NOSE AESTHETICS (RHINOPLASTY)

IS NOSE AESTHETIC SURGERY SUITABLE FOR ME?

In order to have rhinoplasty surgery, you are generally required to be a healthy individual. The most suitable candidates for rhinoplasty surgery can be evaluated in three categories:

1) Appearance: The majority of women or men who decide to have rhinoplasty surgery want this surgery to have a more beautiful appearance. The most common reasons why patients apply for this surgery are:

 

– The nose looks too big compared to the face,

– Arch on the back of the nose when viewed from the side,

– When viewed from the front, the nose appears too wide,

– Nasal tip drooping or drooping,

– Nose tip thickness or width,

– Excessive width of the nostrils,

– The nose is curved to the right or to the left, sometimes in an ‘S’ shape on both sides,

– Undesirable appearance as a result of previous surgery (secondary surgery) in another center,

– An unsymmetrical appearance in the nose as a result of a previous injury.

After the surgery, patients feel great satisfaction with their general appearance and there is a significant increase in their self-confidence. Various scientific studies have shown that this situation also contributes positively to the social and business lives of patients.

2) Injury: If you have been injured in an accident and this has caused a defect in your nose, rhinoplasty can be applied to ensure that your nose regains its old appearance as much as possible.

 

3) Breathing: Especially in patients with narrow nasal cavity due to severe curvature, breathing problems can be eliminated with rhinoplasty and/or septoplasty.

FIRST EXAMINATION FOR NOSE AESTHETICS

In the first meeting, Dr. After examining you, Kamburoğlu will discuss with you the reasons for the surgery, your expectations from this surgery and your general health status. Ask all the questions you want answered at this first examination to Dr. You can ask Kamburoğlu, he will answer all sincerely.

DIAGNOSIS AND TREATMENT OF NOSE BREATHING PROBLEMS

The main task of the nose is to provide healthy breathing. You are considering rhinoplasty; but you also have breathing problems. So how are these breathing problems diagnosed and treated?

First of all, the first stage is the examination of the inside of the nose with the help of an instrument called a speculum. In this way, an area of ​​1/3- 1/2 of the nose can be seen clearly. In this area, septum (cartilage and/or bone) curvatures, flesh (concha, polyp) sizes or nasal canal stenosis and nasal stones can be seen. However, light camera systems (endoscope), which we call rhinopharyngoscope, are needed in order to evaluate the posterior parts. In this way, we can perform endoscopic examination of our patients who apply to our clinic with the complaint of breathing. In addition, we can clearly detect the location of your curvatures, flesh sizes and even stenosis in the nose with our acoustic rhinometry device that works with sound waves numerically. Thanks to these two devices, there is less need for tomography imaging methods that include X-rays, which is another way to see the posterior parts of the nose.

We have viewed the disorders in your nose that cause breathing problems, but how effective and high quality do you breathe? Apart from curvatures, deficiencies in your nasal cartilages can also make it difficult for you to breathe. We use two systems called rhinomanometry and PNIF for the diagnosis and post-treatment follow-up of such conditions. These show us the quantity, shape and quality of your breathing.

After all these procedures are done, we reach clear and scientific information about your breath. In this way, it is possible to solve your breathing problems in the light of scientific techniques while you are having your rhinoplasty surgery.

CAN I RELIEVE MY BREATHING PROBLEM WITH MY NOSE AESTHETIC SURGERY?

During aesthetic nose surgery, all kinds of nasal breathing problems (such as deviation, valve failure, flesh size) are treated simultaneously. It is the best option to have these two surgeries simultaneously. Because the parts removed during the breathing surgery can be used in the plastic surgery part. You will not have such a chance if you have the breathing surgery first.

HOW WILL THE RESULT OF MY NOSE AESTHETIC SURGERY BE?

This is perhaps the issue you are most curious about about your rhinoplasty surgery. For this, we take your standardized pictures from various angles. Then we scan your face in 3D with our Vectra 3D device. The system automatically offers us the length, width, elevation of your nose, its harmony with your face, various angles and proportions and many more parameters. After making these calculations, we perform your surgery simulation on your 3D images together with you. In this way, when you leave our clinic, you can see your surgery result in 3D, as close to reality.

SURGICAL TECHNIQUES IN NOSE AESTHETICS

Dr. Kamburoğlu performs rhinoplasty operations under general anesthesia. Because it is difficult to provide full patient comfort under local anesthesia. However, under general anesthesia, the blood pressure can be kept at the desired level; bleeding can be minimized. On the other hand, smaller procedures can be performed with local anesthesia rather than a full nose surgery.

Aesthetic nose surgery can be done in 4 different ways. The healing and recovery processes of all these methods differ from each other.

1) Open Technique: During this surgery, the surgeon makes a small transverse incision in the columella (the column separating the two nostrils) and gently shapes the bone and cartilage inside by scraping the skin from the tip of the nose. This process leaves a small scar on the lower part of the nose that is often not noticed. The advantage of this technique is that it provides full control of the nose and allows the tip of the nose to be firmly shaped with sutures. The disadvantages can be listed as a slight trace that may remain in the columella and swelling that lasts a little longer than the closed technique. Although the mentioned disadvantages are very rare, this is the most commonly used nose surgery technique in the world today.

 

2) Closed Technique: Since the incisions are made inside the nostrils in this technique, almost no visible scars remain. On the other hand, the tip of the nose cannot be shaped with stitches, since in classical closed techniques, dominance cannot be achieved as in the open technique. This technique, which can be preferred in patients who do not need to shape the tip of the nose, has lost its popularity today.

 

3) Delivery Method: In this technique, the nasal cartilages are delivered and shaped with two parallel incisions through the nose. The advantages of this technique are that it provides dominance as in the open technique and that no incision is made in the columella (the column separating the two nostrils) like the closed technique. The disadvantage of this technique is that one of the parallel incisions has to be made to one of the nasal tip support mechanisms (scroll area). In this technique, there is a widespread consensus that the scroll area should be repaired at the end of the surgery so that this structure does not cause drooping of the nasal tip.

 

4) Modified Delivery Method: This technique allows the tip of the nose to be visualized as in the open technique; In the columella (the column separating the two nostrils), it does not leave a trace as in the closed technique. In addition, since a second incision is not made in the nose as in the delivery technique, the nasal tip support mechanisms are preserved. Dr. This method, developed by Kamburoğlu by adding new suture techniques, was published in 2014 in the journal Aesthetic Plastic Surgery, the official publication of the World Association of Aesthetic Surgery (ISAPS).

 

Dr. Kamburoğlu generally prefers the modified delivery method, which is the 4th line developed by himself, and the open technique, which is the 1st line, in his surgeries. Although the closed (modified delivery) method is a suitable technique for many primary (not previously operated) patients, the open technique may also be preferred in some cases (such as previous surgery, curvature conditions, very small nostrils, etc.).

ULTRASONIC RHINOPLASTY (ULTRAPLASTY)

One of the most important parts of rhinoplasty is undoubtedly the bone shaping process. This process should be designed and performed in full harmony with both your forehead and midface, and your chin. In classical rhinoplasty, this procedure is performed with various surgical instruments and micromotors. In ultrasonic rhinoplasty, this procedure is performed very sensitively with the help of an ultrasonic surgical system without damaging the soft tissues and cartilages. This technique provides a serious advantage over classical methods, especially in patients with curved noses or thick bones. The ultraplasty systems we use consist of specially designed device-tip combinations for rhinoplasty. All kinds of techniques, tools and devices that you may need in your rhinoplasty process are at your service in our clinic.

NON-SURGERY METHODS IN NOSE AESTHETICS

These techniques are based on the principle of shaping the nose with various fillers. Although they seem to be quite easy, they are rarely used by plastic surgeons due to the fact that the results are not permanent and there is aggregation that may occur especially in the areas above the bone.

TYPES OF NOSE AESTHETICS

Rhinoplasty surgeries; It can be divided into 3 groups as reduction surgeries, augmentation surgeries and surgeries in which both reduction and enlargement techniques are applied. The tissues removed only in patients who have undergone reduction are used for reshaping the nose. In patients who need augmentation, ear cartilage, rib cartilage, abdominal muscle membrane or membranes taken from under the scalp without damaging the hair and skin can be used. Augmentation surgeries are mostly needed in the treatment of secondary (previously operated in another center) patients.

DURATION OF SURGERY

Although the duration of the operation varies according to the procedure and the technique to be applied, it is around 3 hours on average. The definitive endpoint of all surgeries is your surgical outcome, Dr. It is the moment when Kamburoğlu gets into it and says, ‘It was very nice…’. No matter how much you care for a structure that stands in the middle of your face and will play a role in your happiness throughout your life, we care more.

THE HEALING PROCESS AFTER NOSE AESTHETIC SURGERY

After the surgery, your nose is enclosed in a special plastic material to maintain its new shape. Dr. Kamburoğlu does not use plaster. Medication and ice therapy are applied to prevent pain and swelling. At the end of a week, the plastic protector on the nose is removed. At this stage, coarse swellings have subsided; but subtle swelling still persists. These thin swellings are such that those who do not know you will not understand, and those who know you can say: “There is a slight swelling.” It will take up to 1 year to reach the final result of rhinoplasty surgery. While bruises vary from person to person, Dr. Thanks to the new techniques developed by Kamburoğlu, most of his patients have no or very little bruises, but in patients with bruises, these bruises disappear completely within a few days. Dr. Kamburoğlu performs his surgeries using silicone splints without tampons or with air channels. In this way, you can breathe through your nose immediately after the surgery.

THINGS TO DO AND NOT TO DO BEFORE AND AFTER rhinoplasty

Before Surgery

Before going into surgery, it is important to consider the following points:

In your pre-operative examination, Assoc. Dr. Haldun Kamburoğlu will ask you with a form whether you have any other disease, the medications you use regularly, whether you have any allergies and your previous surgeries. Some analyzes necessary for you to receive general anesthesia will be performed 1 day before the operation and the results of these will be evaluated by the anesthesiologists.

Before the operation, you should make sure that you do not have a problem with your health. It is important that you are in good physical condition; because this reduces the risks during the surgery and provides a faster recovery process. If there is any treatment or treatments you are currently undergoing, please inform Assoc. Dr. You should notify Haldun Kamburoğlu. Our aim; to minimize possible complications, to increase the result of the surgical application and to provide you with the highest patient safety conditions in today’s current conditions.

Aspirin etc. You should not use blood thinners containing Ibuprofen, pain relievers and flu medications at least 1 week before and 1 week after surgery. In the presence of Coumadin-style blood thinners and anti-rheumatic drugs, the treatment protocol is slightly different, but this situation will be explained to you in detail by your doctor.

If you are using birth control pills (menstrual delay), you should stop these drugs completely for 1 month before and 1 month after surgery. Roacuttan etc. If you are using medications, it is recommended that you stop taking these medications 6 months before the surgery and not use them again within 6 months after the surgery.

Substances such as vitamin E, garlic, cherry, ginseng, green tea, cinnamon, herbal teas, gotu kola, flaxseed, resveratrol (red wine extract) can also cause blood thinning. For this reason, it is recommended that you do not take these substances until at least 1 week before the surgery. It is recommended that you do not use these substances for at least 2 weeks after the operation.

If you are a smoker and have not had surgery before, it is preferable to quit smoking 4 weeks before the surgery to reduce the risks of general anesthesia. If you have had a nose surgery before, you should definitely quit smoking as it will affect the result of the surgery.

If you have thick skin, you may need to start a special skin protocol 4 weeks before the surgery. You will also be enlightened on this subject during your examination.

All kinds of diseases and all the drugs you need to use in the 3 weeks before the operation (including all painkillers) Assoc. Dr. Call Haldun Kamburoğlu and inform him.

2-7 days before the operation, you can prepare your skin for the early postoperative period with a high-tech skin care system such as HydraFacial MD.

The use of 500 mg of vitamin C twice a day for 1 week before and 2 weeks after the surgery will help speed up your wound healing.

It is recommended that you trim your nose hair (and mustache, if any) before surgery. However, pulling them out with tweezers is inconvenient due to the possibility of folliculitis (inflammation of the hair follicle).

Cleanse your face 1 night before the operation with a skin-friendly product of a high-end skin care brand such as SkinCeuticals.

In order to receive general anesthesia, you must be hungry for 8 hours and dehydrated for 4 hours before the operation.

Bring a button-down pajamas on the way to the hospital. Do not bring overnight.

Postoperative

You should not eat or drink anything for a while after the surgery. During your stay in the hospital, the nurses will tell you when you can start drinking water. Start to drink water at the 4th hour of the surgery, and you can gradually switch to solid foods at the 6th hour. (You can consume all kinds of food after 8 hours. Just be careful not to open your mouth too much (forcing) in the first 1 month. What you chew will not harm your nose. You can chew gum. It is recommended to consume plenty of water for 24 hours after you start drinking water.

Please inform the nurses (or Dr. Kamburoğlu if you have been discharged) if there is no rectal gas or stool in the first 24 hours after the operation.

You should walk in the company of a companion and nurse as soon as possible after the surgery (when the nurses measure your blood pressure and say that there is no problem in walking). It is also recommended that you move your legs and feet inside the bed while you lie down. The more you walk during your stay in the hospital, the more the risk of clot formation in the leg veins, which is one of the common risks of anesthesia with all surgeries, is prevented. As a safety precaution during your surgery, a special machine is operated on your legs for this purpose.

It is recommended that you apply ice on both eyes for the first 24 hours after the surgery, replacing them with a new one every 2 hours. You can take a break from ice application for 10 minutes every hour. The easiest way to apply ice is to put ice in two examination gloves, tie them together and put them on the eye. Alternatively, you can use cold gel packs. However, since these products heat up very quickly, you will have to change them more often. Thanks to the application of ice, swelling and bruises that may occur, albeit a little, are minimized.

Thanks to our new surgical techniques, you can use Auriderm XO or Arnica gel 2 times a day immediately after the operation to relieve your bruises, which do not occur in most patients, but sometimes occur in small amounts.

It is recommended that you stay in the hospital for one night after the operation so that you will be under observation. Assoc. Dr. Haldun Kamburoğlu will come to discharge you between 11:00 and 12:00 the day after the surgery. Your discharge time is 12:00 noon. During your discharge, you will be prescribed the medications listed here and some additional medications. It is recommended that you only take Arnica gel before surgery and bring it with you to the hospital.

In the first 24 hours after surgery, some patients may have a slight leak from their nose. This is normal and you do not need to worry. You can completely remove the gauze that was placed on your nasal tip to absorb the leakage the day after your discharge.

Assoc. Dr. Haldun Kamburoğlu does not use conventional tampons. He performs his surgeries either without tampons or with a silicone air channel splint. Since silicone splints are air-channeled, you can breathe while they are in your nose. When you leave the hospital, you will be given a liquid that you can squeeze 3 cc into each channel 3 times a day to prevent these air channels from clogging. When removing these silicone splints, they do not cause any pain or pain like conventional tampons.

Assoc. Dr. Haldun Kamburoğlu does not use plaster. Instead, it uses a special plastic protector. With this plastic protector, you can take a bath 2 days after the operation. However, it is recommended that you do not foam this water-resistant plastic protector.

ALWAYS WASH YOUR HANDS WELL BEFORE TOUCHING IN OR ON YOUR NOSE. CLEAN HANDS WITH DISINFECTANT IF POSSIBLE.

After taking your first bath, you can apply make-up. However, it is recommended that you do not touch the bands with make-up materials. You can have the sides of your eyebrows removed 2 days after the surgery and the middle of your eyebrows 2 weeks later.

In some patients, it may be necessary to make a small incision of 1-2 cm in the mouth from the inner part of the upper lip (with the teeth and behind the lip). If you have had this procedure, it is recommended that you eat liquid foods on the first day after the surgery and switch to soft foods on the second day. On the third day, you can consume any food you want. You should also rinse your mouth with water after every meal for the first three days.

You can brush your teeth right after the surgery if you do not have a small incision in the upper lip. In some special cases where an incision must be made through the lip, brushing should be delayed for 1 day.

When you leave the hospital, you will be given Terramycin eye ointment to apply to your stitches once a day if your surgery was performed with the open technique.

If your surgery was performed without tampons, from the 1st day after the operation, after removing these splints if silicone splint was used, a product containing sea water (such as Nasatol containing both sea water and Xylitol, or if you cannot find a product containing only sea water such as Sinomarin) 3 times a day Using it once will put you at ease. However, applying Rinopanteina ointment to the inside of your nose twice a day will accelerate your wound healing.

On the seventh day, the silicone splints inside your nose and the thin sutures under your nose, if made with the open technique, are removed. These silicone splints do not hurt while being removed.

On the seventh or eleventh day (depending on the technique to be performed and the response of your tissues.) the plastic protector on your nose is removed. Subsequently, tape is applied on the nose. It is enough for these bands to stay for 5 more days, and at the end of the 5th day, it is appropriate to wet them in the bathroom and remove them from the tip of the nose without pulling. In some patients (such as those with thick skin), longer banding or night banding may be recommended.

If your surgery was performed with an open technique, apply a scar reducing gel (silicone gel 2 times a day, for 2 months) to the tiny incision under your nose from the 7th day and a sunscreen product for 6 months by renewing it every 3 hours when you go out in the sun (from a high-end brand such as Dermalogica). Apply a sun protection cream with a factor of at least 30 on your skin. This application is started after the stitches are removed at the end of the 1st week. You should apply sunscreen every time you go out in the sun, even in winter.

Apart from these, applying red centaury oil twice a day will also help reduce your scar. You should apply your sunscreen without interruption, even in winter. The important point here is to apply sunscreen and centaury oil first. Because trace-reducing silicone creates a layer on the skin, it does not pass sunscreen or centaury oil under it.

After removing the bands on your nose, it is recommended to use a moisturizer and cleanser suitable for your skin. Our esthetician will help you with this. You can use high-end professional care brands such as SkinCeuticals, Dermalogica or Perricone MD for this purpose. At the end of the 1st week, you can start applying make-up. There is no harm in having eyebrows removed.

It is recommended not to sleep on your side and not to wear glasses for 4 weeks after the operation. It is entirely in your hands to protect your beautiful surgical result. If you wear glasses, get yourself temporary lenses for this period. After 4 weeks, you can switch to lightweight glasses with organic lenses and titanium frames. At the end of 3 months, you can use the glasses you want.

After the structures in your nose are removed, do not wipe your nose by pulling or squeezing it from top to bottom. You can wipe your nose from the bottom up; however, do not tighten in this case either. To clean it, you can close one nostril and blow your nose from the other. After a week, there is no harm in inhaling water into your nose.

It is recommended that you do not do sports such as jogging, jogging, fitness, cardio for the first 4 weeks after the surgery, and contact sports such as football – basketball or combat sports such as boxing for the first 3 months. It is possible to swim and sunbathe 2 weeks after the plastic protector on your nose comes off. The sun will not cause any negative effects on your nose as long as you do not miss your hat with proper surgical technique and sunscreen. It is best to postpone swimming pools until 4 weeks after the protection is removed due to possible bacteria in the water.

It is recommended that you do not press your upper and lower lips together in order to feed your lipstick to both lips while applying lipstick on your lips for the first 1 year after the surgery. This movement creates more tension than normal at the healing tip of the nose.

Assoc. Dr. Haldun Kamburoğlu does not recommend massage to most of his patients; however, some patients may recommend massage for a few weeks if needed.

NOSE AESTHETICS ANKARA

I COME FROM OUT OF CITY. WHEN TO HAVE A rhinoplasty in ANKARA

SHOULD I BE INSPECTED?

 

Do your rhinoplasty surgery in Ankara, Assoc. Dr. If you are planning to be with Haldun Kamburoğlu, we recommend that you first be examined 3 months in the summer and 5 months in the winter before the date you plan to have the surgery. Because of the density, surgery appointments can be given after a long time. On the other hand, there is always a chance to have your appointment earlier instead of postponed patients. If you do not have a chance to come to Ankara before the surgery, Assoc. Dr. You can contact Haldun Kamburoğlu directly at hk@haldunkamburoglu.com.tr and he will offer you other solutions.

SO, HOW LONG DO I HAVE TO STAY IN ANKARA FOR MY NOSE AESTHETIC SURGERY?

 

One day before the operation, your analysis will be performed, your surgery will be performed the next day, you will rest in the hospital in the evening, and then you will be discharged from the hospital the next day. As a result, it is enough to stay 2 nights in Ankara for rhinoplasty surgery. However, after 7-11 days, you need to come back to Ankara for the removal of the plastic protector on your nose and your first control. During this period, you can stay in Ankara or return to the city you live in. There is no harm in traveling after the surgery.

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