Rhinoplasty, an aesthetic and functional surgery

Dr. Uribe Garcia, plastic surgeon at Top Doctors, will talk about Rhinoplasty.

What types of aesthetic and functional problems can be solved by rhinoplasty?

Well almost all, the truth is that the aesthetic problems depend on each particular case, right? They are usually deformities or deviations or noses that are too big, or noses that are too small or sequelae of other procedures: surgery or accidents. Usually they are also accompanied by functional problems, that is, breathing difficulties when the septum is deviated or internal valvular problems, that is, almost all the problems. Now, the complexity of the solutions depends a little on each particular case, especially in the case of sequelae of previous procedures or accidents.

What anatomical considerations should be taken into account before performing a rhinoplasty?

Well, anatomically, what we look at is the whole, the face in general, because the nose is integrated into a face and that face is the one that has to have harmony and proportion. So we cannot only look for the nose to be beautiful structurally or in measurements, but if it is not well integrated in the facial harmony, it will not look good. We must also pay attention to race, ethnicity, how people’s faces are different according to countries and races.

What does the procedure consist of?

Well, it basically consists of modifying the internal structures, which are the ones that really give the nose its shape, and the skin will adapt to the new contour that we have created. That is to say, through rhinoplasty we modify the bones, we modify the cartilage, we modify the internal structures and then what the skin will do is to adapt to these new contours. In cases of functional surgery, that is to say, to improve function, what we do is also modify the internal structures such as the nasal septum.

How long does it take for the patient to return to normal activity?

Well, the usual activity, the truth is that normally it could be done immediately, what happens is that the appearance, as the nose is in the middle of the face and it is what is most visible, so usually the first week is what we advise the patient not to have important activities because you have to wear a plate, a splint on the nose which is what usually makes the postoperative period a little more showy, but it is neither painful nor prevents any kind of usual physical activity.

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Is there any kind of mark or scar after the operation?

Usually not. Generally speaking, there are two types of techniques: the closed technique which is operated inside the nostrils and then the open technique in which a small cut is made here, in the columella, and a small mark is left there. So, some surgeons are more accustomed to the closed technique and others are more accustomed to the open technique. So I believe that it is a procedure that in general leaves very little scarring.

What types of results can be obtained with this technique?

Well, the types of results depend on two types, it depends on two things. First, how each case is and then secondly, the patient’s expectations, that is very important. That is why talking to the patient and dialoguing with her or with the patient is very important to know what she or he wants, to know what expectations she or he has. And then the type of results will always depend on each case, because what we do is to individualize the technique in each case, that is, there is no catalog where you choose “I want this nose”, but what we do is to advise the patient after listening to what he would like; we have to recommend what is best for his features.

How long will it take for the patient to appreciate them?

Well, they usually appreciate it right away, from the first week when the splint is removed, but the small details are appreciated after more time has passed. I always say that more or less a month after the operation, the nose already looks pretty good, but the final result we usually warn patients that between six months or a year because in the nose half a millimeter is important, half a millimeter counts. So a nose that is a little bit swollen will improve when that little bit of swelling is removed, which may take a few more weeks or a few more months, but usually the appearance is good after 15 days or a month.