Nasal disproportion (a big nose and a small chin) is a common problem: every third person in the USA is not satisfied with his/her nose shape. The most easy and efficient method to enhance your appearance is a plastic surgery. Specialists of the plastic surgery clinics in Germany offer the whole range of operations, including rhinoplasty (“a nose job”, big nose shaping). The rhinoplasty (a nose surgery) requires a wide area of expertise. The German plastic surgeons provide the unsurpassed work and perform about 40 000 nose correction (including the reduction of a big nose) procedures annually, which is twice as many as their peers in Switzerland or France do.
The modern surgical techniques allow making nose smaller just in an hour. Aesthetic nose correction gives a unique opportunity to harmonize the face proportion and make you look more attractive. A prominent (long, big hooked or Roman) nose doesn’t always look aristocratic. The patients report that after the operation they felt more confident and happy.
Each plastic surgery is a complicated process that includes two aspects: solving of aesthetical problems, and preservation or restoration of specific functions of the organ (in this case – nasal breathing).
Therefore, rhinoplasty can be made for both medical and aesthetic purposes. The optimal age for rhinoplasty is 25-35 years. However, this restriction can be avoided in some cases. Main medication indications for the surgery are as follows:
Pretty often, the main reasons of functional disorders and pathologies (complicated nasal breathing, enlargement or atrophy of nasal mucosa, rhinosinusitis, otitis, bronchial asthma, repeated respiratory diseases, snorting) are the changes of nose anatomical structure. Besides, such defects in children can cause brain oxygen deficiency, which slows down physical and mental development, and affects psychological development and behavior. Therefore, such operations can be performed before a child reaches 18 years.
However, in 60% of cases, rhinoplasty is made in patients who want to improve nose shape and their appearance. Plastic surgery is getting more popular. Aesthetic indications for the surgery are divided into two large groups:
These reasons often affect professional and personal relationships, make up for low self-esteem and feeling of dissatisfaction, and may even lead to social withdrawal, especially among women.
Rhinoplasty in aesthetic purposes is indicated when a person has:
In many cases, medical and aesthetic indications correspond and are caused by the same anatomical defects.
According to the aim and the surgical technique used, nasal plastic operations are divided into:
According to the same criteria, the following types of rhinoplasty exist:
All operations are divided into:
Depending on the methods of access variant, the nasal surgeries are divided into:
The operations are performed under general anesthesia and usually take 1-2 hours. Sometimes their duration reaches 3 and over hours.
During the operation on widened nostrils, the skin in the lower part of the nostrils is being cut, and its excess is removed. Cut tissues are joined with stitches that are held for 5-7 days. Such invasion always leaves scars which are almost unnoticeable. In this case, if the nose is slightly flattened, augmentation rhinoplasty (lifting of the nasal bridge) is made. A similar operation is performed for a small or short nose. It’s called “grafting”. Patient’s cartilage or bones taken from other body parts serve as the frame. Most often, surgeons take bones from ribs, skull, or elbow, and cartilage – from the ear. In rare cases, synthetic materials are used, but they can be rejected by the body. Such operations are among the most complicated plastic surgeries, which is why they should be trusted to top surgeons only.
During such operation, the form of the nose tip is improved. Most often, it’s done by the closed method: invasion affects cartilage and the soft tissues, and often – columella. Cartilage is cut, or excess tissues are removed from one place and moved to another. Most often, during the operation, the place above the tip is made thinner, while the tip of the nose is slightly protruded. Sometimes patients want to decrease the nose tip lengths, but such cases are rare. Together with such operation, patients also ask to change the nostril and columella form, as well as nose contours. If the operation presupposes alteration of the nose tip only, it’s simple, and recovery is pretty fast.
Contour plastics is a very exquisite work during which the nose contour is slightly changed. Under the nose skin, surgeons make “pockets” where they inject implants or transplants. Today, this technology isn’t widespread, because bio gel injections are much simpler to use.
During such operation, laser beams serve as a scalpel. This technology allows decreasing blood loss and accelerating recovery after the operation. Besides, working with cartilage is easier with a laser. Heated up by laser, the cartilage becomes softer and pliant. Laser cuts tissues seals vessels and eliminates bacteria. Under laser effect, recovery processes in tissues accelerate. Using a special laser device, surgeons can correct the nasal septum. There are methods that allow both eliminating aesthetic drawbacks and improving nose functions. The operation with a laser is the same as a traditional one. The operation can be closed or open. Cuts are usually made along the bridge and in the lower part of the nostrils. Sometimes, laser and a usual scalpel are combined during the operation. Such invasions are preferable since very fine cuts cannot be made with a usual laser, in comparison with the traditional approach. However, if the skin is cut by a laser, it recovers without scars. A cut is thin, it’s not bleeding, and cells are ready for recovery. Therefore, laser technologies are successfully applied in plastic surgery, including the operations for nose correction combined with usual surgical methods.
Reconstructive rhinoplasty is correction of nose form after a trauma or an inbuilt developmental defect. It’s impossible to predict which state the nasal frame has. Sometimes, reconstructive operations aimed at frame recovery presuppose taking cartilage right from patient’s ribs, ears, or nasal septum. The tissue grafts are taken from the patient’s body, and it doesn’t affect overall state or appearance. Reconstructive operations are usually made to restore normal appearance in case of upper palate or lip gaps. Sometimes, several operations are required. Besides, reconstructive surgeries are made after traumas that have caused the damage of bones and cartilage. In the most serious cases, surgeons work with patients who totally lost their nose. During the operations, microsurgical technologies are used that allow restoring normal patient’s appearance. One of the most widespread nose deformations surgeons deal with is saddle-shaped, or ‘boxer’s’ nose. This deformation can be caused by a strong punch into the nasal bridge, or infectious diseases of nasal cavity. In such case, the cartilage forming the bridge can be totally broken, and a surgeon needs to restore the cartilage bridge and nose frame. Such operation can last up to 6 hours. A patient is given the general anesthesia. Outside, only the area of columella is cut – all the other cuts are made within the nasal cavity. Therefore, all post-surgical scars aren’t visible. The operation affects all types of nose tissues: soft tissues, bones, and cartilage. After the operation, tampons are inserted to preserve the new nose shape and are left for 3-6 days. The plaster splint is removed in 5-12 days depending on the complexity of the operation. In a day after the operation, a patient can go home. In a week, a patients returns to have the stitches removed. During 8 weeks, patients aren’t recommended to wear glasses, and physical activity is prohibited during 2 weeks. In three weeks, the nose shape gets closer to the final results, and the further changes aren’t noticeable. However, the traces of operation disappear within 6-12 months. For a long time, a patient needs to be examined by the doctor.
Secondary nose plastics takes place only when a patient has already experienced surgical invasion in this area. Final formation of the nose ends within 6-12 months. This is the most optimal period for the secondary operation. It’s done in the following cases:
According to global statistics, 25-30% of patients who have undergone the primary plastics need a secondary corrective operation. This is a normal case. As a rule, the operation takes up to 30 minutes and is made under the general anesthesia. Secondary correction rhinoplasty allows eliminating drawbacks of scarring and making nose shape satisfactory for both patient and the surgeon.
In case of primary low-quality plastic surgeries and the unsuccessful recovery period (which often depends on individual peculiarities), it’s harder to perform the secondary surgeries. Such operations require a better research and a more accurate preparation. This is fully-fledged plastic surgery made by some of the above-mentioned methods, but in fact, it’s much more complicated and may even to total deformation of the shape or part of the nose (for instance, nose tip), or the entire nose.
Nose rhinoplasty is considered to be one of the most complicated plastic surgeries: its result depends on surgeon’s experience. Complications happen in 4-15% of cases. They can take place during the operation (bleeding, skin tearing, separation of the mucus-cartilage part, damage of the bone frame, breaking of the bone section, etc), and after the surgery.
General recovery after rhinoplasty takes up to 3 weeks. However, the final period of rehabilitation period when the results are evaluated by the doctor begins in 6-12 months. During this period, certain restrictions should be followed.
In 1-1.5 weeks after the surgery, the plaster splint and stitches are taken off. During the first two weeks, hot bath and washing in hot water are prohibited, because it may cause bleeding, hematoma and swelling spreading all over the face and neck. A person should sleep on his or her back in the uplifted posture, which improved breathing and reduces swelling. In dusty places, a person should wear a protective mask. Bending and weightlifting isn’t recommended.
For 3 months, a person shouldn’t wear glasses and heavy caps. Swimming pools and sunbathing is prohibited for 3 months. A patient should use an umbrella or a hat with wide flaps during hot weather and in the sun.
When planning the variants of rhinoplasty, an experienced surgeon sticks to three kinds of limitations: limitations defined by the surgeon, limitations stated by the patient, and the limitations connected with patient’s overall health and anatomical peculiarities of the nose.