Description of the procedure
Closed approach implies that correction is done through incisions placed inside the nostrils; there are no visible cuts on the outside of the nose after the surgery.
Extranasal or decorticational approach implies a miniature incision on the outside of the nose, more precisely, on collumela, which heals quickly and with minimum scarring. Typical for this approach is that the skin at the tip of the nose is risen from the underlying cartilage, facilitating the approach to the tip of the nose.
Both methods of nose surgery are accepted as a world standard in esthetic surgery; likewise, they can be combined with a series of other procedures in order to achieve the desired effect.
What should always be kept in mind is that nose is already partially determined by its natural shape and dimensions. Nasal structure reduction that is too radical is not recommended because it can weaken the backbone of the nose. Firmness and thickness of the skin have an important effect on the result of the surgery, as well as soft tissue cover, which also limits to what extent the nose can be changed. Although the skin cover does not change, after surgery the skin must cover pre-formed cartilage, because excessive reduction of cartilage and bone can result in inadequate adaptation of the skin.
The consultation examination includes the analysis of physical, i.e. anatomic conditions and possibilities of the procedures, as well as personal motivation and clients’ wishes. A good candidate
- 1. is displeased with the size or shape of the nose
- 2. wants to improve appearance
- 3. has issues with breathing through the nose and snoring
- 4. has experienced injury of nasal structures
- 5. has an inherent malformation or deformity
During the anesthesiologic examination, the patient is provided with information on the type of anesthesia, regime of pre- and postoperative behavior – diet, hydration, activity, taking medication, etc. It is important to memorize that 6 hour prior to the procedure you are not allowed to eat anything; it is only allowed to drink water.
Three days prior to the procedure you should stop using painkillers and blood thinners from the group of nonsteroidal antirheumatics – acetylsalicylic acid (Aspirin, Andol,…). In that way, we prevent possible unwanted bleeding and hematoma (blood bruising) during and after the surgery, which aids and accelerates recovery and improves the result of surgery. You must also warn your anesthesiologist about the possible anticoagulant therapy.
For the sake of safety, everything that is necessary concerning the preoperative preparation, surgical procedure, and postoperative course will be consolidated during the final arrangement for the surgical procedure – personally or over the telephone.
Immediately before the surgery, in his suite, the patient changes into our one-time use clothing; takes premedication – for the sake of relaxation and against anxiety.
Course of the procedure
During the surgery, cartilage and bone of the nose are reduced or reshaped and placed back to get a satisfying shape, appearance and size of the nose. For the design of the nose the cartilage of the nose (usually nasal septum), ear cartilage or rib cartilages usually used if these are insufficient (previously used), or a major reconstruction is required.
Hematoma and swelling are minimal, they disappear gradually and spontaneously within eight days, and recovery is painless. It can be accelerated by using cold compresses and keeping your head elevated during the first couple of days.
During the next month, you should avoid great physical exertion and, normally, risk of injury.
After seven to ten days, the patient is ready to return to his/her usual activities.
Definitive shape and appearance of face and nose is evident after 3 months.
Precautions and limitations
It is of utmost importance that the candidate for the surgery is mentally stable, balanced person, realistic in expectations – a person who wants to improve appearance or function, but does not expect perfection.
There is no unique method for rectification of each nose. Nose surgery is one of the most challenging procedures in plastic surgery of the head and neck. Knowing the different methods and their use, due to the specific problems of each individual is the only way to achieve optimal results: good functionality of the nose, which ensures normal breathing, harmonious overall appearance of the face and the satisfaction of the patient.
Today’s approach to rhinoplasty is different than it was before, and the nose is not viewed in isolation, but rather by trying to bring it into an optimal relationship with existing structures of the face, such as the cheeks, lips, chin and forehead. With regard to that, the goal of cosmetic nose is not getting a “new face”, but reshaping the nose so that it fits into normal relations with the rest of the face.
Side effects and complications
Package does not include: preoperative laboratory tests (blood tests), ECG, intern’s examination, consulting with other specialists (specialist for diabetes, asthma, high blood pressure, thyroid gland, transfusion), medications that you will take at home.