Rhinoplasty is a plastic nose surgery that re-structures the nose without harming the bone or cartilage structure. Initially it should not be tought that the nose is only being strcutured aesthetically. Nose has an integrity of skin, bone and cartilage. All defects in this integrity must be spotted correctly. A rhinoplasty surgery with correct spotting creates a good aesthetic nose and contributes to correct breathing. If the nose integrity is not attended carefully, nose functions will go bad in time. Loss of tissue integirty of the nose will cause aesthetic defect in time.
How an aesthetic face should be?
Generally an aesthetic face is identified as ; a flat forehead with a slight slope, proturuding eyes, succulent lips and a slightly proturaded jaw. The best surgical outcomes about the face happen with the evaluation and planning of facial qualities. Face is seperated to 3 parts and evaluated. Above the eyes, below the eyes and below the nose. The beauty center between the eyebrows called glabella needs to be proturuding. The angle between the nose-root and the forehead needs to be 115-130 degrees. A less degree angle would make the nose look bigger. A big looking nose would ruin the aesthetics. Lower lip should be more succulent than the upper lip. The jaw should be more oval shaped on women. For the face, the face’s shape, proportions and the patient’s height is important.
How an aesthetic nose should be?
In the nose’s aesthetic look even the height is important. The nose should fit the face. A short nose on a tall person would wekaen a strong character, the nose needs to fit well with the patient’s height, character and face in order to look aesthetically good. In rhinoplasty, the goal is to get aesthetic results without harming the face or deform it’s integrity.
In an ideal nose; the angle between the nose and the forehead should be 115-130 degrees. This angle should be lower on men. A nose withthese angles looks smaller and gives a softer vibe. The angle between the nose and the upper lip needs to be 90-105 degrees on men. 100-120 on women. The nose need s to be equal on both right and left sides. Nose needs to be rationed to the face lenght. There should not be a curve on the nose.
How is pre-rhinoplasty process is evaluated?
1-) Nose size is evaluated
Long nose on a tall person, short nose on a short person is preferred. The nose is rationed by the face’s y axis.
Some changes may be made on the nose depending on the height and the face lenght. If no change is needed. The depth of the nasal bridge is changed or the nose tip is lifted depending on the purpose.
2-)Nasal ridge and profile is evaluated
There is 120 degree angle between the nose root and forehead. When this angle is low nose looks bigger. Nose or the soft tissue is removed and the angle is increased.
3-)Nose tip is evaluated
Nose tip, angle and thickness are evaluated. Nose is evaluated by being ratioed againts it’s distance to the upper lip.
4-)nose steepness is evaluated.
On men, if the angle between the upper lip and nose is increased nose becomes steep. But nose steepness gives a feminine look on men. İf nose steepness can not be done, nose can be looked like it is steep by reducing the nasal ridge.
5-)Nasal septum is evaluated
If the septum looks 3-4mm long when looked from the side, it is aesthetically proper. If it is longer or shorter, it is changed surgically.
6-)The differences between the two sides of the nose.
Cartilage may be curved or nasal wings may be curved. Nostrils may not be equal.,
7-)Nose’s low ‘’1/3’’ is evaluated
If there is any enlargment at the ‘’1/3’’ part of the nose it is decided depending of the size of the face.
8-)Nose is evaluated by looking from the bottom
A triangle shape is expected when looked. Septum and wings are evaluated.
An uchecked rhinoplasty surgery might effect the nose’s function. Nose should be evaluated for it’s function to not get a surgery a second time.
Evalautaion of the nose in terms of function
1-)Nose is opened with a tool called speculum. Cartilage is evaluated in terms of curviness and defects
2-)strength of the nasal wings and cartilages are evaluated
3-)patient is told to smile. If the nasal wings go down when looked from the side a change is decided.
4-) hte most important decision; skin thickness after the changes made on the cartilage and bone. Skin’s response to it is important.
5-)nose’s back cartilage and it’s bone is evaluated
What is done before rhinoplasty?
After the nose is examined, pictures are taken on a blue background from 3 different angles from both side. A total of 3 pictures.
What is closed rhinoplasty
It is done between the cartilages without cutting any skin. Important bonds between the upper and lower cartilages are protected. It is preferred on patients who will not receive any changes on the nose-tip. There are no stitches since there is no cuts.
What is open rhinoplasty?
Septum is cut. It is done by lifting the nose-tip and nasal ridge. The skin gets stitched and they get removed post surgery.
In which situation is open rhinoplasty made?
-people who had rhinoplasty before
-in harelip repair
-in saddle nose
-when there is a hole on the cartilage
-when there is a need for advanced caritlage repair
How is rhinoplasty done?
Nose gets opened up. Deformaties on the cartilage are fixed. Hump on the nasal ridge is fixed. No a lot of tissue taking from the bone is preferred. When there is a decision of change fort he nasal wings, ıt is done after the nasal ridge, lastly nose tip is changed.
Why is there cartilage transfer on rhinoplasty?
It is preferred to re attach the tissues. There are frequent cartilage losses on people who already had 2 or 3 rhinoplasties. In this case cartilage transfer is done.
Is there a need for tamps after the rhinoplasty?
Tamps are needed in order to have a healing process without problems afterwards.
What happens after rhinoplasty?
Tamps are removed 1-2 days later. Sticthes are removed 1 week later. If there were changes on the nose-tip then there is a bond and that is removed on the 7th day and another band is placed and that bond is also removed 2 weeks later. Antibiotics and painkillers are used if there is any pain.
How often the check-ups are done?
At the second day, seventh day, first month, sixth month, and the first year the chechk-ups are made.
What are the risks of rhinoplasty?
1-)blood accumulation in the cartilage, absida, puncture and collapse on the cartilage, absida, puncture and collapse on the cartilage
2-) flexion on the nasal ridge
3-)hump on the nasal ridge
4-)deformaties on the nasal ridge
5-infection, tisse loss, bleeding after surgery
6-)swelling and cyanosis
Success of rhinoplasty
Evaluation before surgery is really important for success. Evaluating the nose by itself makes an aesthetic nose but not an aesthetic face. Function of the nose should not be overlooked. Cartilage needs a highly sensitive care. A lot of risks after surgery are because of too much cartilage taking or harming the cartialge, nose needs to be re-made from all aspects. Not even a tiny detail should not be skipped.
A good nose gives good aesthetics and provides goos breathing.
Nose aesthetics and nose function are inseperable.
Main goal in rhinoplasty is to achieve a nose that is perfect fort he face.
Rhinoplasty is remaking. What makes a good remake is seeing the flaws perfectly. A good nose gets attention and boost confidence
In rhinoplasty every decision is up to you but choosing a doctor that treats your cartilage very well should be your first step.
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