Due to its central location on the face, the nose plays a key role in the perception of its aesthetics. There are many types of nose
deformity. Patients usually complain about various forms of distortion, presence of a dorsal hump, drooping nasal tip or excessively big nasal base. Unsatisfactory appearance is the cause of complexes for many of such patients. Therefore, nose surgeries are some of the most commonly performed aesthetic procedures in the world. Rhinoplasty allows not only to improve the nose aesthetics, but also its functioning.
The need for computed tomography imaging (CT or CBCT) is determined at the first consultation. It is indicated in case of
extensive nose deformities, usually with post-traumatic etiology.
Rhinoplasty is a very broad notion, including many different surgical techniques. The surgical method is always selected to suit the given clinical case. It is necessary to perform a detailed physical examination of both the nose and the entire face as well as to familiarise oneself with the expectations of the patient. The scope of the procedure can also include correction of the septum, bony and cartilaginous skeleton of the nose. In my practice, I frequently encounter post-traumatic deformities requiring total correction of all three components.
The procedure is performed under general anaesthesia, applying the open approach which allows to perform a small cutaneous cut on the nasal columella. The post-operative scar is usually unnoticeable. This technique is currently considered the golden standard in nose surgeries around the world. It ensures full insight in the nasal structure and essence of its deformity. The scope of the surgery depends on the patient's preferences and may include, without limitations, septoplasty, hump reduction, narrowing and straightening of the bony pyramid or shaping of the nasal tip or ala. Sometimes a cartilage graft is necessary. It is usually collected from the nose itself. In cases of significant deformities, it may be possible to collect it from other regions, such as the auricle or rib.
The final surgery phase involves nasal packing. It is removed on the second post-operative day.
After the procedure, the patient stays at the clinic and is under care of qualified medical personnel. The patient is usually discharged on the second day.
Post-operative pain ailments are mild and can be treated with OTC pain relievers.
The protective dressing is usually removed on the 7th day after the procedure. It must be remembered that the nose must be
protected against any injuries for 6 moths.
The final surgery result should be evaluated not earlier than 12 weeks after the surgery. This period is necessary for the bony and cartilaginous skeleton to stabilise, for the swelling to subside and for the nose skin to tighten.
Paradoxically, in the early post-operative period, the patency of the nasal airways worsens. It is a consequence of swelling resulting from tissue manipulation during the procedure. This condition persists for 2-6 weeks. Administration of nasal preparations and inhalation alleviates the symptoms and reduces their duration.
Returning to professional and sport activity is usually possible after 2-3 weeks. Contact sports and all other activities bearing the risk of nose injury must be avoided for at least 6 months.