Primary Rhinoplasty

Primary Rhinoplasty

The nose is an organ that is in the middle of our faces, and it determines our facial image and character. Besides its aesthetic impact, it also moistens and warms up the air that we inhale, and then carries it to our lungs; therefore it is a vital organ.
What is Rhinoplasty?
It is the procedure that ensures both aesthetic and functional balance by reforming the three dimensional structure of the nose.
What is the purpose of Rhinoplasty?
The purpose of rhinoplasty should be to establish the ideal harmony by ensuring a balance between the nose and other aesthetic units of the face. Instead of shaping a perfect, flawless nose, the main objective of the procedure should be to shape a less faulty nose which matches the other features of the face. This will prevent people from realizing that the patient had surgery.
Who can undergo rhinoplasty?
Patients who are over 18 years of age with no problems of undergoing anesthesia, and have their completed bone development can prefer rhinoplasty. Patients should also be psychologically mature and have realistic expectations. Patients who suffer from breathing problems, or who are not content with the shape of their noses can also undergo this surgery.
How is the patient evaluated prior to the surgery?
During the examination, the patient and the doctor have a talk about the patient’s complaints and expectations. Then, during the manual examination, the skin, bone and cartilage structures are evaluated. The inner nose is also examined via speculum, or endoscope when necessary. There are times that further evaluation via X-ray and BT is needed.     
The photos of the nose from different angles are taken. The computer generated new shape of the nose is assessed with the patients to give them an idea. The patients are also shown after-before photos of the previously operated patients to provide an insight.
What should be done prior to surgery?
As in all plastic surgeries, the patient should quit smoking minimum two weeks prior to the operation and should also avoid smoking for two weeks after the operation. Anticoagulant drugs, such as Aspirin etc. should be quitted minimum 10 days before the operation. The patient should discontinue any other medication or dietary supplement (medication that include Ginseng, CoQ, Gingko Bloba etc.) 1 week before the surgery. The patient should also disclose any other significant condition to their surgeon.
What is the surgery technique?
Rhinoplasty operations can be carried out with two techniques; open or closed. Every surgeon has their own method that they master and feel more comfortable with; therefore they guide the patients. However, the closed technique is not suitable for any kind of patient. Therefore, it would be much better to have a great command on both techniques and use either when necessary.
The surgery may take up to 1.5 to 2.5 hours, depending on the technique.
In open rhinoplasty technique, with incisions in the tip and the nasal wing, the nose is exposed and reshaped. Severe deformities and the curvatures of the nasal cartilage can be fixed with this technique with greater ease. Depending on the skin type, complexion and the thickness of the skin there is no or a faint scarring.
In closed rhinoplasty technique, the incisions are made inside the nasal cavity. Usually, the cartilages are exposed with a certain technique which allows for limited maneuvering. This technique is more suitable for noses with fewer deformities. Healing is faster and edema is less. There is no visible scarring from the outside.  
In both techniques, the nasal bones, cartilages and the adenoids are reshaped. If there is a curvature that hinders breathing, it is also corrected, and the adenoids are minimized if they cause nasal obstruction. Depending on the size of the procedure, either silicone tampons or tampons with airways are used. Sometimes no tampons are necessary. The part that most patients fear is the removal of the tampons. Thanks to silicone tampons, this procedure has become more comfortable, and the patients feel no pain at all.

What to expect after rhinoplasty?
After the surgery, the patient regains consciousness with an aluminum brace, skin-colored bandages over the nasal ridge and silicone tampons in their nostrils, if they were used.  The patients are generally hospitalized for one night. They do not feel any pain due to pain killer medication. Cool compress is applied around the eyes and on the forehead. And by placing the head higher while lying down, the edema and bruising is minimized.  

If used, tampons are removed within 2 to 5 days after surgery. The brace over the ridge is removed with the stiches on the 7th day. The bandages are kept on the nose for a few more days. Between 7th and 10th days, swelling and bruising fades and there are no materials left on the nose. Patients can resume their work. 
Patients should avoid using horn-rimmed glasses during the first month and should also avoid heavy sports activities in the first three months. It may take up to 6 to 12 months for the nose to take its final shape. 

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