Rhinoplasty (formed from two other Greek words with the meaning of “nose” + “plastic”, therefore it is literally translated as “plastic nose”) is a section of plastic surgery, which is engaged in the correction of congenital (obtained at the stage of embryogenesis) and the nasal deformations acquired throughout the life.Simply put, this is a plastic surgery to correct external and internal defects of the nose.Distinguish between open, closed and non -surgical rhinoplasty.In most cases, aesthetic and functional defects are eliminated surgically.
Initially, the correction was performed only in connection with injuries, serious diseases and noticeable congenital defects.Later, plastic surgery began to be done, most often, according to aesthetic indications, in order to change the appearance of the nose.For example, remove the hump, reduce the tip, raise the bridge of the nose, reduce the nostrils and so on. A little story. For the first time, the surgeons of the ancient world carried out rhinoplasty. She was mentioned in the ancient manuscript of "Ayurveda" dating from OK.1000 BCThis document captures the majority of facts regarding antiquity medicine.The restoration of units of the face was required by the wars and people who were mutilated in the battle during the execution of the court sentence.At this time, transplantation began its history.As a material for correction, the skin of the cheeks or skin in the forehead was taken.Indian technology over time developed so that in the Middle Ages even European doctors, mastering it, successfully operated on patients.
Indications for rhinoplasty
Rinoplasty is made according to medical and aesthetic indications.In other words, one people just do not like what the nose looks like.It can be with a hump or curve, too large or small, wide or narrow, snub -nosed or long, with large or asymmetric nostrils.And it happens that a person’s nose was twisted from birth or due to a blow (while it often cannot breathe and an operation is required to restore nasal breathing).There are frequent cases when the operation is required in order to correct appearance defects after the first unsuccessful plasticity (this is considered the most difficult surgical intervention).The operation is allowed only to persons over 18 years old (if there are no urgent medical indications).This is due to the fact that bone tissue is formed until the age of eighteen, and the cartilage is even up to twenty.That is why the most suitable age for rhinoplasty from 20 - 35 years.The following is a description of the most common problems with which men and women turn to rhino surgeons.
Nose with a hump
The essence of the problem: there is a small hump on the back of the nose, because of which the nose looks more massive, and the face is sullen and dissatisfied.Reason: the defect may be congenital, may appear after an injury, or may be the result of previously unsuccessful correction.The removal method: in most cases, in plastic surgery, the hump is removed by a closed or open method under general anesthesia.If the back of the nose is too wide, it is necessary to do rhinoplasty with osteotomy (rapprochement of the back bones)
A wide back of the nose
The essence of the problem: a person has a very wide nose, which makes the face massive and rude.Reasons: a defect may appear after an injury, be congenital or become the result of an unsuccessful removal of a hump.Resolution method: open correction with osteotomy under general anesthesia.The essence of this technique is that part of the bone in the back is removed, and then the side parts are brought together.
Nosy's nose crooked
The essence of the problem: the back of the nose is asymmetric.Due to curvature, often a person cannot breathe at all.This problem refers to functional indications for surgical correction.How a defect appears: in most cases, this is the result of a fracture.Although it happens that the nasal partition is curved as a result of intensive growth of the bones of the skull during growing up.Is it possible to straighten your nose? In most cases, an operation to equalize the partition (septoplasty) is undergoing a closed method under local anesthesia.The essence of the operation is shown in the diagram below.If this is not enough, in such cases they resort to rinoseptoplasty (when the partition correction is combined with the elimination of other defects of the nose shape).In cases where the injury is quite serious, they resort to reconstructive plastic (more serious surgical intervention, which is often carried out in several stages), this section of plastic surgery studies methods of restoration of the nose after serious injuries and in cases of its complete absence.The task of the surgeon in this case is the restoration of the integrity of the bone-cherry base and the skin.
The saddle shape of the nose
The essence of the problem: the nose is too low.Because of what, the shape of the nose resembles a saddle in profile.Reason: the defect may be congenital, may appear as a result of an injury when part of the bone or cartilage was damaged.How can you change the situation? The correct shape is restored by transplanting a costal cartilage, cartilage from the auricle (on the outside of the ear) or by implanting a synthetic implant.
Big nose
The essence of the problem. Too large (long or wide) nose makes the face disproportionate.Most often, in such cases, the tip is very thickened.Reason: The defect is most often congenital. How do they solve the problem? The nature of surgical intervention depends on the cause (in some cases it is necessary to reduce the tip of the tip, in others the wings of the nose are reduced, but it happens that it is necessary to remove the hump).Before deciding that it is possible to make plastic surgeons often resort to computer modeling 3D.This allows you to see even before the operation how the face will look, after the procedure.
The problem shape of the tip of the nose
The essence of the problem: the correct face proportions are violated due to the wrong shape of the nasal tip.For example, it can be:
- Narrow
- Wide
- Round (nose with potatoes or bulbous)
- Lowered (crochet)
- Raised (kurting)
- Bifurcated
How do they solve the problem? The course of the operation is thought out depending on the type of problem.
- To reduce the wide tip, it is enough to tie the dome of large cartilage, and in others it is additionally necessary to truncate part of the cartilage tissue.
- A round fleshy tip more often needs to remove part of the cartilage, followed by rapprochement of the domes, also often reduce wings during the operation.
- The bifurcated tip of the nose needs to install a transplant from the patient’s own cartilage fabric taken in the ear or rib area, or from synthetic material.
- The tip may look too narrow due to disorders associated with the loss of the rigidity of the lateral legs of the cartilage.They are strengthened, also using transplants.
- During the correction of the lowered tip of the nose, the surgeon removes part of the cartilage and raises it by sewing, fixing it in a new position.
- Another operation of the operation implies the strengthening of Columella of the nose to ensure a good support to the tip.
- There is a third method associated with the truncation of part of the inner muscle, after which the tip is pulled upward
- Kournostability is also eliminated in several ways that involve the installation of their own or synthetic transplants in the tip of the tip or nose bridge.
Big or different nostrils
The essence of the problem: the disproportionate size of the nostrils (too small or too large) or significant asymmetry can disrupt harmony and worsens the appearance of the face.How to eliminate the defect? The course of the operation depends on the source of the problem.They can sew the wings of the nose, it may be required to strengthen the domes of retirement cartilage, and in some cases it is enough to align the nasal septum.It happens that it is necessary to raise or reduce the long tip of the nose
Contraindications to rhinoplasty
To absolute contraindications in which rhinoplasty should not be made in any case:
- Diabetes I, type II
- Coronary heart disease and other diseases serious cardiovascular diseases in which general anesthesia is contraindicated
- Meningitis, tuberculosis, gonorrhea, brucellosis and other serious viral infectious diseases
- System diseases: red lupus, HIV, lepra and others.
- An allergic reaction to anesthesia components.
- Chronic diseases: liver cirrhosis, hepatitis, etc.
- Cancer
- Bronchial asthma
- Blood coagulation problems
- Mental illness
The relative contraindications (rhinoplasty can be done if the disease is cured) relate:
- Age up to 18 years (correction is acceptable only in the most extreme cases)
- Exacerbation of inflammatory diseases (sore throat, frontal, sinusitis, otitis media)
- ARS, SARS
- Skin diseases
- Age after 50 years (surgery is done if there are no chronic diseases related to absolute contraindications)
- Pregnancy, lactation, menstruation
How rhinoplasty passes
Rinoplasty is done only under general anesthesia.The duration of the procedure depends on the complexity of surgical intervention and varies from 30 minutes to 2 hours.During the first consultation, the doctor offers to make 3D modeling in order to achieve complete understanding with the patient.This helps to show a person what final result can be expected.When he imagines that it turns out in the end, it is easier for him to make a conscious choice.Before the operation, the patient needs to pass a general and biochemical blood test and a general urine test.It will also be necessary to take a blood test for HIV and an analysis for blood testing for prothrombin.It will be necessary to make an electrocardiogram and take an inspection with profile doctors, if necessary.The preparation of the patient in the preoperative period includes the following recommendations:
Two weeks before the operation:
- Refuse to drink alcohol (especially carbonated)
- Do not take blood thinning drugs
- Do not sunbathe
- No smoking
A week before the procedure:
- Acquire all the necessary medicines
- Minimize the use of cosmetics
- Buy contact lenses to replace glasses (for people with poor vision)
10 hours before the operation:
- Do not drink anything (or drink the minimum amount of liquid)
- Do not use perfume and cosmetics
- Prepare clothes that do not need to be removed over your head
- Remove jewelry
Rehabilitation after rhinoplasty
Complete restoration of tissues after rhinoplasty occurs a year after surgery.In order to speed up the healing process of tissues and avoid the occurrence of undesirable consequences, it is extremely important to strictly observe the doctor's recommendations regarding behavior in the postoperative period.The first days after the operation, the patient is discomfort due to the fact that he has to constantly wear gypsum and endure tampons in the nose.This means that you can only breathe with your nose, your mouth often dry out.The temperature can be increased.I want to drink.It is difficult to wash and brush your teeth.Remove gypsum and remove tourundas from the nose earlier
It is impossible to.This can lead to undesirable deformations, an increase in swelling and to problems with tissue healing.
The first four five days of edema will intensify, and then it will begin to subside.To restrain swelling, it is recommended to make cold compresses the first day.After removing the gypsum dressing for about two weeks, people will continue to experience discomfort caused by the edema of the nose.Perhaps some loss of sensitivity in the field of surgical intervention.Bruises are still visible.At this time, breathing with your nose is already easier. During rehabilitation, the first week, surgeons rhinoplasts recommend adhering to the following restrictions:
- You can’t eat too salty, spicy, acidic and other, simple -digested food.
- You can not tilt your head down, take a bath, lift weights (including taking a child or pets harder than 5 kg.) And do charging.
- You will have to sleep only on your back, on a high pillow.
A person will be able to go to work two weeks after surgery, though it will be necessary to avoid heavy physical labor.Therefore, it is best to plan a vacation for this time in order to provide complete rest and rest for speedy recovery.
Within two months after rhinoplasty:
- It is necessary to rinse the nasal cavity regularly
- You can not be subjected to serious physical exertion, play sports or go to the pool
- You can not drink alcohol
- You can’t smoke
- Reduce or eliminate coffee use
- It is forbidden to visit a bathhouse or sauna
- It is necessary to avoid direct sunlight on the face
- You can’t wear glasses.They affect the shape of the nose bridges, so you need to wait until the bone completely heals.
Possible complications after rhinoplasty
It is considered a normal state if immediately after surgery there are bruises around the eyes and swelling.They are a direct consequence of damage during surgery of small vessels.After almost two weeks, primary edema and bruise should already go down.
The early complications include the following problems:
- Bleeding
- Hematoma
- Very strong edema
- Fabric necrosis
- Wound infection
- Discovery of seams
- Numbness of the tip of the nose
If these problems appear, it is necessary to turn to your attending surgeon in a timely manner and start treatment in time and prevent their further development.
Late complications include:
- Perhaps the appearance of bone corns
- The formation of keloid scars
- Opinion of the tip of the nose
- The bifurcation of the tip of the nose
- The saddle shape of the nose
- The curvature of the back of the nose
- Asymmetry
- The appearance of a hump on the nose
- Perforation of the partition
- Difficult breathing
Most of the complications listed above can be eliminated using a repeated operation.Some of them appear due to the mistakes of the surgeon, some due to the fault of the patient’s improper behavior during the recovery period, and the occurrence of some is explained by the various characteristics of the human body.