The nose it’s the face’s central aesthetic unit and its symmetry and size considerably affect a person’s appearance. Also, hereditary or national characteristics can give the nose a specific form and shape, but the so-called “French nose” is the standard of fineness and elegance.
It should be noted that the nose must be harmonically combined with other functional units of the face, such as the chin and the eyes. Any change in the morphology of the nose as a result of injury or surgery significantly affects the balance of the face, and it’s exactly that, that a plastic surgeon is called to restore. For this reason the aesthetic reconstruction of the nose with rhinoplasty, commonly known as nose job, is a completely personalized procedure.
As a cosmetic and functional procedure, rhinoplasty (nose job) aims at improving the appearance of the nose, and, if required, to improve its function. Any adult who wishes to change how his/her nose looks may undergo rhinoplasty. The cosmetic problems addressed by rhinoplasty vary, i.e. large (hypertrophy of the nasal pyramid), aquiline, or crooked nose, big alae, etc.
Apart from the aesthetic problems, rhinoplasty also improves breathing, because very often aesthetic nose problems coexist with a deviated nasal septum, which often makes breathing difficult. The deviated septum may be a congenital disorder or the result of an injury.
Rhinoplasty is usually performed under general anesthesia and rarely under local anesthesia or analgesia. It lasts approximately one hour. There are two rhinoplasty approaches.
Closed rhinoplasty, (or closed approach) implies that no skin incisions are made on the outside of the nose in order to accomplish the desired changes. This procedure is also described by others as “endonasal rhinoplasty” since access is achieved via the nostrils and procedure is done inside (endo) of the nose. The nasal skin is pulled up and the mucosa is pulled down to help the fine tools find a way to the nasal bony and cartilage structures. The nasal skeleton is reformed thanks to special tools (osteotome) and thanks to specialized techniques that provide the decided shape. When the procedure is completed, a special splint is placed externally which must remain for eight days to help the nose keep its shape. Gauze is also placed inside the nose for 2 days. The final shape of the nose will be completed within 4 to 6 months.
External (Open approach) rhinoplasty also uses the same basic stages, but involves an additional step, a small incision that is placed across the columella, i.e. the connection point between the right and left nostril. This method is easier for the surgeon, because it gives him a larger picture of the nasal disorders and enables him to intervene easily. Moreover, the results are more predictable. Its drawback is that it leaves a small scar, which is however practically invisible when the procedure is correctly performed by an experienced plastic surgeon. A special splint is also placed for 8 days and the final result will be evident after 4 to 6 months.
Both types can be combined with septoplasty, if the patient also has a functional or breathing problem.
Right after the procedure you will have a splint on and gauze in the nose which will be removed in 2 days. Any bruising and edema that will appear around the eyes is common and will subside within the next days. The use of cold compresses will reduce the swelling and bruises.
The pain is usually tolerable on the nose and you may experience headache. In both cases pain subsides with painkillers (Depon, Ponstan) but aspirin is not allowed.
The external splint will be removed 7 to 8 days after the procedure and you must take care during the next weeks not to injure your nose.
Ten to fifteen days after the procedure the nose will appear completely normal, but the final result will show up to 6 months after the procedure.
Ten days after the procedure, when the bruising will have subsided, you will be able to return to your daily activities and work.
In some cases we are able to correct a nose without resorting to the discomfort of surgery. The procedure only takes 10 minutes and involves the injection of hyaluronic acid. The advantage of this method is that it is fast, non invasive (bloodless) and has no downtime. However, it is not recommended for all noses, only for those that are relatively small and have minor deformities.
The result is impressive and lasts over one year, whereas in some cases the duration of the effect is longer.