Rhinoplasty (rhinoplasty) is an operation to change the outer shape of the nose. Because the nose has a significant impact on the appearance, a hump or a crooked position are often perceived as annoying. The reasons for a nose correction, what it costs and what risks can occur.
Many of those affected wish that with the rhinoplasty, the gaze of another person would not get caught on a dominant nose or a nose that is irregularly shaped due to a hump. In addition, many people hope that the change in appearance will give them more zest for life and a happier self-image. Sometimes a rhinoplasty is also performed for other reasons.
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Goals of a rhinoplasty
A rhinoplasty is mainly performed for cosmetic reasons to harmonize the nose and the entire face (aesthetic rhinoplasty). Common reasons for rhinoplasty are:
- crooked nose (nose has a crooked course)
- humped nose, nasal hump (the bridge of the nose is curved upwards)
- Saddle nose (the bridge of the nose is sunken in the middle)
- Long nose (low-set tip of the nose)
- nasal tip correction
- nose reduction
A functional improvement in nasal breathing (functional rhinoplasty) or the treatment of birth defects such as facial clefts or accidents (reconstructive rhinoplasty) can also be reasons for a rhinoplasty. The aim is then to maintain or improve the functionality of the nose.
Requirements for a rhinoplasty
The nose is very formative for the external appearance. Anomalies such as a crooked position, hump formation and other form defects are decisive for the overall expression of the person. Many people want a nose job to improve their appearance, they want a normal nose shape that fits the face harmoniously.
Anyone interested in rhinoplasty should be between the ages of 18 and 60, as skin elasticity decreases with age. A reshaping of the cartilage and skeleton of the nose would not always lead to the desired results in people over 60 years of age. In addition, the person concerned should be healthy and mentally stable. People should not unduly overestimate the deformity of the nose and have a realistic idea of the result.
A rhinoplasty for cosmetic reasons costs between 3,000 and 6,000 euros. If there are functional reasons for the procedure or if it is a medically necessary operation, for example to correct obstructed nasal breathing, the costs are often covered by health insurance. This needs to be clarified on a case-by-case basis.
Preparing for a nose job
In the run-up to the operation, a detailed consultation in a specialist practice for nasal surgery is important. We discuss what you want, whether your expectations are realistic, and what makes sense and is technically feasible. This depends on many factors: Not every nose shape suits every face or body size.
After the preliminary talks have been completed and the surgical procedure has been determined, the suitability for surgery and anesthesia is usually examined by the general practitioner. These findings should be available at the last meeting, in which the patient is informed about the surgical procedure and the photo documentation takes place. In the last ten days before the rhinoplasty, patients must not take any anticoagulant medication such as acetylsalicylic acid or Marcumar or vitamin E. Otherwise bruising can occur more frequently and the risk of secondary bleeding increases. Discontinuation of the medication related to the operation is also discussed in advance.
Extensive sunbathing should be avoided in the last week before the nose correction. It is important that you are prepared not to be able to cope with the usual everyday tasks in the first few days after the operation. For example, you should shop before the date of the operation so that you don’t have to carry heavy bags immediately after the nose operation.
Rhinoplasty surgery process
Depending on the individual findings, the cartilaginous nasal skeleton is always changed during the operation, usually also the bony nasal structures (nasal framework). In order to get to this, the surgeon detaches the mucous membrane or the skin of the bridge of the nose. The access incisions are invisibly located in the nasal entrance. In rare difficult cases, such as nasal deformities in the context of cleft lip and palate and noses that have been operated on several times, a tiny incision through the outer bridge of the nose is required, which is visible for a while.
As a rule, the technique of closed nose correction, i.e. access from the inside of the nose, is completely sufficient. The nasal septum can be straightened and shortened, or parts of the alar cartilage are removed to correct the tip of the nose. In plastic surgery on the bridge of the nose, the entire skin coat is detached from the bone and cartilage framework, and then humps can be removed with special microchisels. The bridge of the nose is straightened, contours are brought into the right shape by implanting smoothing cartilage transplants. A nasal cast is usually applied, which is worn for about ten to 14 days, after which another plaster bandage is required for a week or more.
Is the rhinoplasty performed under general anesthesia?
Minor procedures such as nasal tip correction can be performed under local anesthesia. For more extensive rhinoplasty surgeries, specialists recommend general anesthesia because this allows a targeted reduction in blood pressure. The aim of this measure is to reduce bleeding during the operation so that there is always a good view of the operation area and the operation can be carried out faster and more precisely.
After general anesthesia, a short stay in the hospital is recommended, at least for one night. If a foam tamponade is inserted in one of the nostrils, patients should remain in the clinic until it can be removed.
What do you have to consider after a rhinoplasty?
After the rhinoplasty and discharge from the practice or clinic, the nose can be suctioned regularly in the days that follow. This is often a relief for those affected, since nasal breathing is naturally significantly restricted after a nose correction. The cast should be changed around the third or fourth day, as it quickly becomes loose as the nose swells. In the case of a tamponade, this is removed on the first or second day after the procedure. After more extensive operations, the bridge of the nose should still be plastered at night for the first six to eight weeks.
Larger increases in blood pressure should be avoided in the first week after the rhinoplasty. That means no hot showers, washing your hair overhead, and avoiding physical exertion like exercise or sex. Light exercise such as going for a walk promotes blood circulation and thus reduces swelling in the nose, and this also applies to cooling.
Within the first few days, slight swelling and minor bruising can often still be seen, and nasal breathing can be impaired. After about one to two weeks, the nose operation is usually no longer visible to the person. However, it takes about six months to a year for the wound to heal completely. During this time there can always be small changes such as swelling over the tip of the nose. On the other hand, a night-time plaster bandage helps.
Can you have a rhinoplasty done more than once?
Small corrections of irregularities and asymmetries of the nasal wings are rarely necessary. They can usually be performed on an outpatient basis and under local anesthesia. Reoperation is even rarer. If this is the case, it will happen six months to a year after the first nose correction at the earliest, since it is important to wait for the physiological healing and scarring processes to take place.
In the case of reconstructions after accidental changes in the nose, several interventions are sometimes planned. As a rule, with purely cosmetic nose corrections, the first operation brings the desired result. However, if the result of the operation six months later is unsatisfactory, those affected should discuss this with the doctor treating them. If no agreement can be reached, you can contact the expert committee of the GÄCD. Obtaining a second medical opinion is also useful.
Risks of rhinoplasty
In itself, rhinoplasty is a low-risk procedure that is rarely associated with serious complications. In order to further minimize the risk, the nose operation should only be performed by qualified specialists. Temporary swelling and bruising that will go away on its own is normal. Bleeding or secondary bleeding, which can occur during the operation and in the first hours up to ten days after the operation, can be hazardous to health. In rare cases, the sensitivity of the nose to touch may be reduced, circulatory disorders in the nasal mucosa or infections may occur. If nerves or the tear duct are injured during the operation, this can have consequences later.
Minor irregularities in the shape of the nose are usually more noticeable to the critical eye of the patient than to other people. Mistakes are avoided through close monitoring and therapy, for example through plaster bandages throughout the healing phase. As a rule, photos of the result of the nose correction are taken again after six months or a year. Because by this time, all healing-related changes should have subsided.
Source: Lifeline | Das Gesundheitsportal by www.lifeline.de.
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