Rhinoplasty

The medical field is characterized by its continuous development which seeks to address various health problems as well as aims to make life easier for people who suffer from problems in their external appearance, which negatively affect their daily lives and often cause them embarrassment, which led to the emergence of plastic surgery as one of the most important medical specialties in the world, and one of the most important disciplines of plastic surgery is rhinoplasty, which has been widespread throughout the world where we will talk about it in detail in this article.

Rhinoplasty:

Is a surgery in which the shape of the nose or tilt is changed through making careful and deliberate changes to the bones of the nose and cartilage and that aimed at treating the problems of the ability to breathe resulting from abnormalities or defects in the structure of the nose or beautify the external appearance of the nose in order to increase the harmony of the nose with the rest of the facial features by reducing the size of the nose or enlarging it or changing the angle between the nose and the upper lip to give a perfect and consistent appearance or both, this operation is performed under the influence of anesthesia general or local depending on the type of operation and the degree of complexity and its duration is usually between two to three hours after the patient’s condition is studied and the appropriate plan for this surgery is drawn up by the competent doctor.

Cases where the patient resorts to rhinoplasty:

• Narrowing of the nostrils which hinders the process of breathing.
• A fracture of the nasal bone as a result of a severe blow to the nose or an accident.
• Congenital problems in the composition of the nose that make the appearance of the nose unacceptable.
• Wrap of the nasal bone.
• Inconsistency of the size of the nose with facial features.
• The tilt of the nasal septum and the presence of internal growths that hinder the breathing process.

The right age for rhinoplasty:

Doctors usually advise that the patient wait until the age of 18 before undergoing nose surgery until the growth of the bones of the nose and cartilage, but if the nose is an emergency and does not tolerate delay until adolescence, as is the case when exposure to an accident then the operation can be performed so that the vital functions provided by the nose are not exposed to any damage.

Steps to follow before the operation:

When the patient intends to perform rhinoplasty, he must do some things that may avoid a lot of problems during the operation as rhinoplasty is considered a rather complex operation and one of the most important of these things:

• Ask the doctor who will perform nose surgery for the patient about his medical history, including how long the patient is suffering from nose problems and if he has had any surgery before and the medications he uses, as well as asking if he has any health problems or diseases that may make him ineligible for the operation such as hemophilia or heart disease and diabetes.
• The doctor takes a set of pictures of the nose from several angles in order to study the state of the nose and treat it by computer in order to be able to view the expected results after the operation and discuss it with the patient, as he uses these images to evaluate the success of the operation and become a useful reference for the doctor for long-term reviews
• Three weeks before the operation, the patient must undergo a set of tests necessary to confirm his physical health, the most important of which are:

1. Perform a full blood test until the doctor makes sure that the patient does not complain of anemia, which may hinder any surgery, including plastic nose surgery.
2. Analysis of blood sugar in order to rule out the presence of diabetes mellitus as it is known that diabetes affects the speed of wound healing.
3. Analysis of liver function to measure the proportion of enzymes due to the direct effect of anesthetics on the liver and can cause serious damage to the liver if it is in poor health.
4. Analysis of kidney function because the body gets rid of the toxins of the drugs used by the patient especially after the operation through the kidneys and if they are in an unhealthy state, this will lead to the accumulation of toxins in the body.

• The patient refrains from using medical drugs that cause blood dilution and delayed coagulation before the operation, such as aspirin and medications containing ibuprofen, in order to speed up the healing of wounds after the operation.
• Completely stop smoking and use any nicotine-containing substances in addition to abstaining from alcohol during the period before and after the operation.
• Adopt a balanced and healthy diet before the operation contains all the nutrients and focus on vitamin C where you should eat at least 1000 mg per day.
• Most cases require being performed under general anesthesia, so you should refrain from eating food and drinks of all kinds 8 hours before the operation.

Steps of Rhinoplasty:

 All surgical procedures performed on the nose, whether cosmetic or functional, go through several stages:

Anesthesia: As in all surgeries, the first plan in rhinoplasty is to numb the patient so that he does not feel pain during the operation and the anesthesia can be local or general where the doctor determines the type of anesthesia optimal for the patient’s condition and appropriate for the operation.

Local anesthesia: The patient is injected with anesthetic substances inside the nasal tissue in addition to injecting the patient through an intravenous tube with a combination of narcotic substances such as ledocaine and epinephrine in order to relieve pain and reduce bleeding during surgery, this method does not cause the patient’s complete loss of consciousness and does not lead to inhibition of breathing.

General anesthesia: it is the most common method in rhinoplasty in order to reduce the possibility of bleeding in the nose and avoid any sudden movement of the patient as in local anesthesia where it causes complete loss of consciousness, which ensures better and more accurate results after the operation, general anesthesia is accompanied by the use of a ventilator which helps to keep blood pressure low during the operation.

Nose incision: After the patient is anesthetized, the doctor opens an incision in the nose in one of two ways as required by the operation and each method has its advantages and disadvantages.

1. Closed surgery: depends on the making of surgical incisions inside the nose where no external incision appears and does not leave scars and its disadvantages that the cracks in it are narrow and the field of view in it is limited.
2. Open surgery: An occasional incision is opened along the columella, which is the section that separates the openings of the nose, and the skin that covers the bones and b of the nose is lifted, allowing the nose to be reshaped easily without causing any damage to the nasal cartilage.

Types of rhinoplasty:

• Surgery of the bone part of the nose: In the case of the external warp, the bone part of the nose is restructured by breaking the bone internally and re-fitting it, but in the case of the protrusion of the nasal bridge, this excess bone is removed.
• Operations performed on the cartilage part of the nose: the cartilage is modified or minimized, as these form the outward appearance of the front and middle part of the nosa<e.
• Snoring problems: Occurs as a result of narrowing of the upper respiratory tract, which causes a section of inhaled air to reach the lung, resulting in a tremor in the roof of the mouth, the pharynx or the upper throat, causing disturbing sounds during sleep.
• Nose reconstruction: The crescent is carried out from the crescent of the reduction of the size of the nose by removing some cartilage and bones, or enlarging the size of the nose either by adding cartilage taken from the nasal septum or ears, or by adding bones to be taken from the hip, elbow or skull to be used in the enlargement of the nose, in case of a defect in the shape of the nose does not require enlarging or miniaturizing the bone of the nose and rearranging the nose to give the desired aesthetic appearance as can be adjusted The nose and upper lip to perform the same purpose in addition to modifying the shape of the skin on the nose in proportion to the modifications made by the doctor to the structure of the nose.
• Correction of the nasal septum: Some people complain of difficulty breathing resulting from deviation of the nasal septum and the presence of growths inside the nose, the doctor during the operation and after adjusting the shape of the nose can correct the deviation of the nasal septum and remove the existing appendages, which saves the patient from problems difficulty breathing.
• Close the nose incision: After the doctor finishes adjusting the shape of the nose and reaches the desired result in his view, the doctor closes the incision of the operation and put splints that protect the nose from the outside and maintain stability during the early healing period, if the doctor adjusts the nasal septum, it installs braces inside the nose in order to maintain the location of the new nasal septum until the tissue heals completely.

What happens after the operation?

After the completion of nose surgery the patient is transferred to his room in the hospital where he should remain under observation for one or two nights depending on the complexity of the operation and then he can leave the hospital after checking on his health, and after a week is removed external splint and internal stents that are placed during the operation in case of correcting the nasal septum, as the doctor will stitch the wounds using stitches often of the type that does not need to be removed after a period where it dissolves automatically with time. But if the doctor uses stitches that do not decompose on their own, the patient should see the doctor 10 days after the procedure to remove the stitches, the bones in the nose that have undergone the operation need to last for at least three months until they are fully healed and the final result can be seen one year after the operation.

Side effects of Rhinoplasty:

• Nasal congestion and the occurrence of mild bleeding from the respiratory tract.
• A slight headache and a slight bruising to the face, especially around the eyes.
• Difficulty breathing from the nose and can be treated using nasal drops and spray and it will be possible to breathe from the nose after three weeks.
• A disorder in the sense of smell that disappears after several weeks.
• The presence of bruises in the nose due to the restructuring of the bones and cartilage during the operation, which disappears after a maximum of two weeks.

Tips to follow after the operation:

• The patient should lie on the back so that his chin is away from his chest in order to reduce the bleeding and reduce the swelling resulting from the operation.
• Stay away from the sun during the first week of recovery so that the patient does not develop dizziness and bleeding in the nose as a result of direct exposure to sunlight and also to prevent the formation of skin pigmentation in the surgical area.
• Avoid violent sports activities, jogging and carrying heavy objects in the first month of the recovery period so as not to affect the outcome of the operation as strong movements directly damage the tissues and cartilage of the nose during this period.
• Bathing using the tub so that the nose and surrounding splint are not directly exposed to water.
• Eat fiber-rich fruits and vegetables in order to avoid constipation, which may cause pressure on the surgical area.
• Wear comfortable clothes and stay away from clothes that are worn by the neck like sweaters so as not to be in contact with the nose.
• Commit to using medications and painkillers prescribed by the doctor in an orderly manner and stay in direct contact with the doctor who performed the operation in case of any emergency.

Rhinoplasty in Turkey:

Turkey has recently been characterized by the fact that it has become a prestigious destination for medical tourism, which is visited by patients from all over the world, due to the development of the medical sector in all its fields and the provision of treatment services at acceptable prices compared to the countries of Europe and America in addition to the support and facilities provided by the state for those who want to work in this field, creating a competitive environment through which everyone seeks to be the best. Speaking of rhinoplasty, Turkey is characterized by the abundance of beauty centers and hospitals that perform this operation and get high ratings in terms of service and quality, as Turkish doctors left their mark in this field by successfully carrying out hundreds of complex operations and developing nose surgery techniques.