Introduction
An unattractively shaped or deformed nose is often perceived as annoying by the wearer. This sometimes leads to the desire for surgical rhinoplasty. The most common procedures/interventions in nasal surgery at the University Hospital Zurich include
- Hook nose correction
- Nose tip surgery
- Hump nose surgery
- Snub noses correction
- Bulbous nose correction
- Reduce the size of a large nose
- Correcting asymmetrical nostrils
- Correction after nasal injuries, for example after dog bites or other accidents, and after malignant skin cancer(melanoma, basal cell carcinoma)
- Nose corrections (pre-operated noses)
In some cases, the aesthetic correction of the nose is combined with a nasal septum operation. The aim of nasal septum surgery is to improve breathing.
Procedure
In the run-up to the nose operation, the patient’s wishes and the realistic surgical feasibility are discussed in detail in a detailed consultation. Since this type of operation is an irreversible change, such an intervention must be carefully considered. The decision to have a nose correction should not be based on a momentary mood or dissatisfaction. The risks and complications must also be carefully weighed up. During the anamnesis, previous accidents, nasal injuries or previous operations are discussed and the surgical concept tailored to the individual is discussed accordingly.
The external shape of the nose is examined by determining important angles, distances and proportions with other parts of the face, the quality of the skin and the shape and function of the inner nose. In the inner nose area, the course and integrity of the nasal septum, the size of the turbinates, examination of the outer and inner nasal valves and air patency are examined. These parameters are analyzed with the help of professional photographs and on the patient. In addition, endonasal endoscopy is occasionally performed on patients if a more detailed examination of the posterior nasal septum is necessary. If necessary, an additional functional examination by rhinomanometry can also be ordered.
The desired surgical target can be defined in a drawing based on the images. Modern techniques for digitally altering the nose can also be offered. Only after these examinations and the consultation can a precise surgical concept be developed to achieve the most harmonious nose shape possible.
In principle, rhinoplasty consists of a combination of correcting the inner and outer nose, which can basically be divided into the following steps:
- Access (open/closed)
- Nose bridge correction
- Shell correction
- Correction of the nasal septum (septum correction)
- Correction of the bony nasal pyramid
- Nose tip correction
- Refinements (final fine adjustment and correction of irregularities)
- Bandage (special combination of plaster tapes and nasal plaster)
Aftercare
Depending on the procedure, the inpatient stay is approximately one to four days. The foam tamponades are usually removed after one to two days. The special bandage made of plaster tape and plaster usually has to be worn for one to two weeks.
The first check-up is carried out after approximately one week, during which the stitches are removed through an open access at the nasal bridge. If the plaster is loose after the swelling has subsided, it is changed after a week.
The inserted silicone splints, necessary for additional stability, prevention of adhesions and bleeding of the nasal septum, are removed one to two weeks after the operation.
After removal of the plaster cast, plaster tapes usually remain for a further week. Sport should be avoided for six to eight weeks after the nose operation. Incapacity to work is usually necessary for one to two weeks. Wearing glasses should be avoided for six weeks. If contact lenses are incompatible, the plaster splints can be specially adapted.
Possible complications
Overall, rhinoplasty is an operation with few complications. If your rhinoplasty is performed by a qualified specialist in rhinoplasty, complications are rare and a lasting good result can usually be achieved. However, it is not possible to guarantee a surgical result. Like any operation, rhinoplasty also involves risks. Possible complications could be:
- Swelling (two to three days, then continuous decrease)
- Postoperative bleeding (e.g. bleeding into the nasal septum)
- Infections in the wound area
- Wound healing disorders
- Temporary numbness, hypersensitivity of the tip of the nose
