Rhinoplasty: Bridging the Gap Between Aesthetics and Surgery

Rhinoplasty is a surgical procedure performed for various reasons, including changing the appearance of the nose, improving breathing, or a combination of both. The structure of the nose consists of two main components: the upper part is made up of bone, while the lower part is made up of cartilage. Rhinoplasty offers the flexibility to modify bone, cartilage, skin, or all three elements to achieve the desired results.

M.B.
Dr. Manuela Băbuș, MD
Rhinoplasty: Bridging the Gap Between Aesthetics and Surgery
source: image by Freepik

Recommendations: 

Rhinoplasty is recommended for a variety of reasons, including correcting nasal asymmetry, reducing a dorsal hump, refining the nasal tip, addressing breathing difficulties, or reconstructing the nose after trauma

Excessive nose length: Rhinoplasty can help shorten the nose for a more balanced appearance.

Large nostrils: Rhinoplasty can refine and reduce the size of the nostrils to create a more harmonious appearance.

Crook in the nose: Rhinoplasty can straighten and align the nose for improved symmetry.

Irregular tip shape: Rhinoplasty can reshape and refine the nasal tip to achieve a more pleasing contour.

Nose deformity due to injury: Rhinoplasty can restore the appearance and functionality of the nose after such incidents.

Congenital curvature: Some individuals are born with congenital curvature or deformities of the nose. Rhinoplasty can correct these structural problems for aesthetic and functional improvements.

Nasal breathing difficulty: Deviated septum or other structural abnormalities can prevent nasal breathing. Rhinoplasty can address these issues to improve airflow and respiratory comfort. Surgeons can evaluate and improve nasal breathing by addressing issues such as a deviated septum or enlarged turbinates.

Image by Freepik

Numerous studies have explored the impact of rhinoplasty on patient satisfaction and self-esteem. Research shows that aesthetic rhinoplasty patients often experience increased self-esteem following the procedure. However, it is essential to manage expectations and ensure realistic goals are set during the preoperative consultation.

Contraindications for Rhinoplasty

Rhinoplasty is not suitable for everyone. Several contraindications exist that may make individuals ineligible for the surgery:

  • Oncology (Cancer): Individuals with a history of cancer are generally not candidates for rhinoplasty due to the potential risks and complications associated with the disease and its treatment.
  • Diabetes: Poorly controlled diabetes can impair the body's ability to heal properly after surgery, increasing the risk of infection and other complications. Stable blood sugar levels are essential for a safe rhinoplasty.
  • Respiratory Diseases: Conditions affecting the nasopharynx, throat, or other respiratory organs can complicate rhinoplasty and may lead to breathing difficulties or other issues. It's essential to address these conditions before considering surgery.
  • Incurable Viral Diseases: Diseases like HIV, hepatitis, and other incurable viral infections can weaken the immune system and increase the risk of complications during and after surgery. Rhinoplasty is generally not recommended for individuals with these conditions.
  • Hemophilia: Hemophilia, a blood clotting disorder, can lead to excessive bleeding during and after surgery. Individuals with hemophilia are typically not candidates for rhinoplasty due to the elevated risk of severe bleeding.
  • Inflammatory Processes: Active inflammatory processes in the area where the correction is needed can interfere with the surgical procedure and hinder the healing process. It's important to address and resolve any ongoing inflammation before considering rhinoplasty.
  • Cardiovascular and Respiratory Diseases: Conditions affecting the heart, blood vessels, and lungs can pose significant risks during surgery. Proper evaluation and management of these conditions are essential before rhinoplasty can be considered.
  • Mental Instability: Individuals with severe mental health issues, such as untreated psychiatric conditions, may not be suitable candidates for rhinoplasty. Mental stability is important for informed decision-making and post-operative care.

Techniques in Rhinoplasty

Rhinoplasty techniques have evolved over the years, and today, surgeons have a range of options to address various nasal concerns. 

Open Rhinoplasty: This method involves making a small incision at the base of the nose and lifting the skin to access the underlying structures. It provides excellent visibility for intricate adjustments.

https://www.hayatmed.com/rhinoplasty-nose-job/

Closed Rhinoplasty: In this approach, incisions are made inside the nostrils, leaving no visible external scars. It's suitable for less complex cases.

Augmentation Rhinoplasty: This technique involves adding volume to the nose, often using cartilage grafts or synthetic implants. It's commonly used to build up a flat bridge or refine the tip.

Reduction Rhinoplasty: Conversely, reduction rhinoplasty focuses on removing excess tissue to reshape and resize the nose. It's often chosen to address issues like a prominent hump or wide nostrils.

Functional Rhinoplasty: Besides aesthetics, rhinoplasty can also improve nasal function. Deviated septum correction and turbinate reduction are common procedures to enhance breathing.

Ultrasonic Rhinoplasty: Ultrasonic rhinoplasty, also known as piezo rhinoplasty, is a new technique for reshaping the nose. This method harnesses the power of ultrasonic waves to precisely address the bone structure of the nose.

In this specialized procedure, a dedicated device vibrates the small cutting and shaving inserts, essentially mimicking the precision of a surgeon's scalpel. These ultrasonic waves allow the surgeon to reshape the nasal bones and cartilage with greater speed and precision compared to traditional methods.

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What to DO/NOT to Do Before Rhinoplasty: 

To optimize the success of your rhinoplasty surgery, it's essential to avoid certain activities leading up to the procedure:

  • Refrain from drinking alcohol at least a week before the surgery, as it can increase the risk of complications and interfere with anesthesia.
  • Quit smoking cigarettes at least a week before the surgery and continue to abstain throughout the recovery period, as smoking can impair healing and lead to complications.
  • Avoid exposing unprotected skin to UV rays several days before the surgery and during the recovery period to minimize the risk of scarring and pigmentation changes.
  • Refrain from starting any complicated skincare regimens at least four days before the surgery to minimize irritation and potential complications.
  • Undergo any necessary blood tests or medical evaluations recommended by your surgeon to ensure readiness for the surgery.
  • Follow your surgeon's instructions regarding eating and drinking after midnight on the day of the procedure to ensure a smooth anesthesia process.

Recovery and Care After Rhinoplasty

Preparing for Recovery: 

  • Stock up on necessary medical supplies and prescriptions recommended by your surgeon.
  • Prepare comfortable clothing, such as loose or button-up shirts, that won't put pressure on the nose.
  • Adjust your diet to include more fibrous foods and avoid processed foods, as this can aid in a healthy recovery.
  • Plan for a leave of absence from work/school for at least 7-10 days, ensuring adequate time for rest and healing.

After your rhinoplasty surgery, it's common to experience several post-operative effects:

Drainage and Bleeding: In the initial days following surgery, you may notice drainage and minor bleeding. A drip pad, a piece of gauze affixed below your nose, is used to absorb blood and mucus. Your surgeon will advise you on how frequently to change the drip pad.


Discomfort and Medication: Headaches and facial puffiness are common post-surgery sensations. Your doctor may prescribe pain medication to manage any discomfort (painkil.


Activity Restrictions: For several weeks post-surgery, your doctor may recommend avoiding the following activities:


  • Strenuous physical activities, including running
  • Swimming
  • Blowing your nose
  • Excessive chewing
  • Animated facial expressions such as laughing or smiling
  • Pulling clothing over your head
  • Resting eyeglasses on your nose
  • Vigorous tooth brushing

Sun Protection: It's crucial to be cautious about sun exposure, as excessive sunlight can lead to permanent skin discoloration around your nose.


Return to Normal Life: Typically, you can expect to return to work or school within a week, but follow your surgeon's guidance.

Eye Area Effects: Rhinoplasty can affect the area around your eyes. Temporary numbness, swelling, or discoloration around your eyelids may persist for a few weeks. In rare cases, these effects can last up to six months, with slight swelling potentially lingering longer. You can alleviate these symptoms by applying cold compresses or ice packs.

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Follow-up care: 

Rhinoplasty, like any surgical procedure, comes with its own set of risks and considerations!

Post-operative follow-up appointments are crucial. Be sure to attend all scheduled appointments and follow your doctor's instructions diligently for a smooth and successful recovery.

Everyone's recovery experience can vary, so it's essential to communicate openly with your surgeon and seek their guidance throughout the healing process.

Article Citations & Bibliography
  1. Harb A, Brewster CT. The nonsurgical rhinoplasty: A retrospective review of 5000 treatments. Plast Reconstr Surg. 2020;145:661–667
  2. Zhu et al, Trends of rhinoplasty research in the last decade with bibliometric analysis.Frontiers in Surgery
  3. https://www.healthline.com/health/rhinoplasty#recovery  accessed on 12.11.2023
  4. https://www.hayatmed.com/rhinoplasty-nose-job/ accessed on 12.11.2023

Please note that the information provided on this blog is for educational and informational purposes only. It is not intended to be used as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this blog.

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M.B.
Manuela Băbuș.
Medical Writer