Nose Aesthetics (Rhinoplasty)

Preliminary Interview and Simulation in Nose Aesthetics

The alterations sought by the patient on his nose are first listened to during the preliminary conversation with the patients before the operation in our clinic. The patient is specifically questioned about any alterations in the nose that the patient does not want following the operation. After that, an intranasal examination is performed to see if the patient has a functioning impairment.

The patient’s photographs are taken, and the simulation is planned with the patient’s demands in mind. The patient’s wishes and the physician’s abilities are thoroughly reviewed, and the best possible patient-physician compatibility is attempted.

Rhinoplasty is not a procedure that is appropriate for everyone. A preliminary interview should be conducted by an experienced physician who is familiar with the patient’s wishes and what may be done, allowing for the creation of a common picture.

The patient should be told about the possible complications following the procedure based on the patient’s facial and nasal characteristics and inspection.

No rhinoplasty surgeon can guarantee a 100 percent success rate. Every procedure comes with a risk, therefore anyone seeking plastic surgery should be aware of this. As a result, the surgical experience of the doctor doing the procedure is critical.

Nose Aesthetics

Rhinoplasty is a surgical procedure that should be performed by a rhinoplasty specialist who can correct functional and aesthetic defects in the nose. The nose is a functional organ as well as an aesthetic element of the human face. The success of the procedure is considerably reduced if the nose is unable to breathe correctly. The only method to ensure patient satisfaction is to surgically produce a beautiful nose while both protecting and enhancing the nose’s important functions for humans.

The most natural nose suitable for that patient is recommended during the preparatory interview before the procedure based on a face analysis and images taken of the patient. During the preliminary interview, the patient is informed about what can and cannot be done, while also considering the patient’s major desires.

The main goal of rhinoplasty is to make the patient happy. As a result, the patient’s wants should always be prioritized, and possible and impossible requests should be communicated to the patient honestly.
In our clinic, rhinoplasty operations are performed with open and closed techniques. Nasal aesthetics with a closed technique is preferred in patients who have not been operated on before. In revision patients, open and closed technique surgery is used in line with the nasal condition and the patient’s wishes.

Nose Aesthetics Techniques

The nasal skin is raised by making a V or W-shaped incision on the base of the nose, which we call the columella, and the nasal skeleton is sculpted and the nasal skin is stitched again at the same incision site in open rhinoplasty. The most significant benefit is that it gives the physician a wider field of view and allows for a more comfortable resolution of difficulties, especially in patients whose anatomical structure has entirely changed and who have undergone surgery for the second time. The drawbacks include stress to the muscles and ligaments at the base of the nose, suture marks on the skin following the incision, delays in the healing of the nose tip, and increased oedema and swelling. Even though these drawbacks aren’t seen in every patient, the open approach isn’t our first choice for revision patients with significant deformities.

The skin at the base of the nose is not incised in closed method rhinoplasty. Working beneath the skin with incisions into the nose reveals the nasal skeleton. Important issues at the tip of the nose are retained as much as possible, and the operation results in less oedema and more comfortable recovery. There are no sutures in patients since no incision is made on the skin. Keloids, which are abnormal healing tissues that grow after a skin incision, are not seen very often.

Tools Used in Nose Aesthetics

Conventional Tools: These are the tools used to shape the nasal bone, which we roughly call hammer rasp chisel.
These instruments are less used today due to newly released instruments.

Piezo and Micro motor: These are instruments used during surgery, not a rhinoplasty technique. It is used in shaping and rasping the bone. They enable us to make incisions and rasping operations on bone tissues with micro-vibrations or ultrasonic waves.

Nose Aesthetics Types

• Primary Rhinoplasty
• Revision Rhinoplasty
• Tipplasty
• Preservation Rhinoplasty / Preservation Rhinoplasty

Primary rhinoplasty is a procedure performed on patients who have never had a previous nasal cosmetic procedure. Because the patient has never had surgery before, anatomical landmarks are available and revision operations are significantly easier.

Revision rhinoplasty is an operation applied to patients who have had problems with a previous nose operation. Although it is basically more difficult than primary surgery, it can be performed much more easily in patients with uncomplicated and simple problems. In revision rhinoplasty, the cartilage required to reshape the nose is taken from the inside of the nose, if any; If not possible, it is taken from the ear or ribs according to the cartilage needed.

Revision surgery can be performed in a much longer or shorter time than primary surgery, depending on the problem.

Tipplasty is a nose surgery that focuses just on the tip of the nose. There is no breaking or rasping of bone structures in tipplasty. Only the cartilage components of the nasal tip are altered. Only tipplasty can alleviate nose cosmetic problems in a small number of people.

Preservation Rhinoplasty is the process of correcting the protrusion on the ridge of the nose by relocating it into the nose while maintaining its integrity, rather than cutting and removing it during rhinoplasty surgeries. The preservation rhinoplasty technique is applied in two different ways pressing “push down” and “let down”. Although the most important advantage is the preservation of the natural structure of the nasal ridge, it cannot be applied in patients with asymmetry on the ridge of the nose or with bone curvature extending from the inside to the ridge of the nose. It is also not always possible to apply to patients who have been operated on before.

The Importance of an Experienced Physician in Rhinoplasty

Because experienced physician experiences unforeseen negatives far more frequently before the procedure, s/he knows much better what to do during it.

Simultaneously, an expert physician will better examine your expectations before the procedure and notify you of any potential issues.

While the value of experience is undeniable in even the most basic task, it is especially apparent in surgical procedures, which are the most difficult of all aesthetic procedures, such as rhinoplasty, and which also promote good breathing.

Problems in Nose Aesthetics

It is a secondary surgery performed in cases such as asymmetry, anatomical problems such as bending, functional problems such as nasal congestion, or when the visual result is not as desired after aesthetic nose surgeries.

Rhinoplasty is one of the most popular surgical treatments. The main reason for this is that the nose is in the centre of the face, which means that a potential problem is constantly visible.

In skilled physicians, the rate of development of a complication necessitating re-operation after aesthetic nose treatments is 10-15%.

There are a variety of reasons that can result in unfavourable outcomes or complications following surgery. The following are the most common among them:

• Inability to identify the problems before surgery
• Incomplete understanding of the patient’s expectations
• Mistakes in surgical technique
• Structural features of the patient (having very thin or thick skin, crooked nose, etc.)
• Problems experienced during the recovery period after surgery

It is widely known that the healing process and final form of the nose following rhinoplasty can take anywhere from 6 months to a year, depending on the surgical intervention. As a result, it is recommended that a second surgery be postponed for at least 1 to 1.5 years.

In cases of advanced deformity correction and graft application, the risk of a second intervention increases in patients with light skin colour and thin skin structure, but this risk is significantly lower in patients whose skin is not extremely thin and who do not have severe asymmetry in the front view.

When patients with ‘C’ or ‘S-shaped asymmetry or facial asymmetry are viewed from the front, some curvature and asymmetry are apparent after the operation.