Rhinoplasty and Septorhinoplasty (Nasal Surgery) Ankara

Rhinoplasty or septorhinoplasty, improves the appearance and breathing difficulties of the nose. From an aesthetic point of view, all problems are corrected from the dorsum of the nose to the tip of the nose. Respiratory disorders are also treated. A beautiful nose should breathe well, and a good breathing nose should look beautiful. The conventionally defined nasal aesthetic surgery was essentially only a nose reduction surgery. In contrast, contemporary rhinoplasty operation is a combination of reduction, strengthening and re-positioning procedures.

What is Preservation Rhinoplasty?

Basically, it is a surgical technique that protects the ligaments of the nasal muscles and anatomical structures of the nasal dorsum. There are two important nasal ligaments, the Scroll ligaments and the dermocartilageneous (Pitanguy) ligament. Nasal muscles stabilize and open the internal nasal valve with the using of Scroll ligament. The Pitanguy ligament has an important role for nasal tip aesthetics. If the Pitanguy ligament is not properly managed, nasal tip dropping can be occured in the postoperative period. The most important part of the nasal dorsum is the keystone area. Six different anatomic structures join in the keystone area. If the keystone area is broken by a surgical intervention during rhinoplasty and could not well repaired, severe aesthetic and functional problems can be resulted.

What kind of Aesthetic Gains can be Achieved with Rhinoplasty Operation?

Problems such as an unattractive saddle on the dorsum of the nose, a wide nasal base, deviation and crookedness on the nasal dorsum, width, low or sagging of the tip of the nose, width of the nostrils can be corrected after aesthetic nose surgery.

What kind of the improvements in respiration can be achieved after septorhinoplasty?

The septal deviations obstructing the airway, inferior turbinate (concha) hypertrophies, internal and external valve problems that reduce airflow are solved by this intervention.

What should be considered before the Nose Surgery?

Before the operation of rhinoplasty, it is necessary to discontinue the drugs that will cause bleeding during and after the operation, especially painkillers one week before. In addition, vitamin E, fish oils, some nutrients such as garlic which can dilute blood and can cause bleeding should not be used before surgery.

Is the thickness of the skin important in rhinoplasty?

Skin thickness may affect rhinoplasty results. Swelling is continuous for a long period in very thick and oily skin after rhinoplasty. Rhinoplasty candidates with thick skin should be informed that the swelling will last longer than the others. Thick skin has less elasticity, and poor redrape capability. The gaps between soft tissues and rigid structures of the nose may be filled with scar tissue in case of poor redrape capability because thick skin can not adapt the shape of rigid structures such as cartilage and bone. In general, nose with very thick skin has thin and weak cartilages and bones, therefore, it is more difficult to prepare strong skeleton support. In contrast, care should be taken in very thin skin as it will directly reflect the interventions on cartilage and bones.

Can be useful preoperative simulation and planning using computer imaging?

I think that showing possible postoperative results on computer is useful for both physician and patient to understand each other. If the surgeon shows the changes he/she intends to make on the nose of the patient before the surgery and the patient likes it, they will have a good sample that they can improve.

How long does the Rhinoplasty operation take?

A standard time for rhinoplasty operation may not always be accurate. How long it should last until needed. Usually rhinoplasty operation takes two and a half to three hours. It should also be noted that this period includes preparation for general anesthesia and improvement for general anesthesia. This period may be prolonged in cases of severe septal deviation or in previously operated cases.

What are the rhinoplasty operation types and techniques?

1. Closed Rhinoplasty
In closed nasal aesthetic surgery, all incisions are made on the membranes inside the nose. There is no scar outside the nose after surgery. Other advantage of the closed method is that there is less postoperative swelling of the nose and earlier recover of the swelling. Closed technique can usually be applied to every patient except secondary cases who have been operated with using open technique.

2. Open Rhinoplasty
An incision is made on narrow part of the columella in open rhinoplasty. The incision is unclear unless there is an unusual condition such as hypertrophic scar. Swelling are more pronounced and recover slower than the closed technique. In the past, it was thought that open rhinoplasty provides better exposure nasal tip than closed rhinoplasty. However contemporary closed rhinoplasty techniques permit the same exposure for nasal tip.

When open rhinoplasty is preferred?

If patient was operated with using open technique in the first operation, secondary operation is usually performed with open technique.

Which Type of Anesthesia is Preferred in Rhinoplasty operation?

I think that it is beneficial both surgeons and patients to perform rhinoplasty under general anesthesia. Both the respiratory and circulatory systems of the patient are under the control of an anesthesiologist during this operation therefore surgeon can focus on rhinoplasty. General anaesthesia also eliminates difficulties of lying on the operation table during a long time in a stressful condition for patient.

Should nasal bone be fractured performed in all rhinoplasties?

The patient’s wishes are taken into consideration, but if there is severe deviation of the nasal bones or a very large nasal hump, nasal bone fractures can be necessary. In addition when the nasal bony base is large, perinasal fractures are mandatory.

Will swelling and ecchymosis occur around the eyes after rhinoplasty ?

The ecchymosis, swelling that may occur around the eyes after the operation may depend on both the patient’s skin features and the surgical technique used. If people who have experience swelling and ecchymosis after other traumas in their body, may have ecchymosis and swelling around eyes after rhinoplasty operation. In addition, to take some drugs or nutrients, which increase bleeding, in preoperative period, may increase ecchymosis after rhinoplasty surgery. Surgical interventions to the nasal bones may increase bruising and swelling after surgery. Narrowing the bony base of the nose or correcting the curvature of the nasal bones can increase the bruising and swelling after surgery.

Can intranasal splints lead postoperative breathing difficulty after rhinoplasty and be easily removed?

The intranasal splints we use have passages that keep the airway open. Breathing through the nose continues unless these passages are blocked. Ocean water nasal spray or saline should be used frequently to prevent clogging. Intranasal splints are fixed with fine sutures and are easily removed.

When should you start physical activity after rhinoplasty?

In order to reduce the risk of bleeding and swelling in the nose during the first month, it is recommended not to increase the blood pressure and pulse . In the second month, light exercises may begin. In particular, sports that are at risk of collision should be avoided for the first 6 months after rhinoplasty.