Nose reshaping is the most common type of service that plastic surgeons provide. Many people always perceive even a small defect in the nose as a tragedy. But it can be difficult to decide on an operation - rhinoplasty. Modern aesthetic medicine offers an innovative way to eliminate imperfections. In the presence of minor defects, non-surgical rhinoplasty can improve the appearance and make the face symmetrical.
Types of rhinoplasty
In plastic surgery, it is customary to distinguish between several types of rhinoplasty according to the technique and goals of surgery.
All types of operations are divided into primary and secondary (repeated), while they can be:
- Reconstructive. This group includes manipulations aimed at restoring anatomical disorders that have arisen due to improper intrauterine development or as a result of traumatic injuries or diseases.
- Aesthetic. Aimed at correcting deficiencies.
In accordance with what problem must be solved, there are many types of rhinoplasty:
- Reducing. Provides for a reduction in the size of the osteochondral framework of the nose. This can be a shortening of the tip, narrowing of the nasal bridge, the width of the nostrils and lateral cartilage.
- Augmentation. Aimed at correcting defects by increasing the size of the nasal skeleton. It is also used for secondary plastics.
- Septorhinoplasty. Elimination of the curvature of the nasal septum in order to facilitate nasal breathing, including to solve the problem of snoring.
- Grafting. The required shape of the nose is created from the patient's cartilage tissue. For transplantation, the cartilage tissue of the auricle and nasal septum can be taken.
- Reconstructive rhinoplasty. Aimed at correcting the results of previous operations.
The goal of the intervention may also be a separately hypertrophied nasal mucosa, columella (the bridge between the nostrils). Changing the shape of the tip of the nose (eliminating hooked or upturned) is a separate and most difficult type of surgery.
For any correction, the surgeon can choose an operational or non-surgical type of intervention.
Operating room
It is performed under general anesthesia. The duration of the operation can be up to several hours, and the result is maintained for many years. Before the operation, the patient must sign a written consent for the surgical intervention, therefore, it is required to carefully weigh the pros and cons and strictly follow the rules of preoperative preparation, which includes:
- delivery of blood tests, fluorography, electrocardiogram;
- consultation of doctors of other specialties (dermatologist, therapist, psychiatrist);
- adherence to a diet.
After the operation, the patient is in the hospital for several days under the supervision of medical personnel. After discharge, you should also strictly follow some rules and restrictions.
Like any surgery, nose repair surgery has a number of contraindications and can cause side effects and complications.
Non-surgical
Alternatively, plastic without surgery is used. Contour plastic is minimally invasive and does not involve surgical intervention. It allows you to correct asymmetry, slightly reduce the tip, remove the hump, straighten the nose, but is not suitable for solving complex problems (restore respiratory function, eliminate congenital defects).
Differs from classic rhinoplasty:
- the absence of a complex operation and a long rehabilitation period;
- speed of carrying out;
- short duration of the effect (no more than a year);
- the possibility of re-conducting as the result is lost.
This can be injection plastic with fillers, hyaluronic acid-based gels, hormonal breakdown drugs, or non-injection correction using threads or splints.
At a cost, contour rhinoplasty is several thousand rubles cheaper than traditional rhinoplasty.
Operating rhinoplasty classifications
Primary complete rhinoplasty does not involve an intervention that corrects the entire nose. This is the most popular type of surgery. Conditionally, indications for surgery are divided into 2 types, in accordance with which the following will be carried out:
Cosmetic plastic. If you want to get rid of the following nose defects:
- back bulges (humps);
- excessive length;
- thickened nose (potatoes);
- saddle back;
- large nostrils.
Functional plastic. Aimed at eliminating defects that lead to poor breathing, interfere with the passage of air through the nose:
- an injured septum with a curvature;
- Narrowing of the nostrils (birth defect)
- congenital imperfections of cartilage tissue.
Open
The technique is used in cases where it is not possible to achieve the assigned task in a closed way. The incision is made along the columella (the skin part of the fold between the nostrils) and on the wings of the nose where they join the lip. Open rhinoplasty allows you to raise soft tissues and cartilage upward, to gain access to the internal sections for manipulation. Required for technically complex and large-scale operations:
- severe deformity of the nose, including with lateral displacement;
- combination of deformity of the nose with malformations ("cleft lip" or cleft of the hard palate);
- reconstruction in which grafts are used.
The disadvantages of this intervention include damage to the arteries of the columella, the formation of a postoperative scar, and long-lasting postoperative tissue edema.
Re-rhinoplasty is performed only in an open way. Correcting the defects of the primary plastic is a difficult task, therefore, an uncompromising aesthetic result is not always guaranteed.
Closed
The method is less traumatic than the open one. The incision is made from the inside, on the mucous membrane of the vestibule of the nose. Such access is performed when a small-volume operation is to be performed. This type of intervention is divided into marginal (along the inner surfaces of the wings of the nose), transseptal, inter- and transchondral. A closed access option is endoscopic rhinoplasty using microinstruments.
Allows to exclude damage to arteries and tissue malnutrition, postoperative scars are not visible, since they are located in the nasal cavity, the outside of the skin remains unaffected. The method is often used for aesthetic operations.
Laser
An operation in which a laser is used instead of a scalpel to cut tissue. The laser incision is more gentle, since the parallel cauterization of the vessels excludes the development of bleeding.
There are 2 types of laser rhinoplasty:
- open, which involves dissection of tissues before modeling the soft part or cartilaginous base;
- superficial - not skin incisions are performed, but the evaporation of the surface layers to correct small changes in the tissues of the nose.
Injection reconstructive rhinoplasty
Sometimes those who decide to undergo rhinoplasty surgery want not only to predict and develop a model, but also to see the final result. This can be helped by the procedure of contour injection nose plasty. The result is achieved faster, more comfortable and cheaper.
You can inject drugs repeatedly. In some cases, fibrous tissue forms at the injection site, and the nose can take shape for a long time.
Hyaluronic acid injections
The effect of hyaluronic acid injections lasts about six months. The introduction of drugs allows you to level the skin surface and make the nose symmetrical, small irregularities are filled. Fillers based on hyaluronic acid are used in aesthetic surgery. These funds are classified as biodegradable, that is, dissolving. Over time, the drug breaks down into safe components - water and carbon dioxide.
Plastic nose fillers
There are several groups of fillers. Biodegradable, in addition to those mentioned above, include:
- based on animal collagen;
- on collagen of human origin;
- on calcium hydroxyapatite;
- on synthetic lactic acid.
These fillers can have a long lasting effect.
Biodegradable (non-absorbable or permanent) fillers are made on the basis of silicone or other synthetic base (biopolymers). The effect after their application persists for a long time, but experts do not recommend using them. There are several reasons for refusing synthetic fillers:
- they can cause tissue fibrosis;
- it is impossible to remove them from the body;
- may in the future become an obstacle to operating rhinoplasty.
Hormonal drugs
To correct some imperfections in the nose, glucocorticosteroids are used - synthetic substances similar to hormones produced by the human adrenal cortex. They are able to soften and partially dissolve cartilaginous tissue, which makes it possible to correct the shape of the wings and tip of the nose, to smooth the hump.
The procedure is relatively simple to carry out, but difficult to prepare: it is necessary to very accurately calculate the dosage and the depth of injection of the drug in order to avoid asymmetry and the formation of unnecessary cavities on the nose. In addition, excess hormones can trigger uncontrolled tissue atrophy.
Most often, such a correction is carried out in courses of several procedures.
Lipolytics
Lipolytics are agents that are used for mesoinjections. It is a biologically active material that promotes the burning of subcutaneous fat. Dermaheal is used to correct the shape of the nose. It helps to remove wrinkles and folds, will get rid of the "fleshy" nose. Contains active ingredients: phosphatidylcholine, hyaluronic acid, carotene and others.
Non-injection rhinoplasty
Much less often, nose correction is done without injections. Experts consider such procedures to be insufficiently effective.
With a clip-on tongue
To align the back of the nose and its tip, use a splint - a device made of plastic or plaster. The design creates constant pressure on the cartilage and soft tissues and changes their position over time. With the help of a splint, you can raise the tip, narrow the wings, reduce the length (by raising the tip), smooth the hump and restore symmetry.
Nowadays, lightweight removable structures in the form of clips or clips are spreading. They need to be worn every day for several months.
Threads
Filament rhinoplasty is used to eliminate asymmetry, straighten the back, correct the wings and tip of the nose. The correction technology consists in inserting strong self-absorbing threads under the skin. Unlike fillers, the nose does not visually enlarge after the insertion of threads. The result lasts for 3 years.
The bion threads are made of caprolac and fix the tissues of the nasal area through a multitude of grooves. The threads are inserted through small punctures, then the beautician tightens them and gives the desired shape to the area of the nose. The result becomes evident after 2-3 days. Other benefits of using threads:
- low invasiveness;
- painlessness;
- the use of local anesthesia;
- no complications;
- no swelling and bruising.
Disadvantages of this correction method:
- scars may appear in the puncture sites;
- the threads can be contoured, that is, they will be visible.
The procedure is contraindicated for people with thin fair skin and those who have a tendency to form keloid scars.
Indications for the procedure
When the shape and size of the patient's nose is satisfied, the doctor will most likely prescribe a procedure for him without performing surgical manipulations. You can do without a scalpel when correcting details in order to get rid of:
- from the asymmetry of the nose;
- from dents, dips, depressions and irregularities;
- from the drooping tip of the nose;
- from the hump;
- from a flat top back;
- from loose skin near the nose.
Such a procedure is also used as a temporary measure in the event that a minor patient with severe disabilities (as a result of a fracture or injury) cannot be operated on.
In men
Men prefer a radical approach to modeling with fillers in order to get rid of defects once and for all. Indications for rhinoplasty in men may be:
- frequent sinusitis, chronic nasal congestion;
- injuries that led to deformation of the nose and its septum;
- congenital pathologies and deformities in the bone structure of the organ;
- saddle shape, large nostrils, wide bridge of the nose, large length or thickness of the nose;
- breathing disorders;
- the presence of an ugly hump.
Among women
Any type of intervention can be applied to women. Which one to resort to, the surgeon decides. If small changes are to be made, then the aesthetic problem will be solved without the use of a scalpel. Often the injection method is used on the eve of the operation, so that a woman can assess how her nose will look in the future.
What can be fixed using this procedure
Hump correction
Reduction is achieved by injecting filler into the curved portion. To correct the hump, the gel is injected along the entire length of the nasal dorsum. Most often, absorbable preparations with hyaluronic acid are used to straighten the nose.
Tip correction
It is performed by injecting fillers into problem areas. Such rhinoplasty is especially in demand when there are small pits or depressions on the tip of the nose. The potato nose is corrected by introducing a filler into the very tip, this makes it sharper.
The tip can be raised by injecting the gel into the columella area of the nose. Visually, this hides the hooked tip. In some cases, it is also necessary to inject into the wings of the nose to slightly shrink the nostrils.
Repairing a broken nose
If the nose has been injured more than once, then contouring will not help. In such a situation, only surgery on the nasal septum is indicated. And most likely a full-fledged reconstructive and aesthetic operation. Reconstruction of both the septum and the external cartilaginous skeleton may be necessary.
Backrest alignment
It is impossible to align the crooked nasal bridge without surgery. Rhinoplasty by injection only makes it possible to mask the defect. For example, a snub nose correction (with a low bridge and a raised tip) is done by injecting fillers over the entire surface of the nasal bridge to the very tip.
Reduction of wings
Hyaluronic acid gel is used to correct the asymmetry of the wings of the nose. In this case, the specialist must accurately calculate the dose.
The nose becomes thinner and more expressive after rhinoplasty with hormones.
If it is necessary to remove the asymmetry of the nostrils or to reduce them, then fillers are injected into the lower part of the wings of the nose.
How old is the operation
There must be clear reasons for the operation on the face. A conscientious plastic surgeon will not undertake the correction of a minor's nose if a certain whim of a girl or boy serves as the basis.
Persons who have reached the age of 18 are allowed to the operation. In extremely rare situations, this condition can be violated. The minimum age for rhinoplasty for girls is 13-14 years old, for boys - 15-16 years old.
For medical reasons, a teenager can undergo almost any plastic surgery. However, doctors recommend to be patient until the onset of age, when the operated organ is formed by at least 80-90%.
How is the preparation for the non-surgical procedure going
In contrast to classic surgery, it is easier to prepare for a non-surgical procedure. Perhaps the doctor will advise you to consult a dermatologist, tell you what tests are taken to identify contraindications and restrictions.
Compliance with the following rules will help reduce the risk of complications:
- 10 days before the plastic surgery, you need to stop taking alcohol;
- salicylates increase bleeding, which means that a week before the procedure, you should stop taking "Aspirin" and other similar medications;
- refrain from eating at least 10 hours in advance;
- a few days before injection plastics, it is recommended to exclude high physical activity;
- it is necessary to wash your hair the day before, since you cannot bend over and wet your face after the procedure.
The doctor prescribes the intake of antihistamines. At an elevated temperature, menstruation, respiratory diseases, the procedure will have to be abandoned until recovery.
Do I need anesthesia
General anesthesia is not required for non-surgical rhinoplasty. For anesthesia, local application or infiltration anesthesia is used.
Carrying out technology
Non-surgical plastic surgery is performed on an outpatient basis, there is no need for hospitalization of patients. After the procedure, the clients of the plastic surgeon go home.
A thorough examination and computer modeling of the future shape of the nose are preliminary carried out. The average duration of manipulations is 35-60 minutes. The operation proceeds step by step as follows:
- The patient is conscious, only local anesthesia is used. The doctor applies a lidocaine-based cream to the nose and area around it. The exposure time under the film is 10-15 minutes.
- After opening the ampoule with the drug and filling the gel into the microcannula, gradually and carefully injects the filler into the designated areas of the nose. If the client has a desire, he can observe the progress of the process with the help of a mirror, which he will hold on his own.
- If necessary, the beautician can re-infuse the filler.
- The final stage is a light manual massage. It is needed for better distribution of the filler.
The result can be assessed immediately. Fillers are safe and completely absorb within 1. 5 years.
Consequences and contraindications of nonsurgical rhinoplasty
Correction should not be done to women during pregnancy or during menstruation. Non-surgical correction is contraindicated for people suffering from the following diseases:
- acute infectious diseases;
- keloidosis;
- autoimmune pathologies;
- endocrine system pathologies, including diabetes mellitus;
- hemophilia and other blood clotting problems;
- allergies and individual intolerance to the components of the drugs used;
- oncological diseases, tumors of any localization.
What complications can arise
Complications after surgery occur in 10% of cases. They can also occur during surgery (bleeding, skin ruptures, detachment of the muco-cartilaginous flap, violation of the integrity of the bone pyramid, fracture of the bone site).
If several cosmetic defects are eliminated during the operation, then a number of complications may develop:
- nosebleeds;
- postoperative pigmentation;
- bone callus;
- swelling and hematoma of soft tissues;
- loss of smell;
- the appearance of keloid scars;
- difficulty breathing;
- curvature of the nasal septum.
Rhinoplasty without surgery is not so dangerous, although it is also considered a difficult procedure in aesthetic surgery. After that, a special splint is applied to the patient's nose, which fixes the result and protects from injury.
For several hours after the procedure, there may be redness and swelling of the skin in the nasal area. These problems completely disappear within 24 hours. After tightening with threads, bruises may form, which completely disappear within a week.
Rare complications include processes that can occur due to the inexperience of the surgeon performing the procedure, or the patient's failure to comply with postoperative rules: displacement of fillers and rupture of threads inserted under the skin. The doctor should deal with the problem, and urgently.
Caring for your nose after surgery
Rhinoplasty with a laser, hyaluronic acid injections and fillers reduces the rehabilitation period to a minimum. Immediately after the nose contouring procedure, you can go home. The swelling subsides within 1-2 days.
On average, rehabilitation lasts up to several days (depending on the correction method performed). There are almost no restrictions after the performed manipulation. You can continue to go to work, play sports and live your normal life.
In the postoperative period, it is necessary to monitor facial expressions: you can not squint, frown. For several hours, you should not strain your muscles, blow your nose, sneeze and cough. In the first 2-3 days of recovery, you should not wear glasses.
Strict restrictions apply to visiting any swimming places (ponds, swimming pool, bathhouse, sauna). You also need to give up sunbathing, smoking, foundation.
You cannot massage the injection site or carry out physiotherapy for 2 weeks.
How long does the edema last after surgery?
The entire rehabilitation period after surgery can take about a year. In the first days, the patient must wear a bandage, bandage or plaster cast. Facial swelling will subside in 1-2 days. After 21 days, the plaster cast is removed and the blood clots from the nose and tampons are removed.
Active recovery occurs in the next 3 months, traces of side effects subside, but minor changes can take place until the end of the year.
What to do if the operation is unsuccessful
The result of the performed operation can be judged only after 6 months. Practice shows that 20% of all interventions to correct or eliminate nose defects are not the only ones.
If after this time the nose does not take the desired shape or swelling remains, then the operation can be considered unsuccessful. In such situations, repeated operations are assigned.
When to repeat the procedure
The effect of non-surgical nose surgery lasts about a year on average. You can repeat the procedure at any time.
After surgery, repeated (secondary) rhinoplasty can be prescribed no earlier than a year later. Technically, this is a more complex procedure. It is prescribed if the patient is not satisfied with the result, or the previous operation was unsuccessful (did not give the expected effect).
Benefits of Non-Surgical Rhinoplasty
The filler and suture procedure cannot be considered a full-fledged alternative to surgery, but it has a number of obvious advantages. The main ones are:
- painlessness;
- short rehabilitation period (sometimes absent);
- fast achievement of results;
- reversibility (you can always return the previous form if the result is not satisfactory).
The procedure has both pros and cons. It has an extremely low effect on the general condition of the body, does not injure the tissues of the face, after which scars and scars do not form. But if injected incorrectly, gel lumps can form under the skin. Their displacement will lead to a change in the shape of the nose.
After minimally invasive intervention, there are no stitches, the skin heals better. But the risk of infection and infection still remains.
Low cost makes the procedure available to everyone who wants to improve their appearance. However, possible complications oblige to treat the choice of the clinic with extreme care.Most often, unsuccessful cosmetic interventions occur after visiting non-specialized salons and doctors who do not have the appropriate qualifications.The final decision should be made only after studying the previous work of the master and the clinic's assessments.