The nose is one of the main features of your face. Generally, when someone looks at your face, the nose is one of the first features that they notice. Then the eyes, but above all the size and shape of the nose.
It is one of the most frequent consultations in Plastc Surgery, being for aesthetic defects or funcional problems (nose obstruction). The Surgery looks at improving the appearance and/or function of the nose (improving breathing).
A PERFECT NOSE DOES NOT EXIST. All noses are different, due to ethnic factors, type of skin, age and the geographical location etc. Aesthetically it´s important to know the size and shape of your nose, in relation to the rest of the face. If there is or is not a disharmony? Functionally, it is important that your breath well. Every case is unique and must be studied in great detail.
INDICATIONS OF AESTHETIC RHINOPLASTY:
* For those who have an aesthetic defect, in the case of young females, they must be at least 14 years old and young males at least 15 years old. There is no age limit to remodel your nose
FUNCTIONAL RHINOPLASTY:
* For those who do not breath as they should because of the alteration of nasal septum and/or turbinates.
CONTRAINDICATIONS:
* We will not operate if we believe that your objective is not realistic. IT IS IMPOSSIBLE TO OPERATE ON PEOPLE WITH EXAGERATED OR FANTASY EXPECTATIONS. I recommend you read the chapter” Psychological Aspects of Plastic Surgery” of this website.
SURGICAL OBJECTIVES OF AESTHETIC SURGERY OF THE NOSE:
* Improve the shape and size of the nose in relation to the rest of the face, achieving a more natural nose, one that nobody can tell that has been operated on.
These are the different options:
- decrease or increase the nasal dorsum
- reduce the size and width of the nose
- remodel the point of the nose
- change the angle between the nose and the top lip
- reduce the size of the nostrils
THE DIFFERENT OPTIONS OF FUNCIONAL SURGERY OF THE NOSE.
- Correct the nasal septum.
- Correct the possible alterations of the turbinates, above all the lower turbinate.
PLANNING THE YOUR NASAL SURGERY:
BEFORE THE OPERATION,
* First you must undergo a complete medical examination. Then we will be able to give you in writing, the modifications that are suitable for you. We always do a photo session as a fundamental part of evaluating your case.
WITHOUT PHOTOS WE DO NOT OPERATE. IT IS ALSO VERY IMPORTANT THAT YOU REMEMBER THAT ALL THE INFORMATION YOU RECEIVE IN WRITING, SHOW AN ESTIMATION OF THE FINAL RESULT. Between you, the patient and me the Plastic Surgeon, we should agree on the results that we are able to achieve.
We ask for blood tests regularly.
INTEGRATING DIFERENT SURGERIES:
Many people do not like to be photographed, others do not like to be photographed from certain angles and also prefer to look at themselves front on in the mirror. Some faces have a protruding nose and chin or a inverted chin, and even the smallest of these discrepancies can significantly reduce ones self- esteem.
Plastic Surgery of the chin is a type of Plastic Surgery that helps balance the face and can produce great aesthetic results. Sometimes the patient believes they have a big nose, but in reality have and inverted chin that causes an imbalance of the face. The nose is only one of the facial features.
The profile of your face is defined by the relation between;
YOUR FOREHEAD (the height is important, width, the angle of inclination and the area between the eyebrows).
THE NOSE (the angle between the nose and the forehead and the angle betweeen the nose and the lip).
THE LIPS (the height is important, the relation between the skin and mucosa-red part-)
THE CHIN AND MALAR: (Generally surgery of the nose, plus surgery of the chin is associated with Rhinoplasty. I recommend you visit the chapter “Plastic Profiles” in this website for more information.
ANESTHESIA:
- The first choice is local anesthesia and sedation.
- In a certain cases general anesthesia is used.
PROCEDURES:
* In the first nasal operation, it almost always consists of an incision internal, that does not leave any visible scaring. I learnt this technique from the Profesor DR. Fernando Ortiz Monasterio from México, without doubt one of the true masters in the world of Plastic Surgery.
* In some selected cases, I use the open rhinoplasty. This involves an incision at the bottom of the nose, between the nostrils.
* The other surgical steps include:
- Hump resection to decrease dorsal prominence
- Modification of the cartilages.
- Lateral osteotomies to narrow the nose
- septoplasty to correct nasal deviation.
* CURING:
Once the operation is completed, a plug is placed inside the nostrils. This plug is kept in place for 48-72 hours. In selected cases longer, for example when you operate on the nasal septum. On the outer side of the nose, we apply a plaster cast that is kept in place for seven days.
The duration of the surgery is approximately 3 hours. If the operation is on the nasal septum, a little longer. DO NOT CONFUSE THIS WITH THE TOTAL TIME YOU WILL BE IN THE HOSPITAL OR CLINIC.
RECOVERY:
- Generally the patient stays in hospital for a few hours after the operation and is able to go home the same day.
- The majority of the patients are able to walk and active two days later. The first day must be spent in a lying position with the head semi-elevated.
- Your nose will probably have some pain and you will feel somewhat swollen but pain killers will help. ASPIRIN MUST NEVER BE TAKEN, AS IT CAUSES BLEEDING.
- Infections are rare, we only give antibiotics if there is risk of infection.
- After three days the swelling and bruising around the eyes begin to go away. Do not panic. You should use ice packs for at least 3 days to help the healing process.
- From 48 to 72 hours the plugs can be taken out, except for the case of a nasal septum operation.
- It is common to experience some bleeding in the first couple of days. DO NOT PANIC. Put a small bandage below the nostrils, and change it when necessary
- Try not to sneeze or blow your nose in the first couple of weeks, while the tissue is still healing.
- After 7 days the plaster cast, BUT YOU WILL NOT BE ABLE TO SEE THE FINAL RESULT AT THIS STAGE, because the nose will still be swollen and the tip of the nose is somewhat elevated. Try to maintain the cast dry and resist the temptation to remove it.
- You may experience some breathing difficulties for a few weeks after the operation due to internal swelling.
- After 2 weeks you will be in a condition “presentable” and you will be able to return to your every day activities, BUT INTENSIVE PHYSICAL ACTIVITY MUST NOT BE UNDERTAKEN FOR A FEW MORE WEEKS.
- Exposure to the sun and swimming in the ocean are recommended for 45 to 60 days after the operation, or when the bruising has disappeared. Using always 30 plus sunscreen.
- Do not use glasses for at least one month, only if it is entirely necessary.
Remember to always clarify your doubts before and after operating, remember that all questions are valid.
FINAL RESULTS:
Generally, a well planned and timed operation, following all the indications necessary obtains satisfactory and natural results. But the final results appear 6 months to 1 year after the operation. Some patients can reach the final result sooner but only 3 months after the operation will you have an idea of the final result.
In some cases it is necessary to touch up the fine details. The result of nasal surgery lasts for almost your whole life. After a few years, like any part of your body you may see changes in the anatomy of the nose.
POSIBLE COMPLICATIONS:
Complications are rare but do exist. REMEMBER THAT PERFECT AND RISK FREE PLASTIC SURGERY DOES NOT EXIST.
- Bleeding
- Infection
Unpredicted complications will can be corrected later.
