What is Rhinoplasty 1

Rhinoplasty

Rhinoplasty(Nasal plasty, rhinoplasty): Surgical correction of the external shape of the nose to make the nose smaller, larger, narrower, wider and / or straightened. One of the technically most difficult aesthetic-medical operations.

The engagement

First, the doctor uses a portrait photo to create a computer simulation of the desired nose, which he uses as a guide. It is crucial that her chin and forehead are in an "optical balance" and that she fits harmoniously into the face. At the beginning of the operation, the mucous membranes are loosened by invisible incisions inside the nose and the cartilage and bones are exposed. With instruments specially developed for nasal plasty, a hump nose is then removed, the skeleton narrowed, a saddle nose with bone and cartilage modeled or the tip of the nose reshaped. In the case of a crooked nose, which is often caused by an injury, all malpositions of the bone and cartilage framework must first be resolved and then brought into a correct position. In 80% of nasal operations, a correction of the nasal septum is necessary in order to improve the aesthetic result or to counteract obstructed nasal breathing. When the nose is shaped, the doctor rests the mucous membranes exactly and sutures them with fine, self-dissolving sutures. The inner nasal passages are splinted with soft tubes or ointment gauze (gauze tissue soaked with ointment). The patient can then only breathe through the mouth, which many people find uncomfortable. Finally, the surgeon models the skin of the nose with fine strips of plaster and adjusts an individually shaped plastic splint that stabilizes the bone. A nose job takes 1–2 hours and is usually performed under general anesthesia.

27-year-old patient with Hump ​​nose, before and after surgery. In addition to the external shape, the nasal septum has also been straightened (not visible in the picture).
Georg Thieme Verlag, Stuttgart

Aftercare

Immediately after the procedure, only slight pain, but visible swellings and bruises, especially in the cheek and lower eyelid area, can be expected. However, these symptoms disappear within a few days. The internal splinting of the nasal passages is removed painlessly after a week and the patient can breathe through the nose again. Depending on the procedure, a hospital stay of 1–7 days can be expected; after two weeks the patient is fit again. However, the plastic splint should be worn as often as possible for a further two weeks so that the new shape of the nose can finally heal. A nourishing nasal ointment helps the mucous membranes to regenerate faster.

In the first time after the operation, the patient should speak and laugh little, only consume liquid or pulpy food and keep his head high in bed. Until the new nose shape is stable enough (4–6 weeks), he should refrain from sporting activities - martial arts and ball sports in particular are taboo. The nose may be exposed to direct sun again after three months at the earliest. If swelling occurs due to water retention or scarring, light lymphatic drainage can help. Wearers of glasses can make healing easier by attaching a special straightening bracket. The final result of the rhinoplasty will only be visible after six months; only then can you see whether corrections are necessary.

Risks and Contraindications

During the preliminary examination, the doctor checks the breathing function and the condition of the nasal mucous membranes. In the case of sensitive mucous membranes, it is advisable to use a nourishing nasal ointment such as Bepanthen® 2–3 weeks before the date of the operation. Chronic inflammation of the nose, throat and ears should be treated in advance.

A correctly performed rhinoplasty is relatively low-risk. Serious complications such as purulent wound infections, injuries to the tear duct or the frontal sinus, embolism and thrombosis are very rare. After the procedure, the nose and surrounding skin areas of the cheeks and upper lip may be less sensitive to touch for several weeks.

One risk of the procedure is that the desired shape of the nose is not achieved. And even with successful operations, there can still be surprises later: During the healing process, bone displacements and new connective tissue formations occur, which change the result achieved. With extensive corrections, especially on the nasal septum, scars and circulatory disorders of the inner mucous membranes can remain, which in the worst case lead to cartilage damage. These very rare complications can affect the shape and function of the nose. Changes in shape caused by uneven scarring on the bones and cartilage are more common. If such bumps do not recede even after several weeks, another minor intervention may be necessary.

Authors

Dr. Nicole Schaenzler, Dr. Hans-Hermann Wörl | last changed on at 09:54