy to chew foods. Use gel or lip balm to keep your lips moist.
• Only use medications prescribed by your doctor. Do not use aspirin, medicines containing aspirin, or anticoagulant medicines.
• If the dressings on your nose remain, keep your head elevated with at least two pillows while sleeping or resting. Try to keep your head up throughout the day as much as possible; this will maintain normal blood circulation and help reduce post-operative swelling.
• Some leakage from your nose is expected. It will be pink/light red in color, but if you have persistent red blood, you should call your doctor.
• When you come out of surgery, you will have two layers of plasters and a splint on your nose. These are important for protecting as well as shaping your nose. Do not touch or pick at these dressings. These will be removed by your doctor within a week.
• The small packing under your nose can be changed as needed (or removed if there is no bleeding).
• Do not rub your nostrils or attempt to blow your nose. A good rule of thumb will be to keep your hands off your nose. Be careful not to hit your nose. Wear clothes with buttons on the front. Stay away from t-shirts and turtlenecks.
• Brush your teeth carefully and use only a soft toothbrush. Do not pucker up your lips or try to raise your upper lip more than actually necessary.
• Avoid straining, bending, lifting heavy objects (and especially your little children), strenuous exercises and sports for two weeks after your operation.
• Avoid exposure to direct sunlight for 2-3 months.
• When the dressings outside your nose are removed, you will notice some swelling and color change in the surrounding tissues. Your nose may be swollen. These complaints will improve over time.
• You may feel numbness in the tip of your nose and sometimes in your upper lip. This will disappear in a few weeks.
• 2-3 weeks after the operation, you can gently clean your nose 2-3 times a day using a cotton swab and tap water. Do not put the cotton swab up your nostril.
• Even after the pads are removed, your nose will be congested. This is the normal response of the tissues to surgery. Do not attempt to blow your nose for a week. When you have to sneeze or blow your nose, do it gently with both nostrils open. Do not use nasal sprays or drops. If you have to sneeze, sneeze with your mouth open.
• Fatigue and weakness are quite common after the use of sedative or anesthetic drugs that you were administered during your surgery. You will feel stronger in a day or a few days. Sometimes patients may suffer from insomnia. To help alleviate this, you may be prescribed sleeping pills during the first week.
• It is not uncommon to experience depression 12 to 36 hours after surgery. The first look of your nose after surgery may surprise you. Remember that you need to be patient and realistic. Do not forget that your nose has undergone a surgical intervention and it will improve and be much better over time. It may take 6 to 12 months for your nose to fully heal.
• After the dressings are removed, you can return to your normal work life (depending on the type of work you do). Makeup can be used to help conceal small bruises.
• Make sure you go to all of your post-operative appointments. These are essential for the post-operative photographs to be taken for your doctor to follow your recovery and the progress in your nose and to evaluate the improvement in the appearance of your nose. Post-operative appointments are usually given for 1 week, 1 month, 3 months and 6 months after surgery.
• Do not wear glasses for two months after the operation unless it is mandatory.