The aim of rhinoplasty surgeries is to obtain a natural-looking and beautiful nose that is compatible with the whole face of the patient in line with the patient’s wishes. No matter how beautiful the nose is on its own, if it is not in harmony with the patient’s face and is far from natural, the result will not be satisfactory. It should be noted that each patient’s facial features are different. Some patients’ face is thin and long, some patients have wide and flat faces, some patients have narrow foreheads, some patients have wide ones. For this reason, it is necessary not to make the same nose for each patient, but to make the nose that is suitable for the characteristic features of each patient’s face. In this, it is necessary to understand the patient’s expectations correctly, to analyze together with the patient whether the nose shape desired by the patient really fits the patient’s face, to inform the patient correctly and most importantly to ensure that the patient’s expectations are realistic. In a successful nose surgery, people should not realize that the patient’s nose has been operated after the healing is complete. In this, the nose should be as natural as possible.
It should never be forgotten that the nose has a very important function such as breathing outside of the image. In this, every precaution must be taken to ensure that the nasal passage is open. Otherwise, even if it looks beautiful, a nose that cannot breathe will always be a big problem for the person. For this reason, the physician should evaluate the nose very well not only in terms of cosmetics but also in terms of function during the examination. Sometimes, small curvatures in the nose that seem insignificant before the surgery can cause serious nasal congestion due to the narrowing of the nasal roof after rhinoplasty surgery. On the other hand, the curvature of the cartilage in the nose is the main reason for the curvature of the external appearance of the nose. It will not be possible to fully correct the external image without correcting the inside of the nose. The physician who performs aesthetic nose surgery should have the knowledge and experience to both correct the external appearance of the nose and solve the problems inside the nose.
In some patients, the nose may be very deformed. There may be serious curvatures on the roof of the nose and serious congestion in the nose. Such patients must be operated by experienced surgeons. Because in these patients, the nose support should not be lost or the nose support should be reconstructed while correcting the inside of the nose. Otherwise, collapses may occur in the nose contour in a very short time after the surgery.
BY WHICH TECHNIQUE SHOULD RHINOPLASTY SURGERY BE DONE?
Two main techniques are used in rhinoplasty operations. One of them is closed technique and the other is open technique rhinoplasty. In closed technique rhinoplasty, no incisions are made on the outer part of the nose and on the nasal skin. In the open technique, an incision of 3-4 mm is made on the skin under the nose. Both techniques have their own advantages and disadvantages. The most important advantage of the closed technique is that there is no risk of scarring on the patient’s skin due to the incision. In the open technique, on the other hand, very rarely, a slight scar may remain at the incision site, depending on the characteristics of the patient’s skin. However, this is very rare. The most important advantage of the open technique is that it provides complete visual dominance to every point of the nasal skeleton.
Which technique will be used in aesthetic nose surgery is determined according to the deformity of the patient’s nose. If the nasal tip of the patient does not require a serious intervention, the closed technique can be applied. However, if the deformity at the tip of the nose is severe, the open technique should be preferred. The surgeon who is interested in rhinoplasty should be well-versed in both techniques. Surgery should be performed as it should be done for every patient. In my own practice, I generally operate on 75% of my patients with the open technique and 25% with the closed technique.
WHEN IS RIBBON CARTRIDGE USED IN NOSE SURGERY?
The first choice in aesthetic nose surgeries is always to shape the nose using the bone and cartilage tissues of the patient’s nose. However, there may not be enough support tissue in the nose in patients who have had severe nasal trauma or have undergone several nose surgeries. In this case, the cartilage required for shaping the nose is taken from the auricle or rib. When this process is done properly, it does not cause any deformity in the auricle and ribs.
HOW IS THE PROCESS AFTER THE SURGERY AND POST-OPERATIVE?
Rhinoplasty operations can be performed with local or general anesthesia. Personally, I have been performing these surgeries with general anesthesia for the last 10 years. General anesthesia is comfortable for the patient as well as providing a more comfortable operation for the surgeon. Rhinoplasty operations usually take between 1.5-3 hours. At the end of the operation, a plaster or silicone mold is placed outside the nose. In the first 24 hours after the surgery, there is some swelling and bruising around the eyes and nose. These swellings resolve within a few days. One week after the surgery, the mold on the outside of the nose is removed and several plasters are placed on the back of the nose. These patches are removed after 4-5 days. Generally, around the 20th day, the patient is given a nasal massage. Post-operative care is very important. By the end of the first month, the improvement in the nose is at the level of 90%. However, it takes about 6 months for the nose to fully settle.