Rhinoplasty or rhinoseptoplasty is the aesthetic and functional intervention that deals with the correction of deformities of the nose, treating the nasal osteocartilaginous structures to correct both the external shape of the nose and the deviation of the nasal septum. In this way a better appearance, better shape and harmonious size of the nose is achieved, proportional to the face and maintaining the nasal respiratory function.
Nasal interventions are one of the most frequent within the Plastic Surgery and Facial Aesthetics and can be primary (for the first time in a person) or secondary (surgeries to improve the results of a primary rhinoplasty).
Rhinoplasty Techniques
Rhinoplasty techniques used for nasal correction can be:
- Rhinoplasty operation:
– Closed rhinoseptoplasty: it is the most classic and the first one described; all its incisions are hidden inside the nose. Since it is more difficult to visualize the internal structures of the nose, it is a more complex technique and requires more experience on the part of the surgeon. It usually presents less postoperative edema, with less risk of infection and of altering the cutaneous circulation.
-Open rhinoplasty: this technique, in addition to the internal incisions, associates an external incision in the lower part of the columella (medial part that separates the two nostrils). This allows to detach and lift all the skin of the tip, visualizing better the internal structures and allowing a direct remodeling. It requires less experience on the part of the surgeon, although it is more invasive and leaves a scar that in most cases is not very visible.
– Open-closed rhinoseptoplasty (delivery technique): it is a technique that combines the advantages of handling the internal nasal structures with direct vision (open technique), but without making the incision in the Columella and, therefore, without leaving visible scars (closed technique). It is the least known technique but with the greatest advantages of all the techniques.
- Non-surgical rhinoplasty or Rhinomodelation: it is a relatively new technique, without surgery, which consists of using a substance (resorbable or definitive) biocompatible with the body to fill certain strategic points of the nose, achieving changes such as: lengthening, profiling, tip lifting and correction of humps, with very acceptable aesthetic results from the moment of application. It is a technique with practically no postoperative period and with an instantaneous return to normal activities. It is very useful and is increasingly used to improve the results of secondary surgeries and also in some primary surgeries, with very satisfactory results. It is very important the previous evaluation of the indication of this procedure in each patient, to see how the nose is going to look like and the points that need to be corrected.
Advantages of Rhinomodelation
- It does not require surgery, there is no surgical trauma.
- Lower cost than a rhinoplasty.
- Fast technique, your change is achieved in less than 20 minutes.
- With this technique, you can forget about the annoying plaster casts, nasal plugs, bleeding and all the post-operative discomfort.
Disadvantages of Rhinomodelation
- It has precise indications and it is not suitable for all cases.
- It does not improve respiratory function.
- In case of using reabsorbable filling materials, it is not definitive.
– Botox. It is infiltrated at the level of certain muscles of the nose to change the appearance of the nose.
– Suspension threads. They are placed in the dorsum to achieve a lifting of the tip.
With these techniques, annoying splints, nasal packing, bleeding and all postoperative discomfort can be avoided.
In preparing for nasal correction, as with any treatment, it is important to listen to the patient’s concerns and desires, as well as to know why he/she has made the decision to undergo nose surgery. To value the aesthetic and/or functional motivations, making them have realistic expectations of the possibilities of each technique, that they are informed of all the possible consequences and possible adverse effects.
Rhinoplasty operation
In surgical cases, it is necessary to perform a complete preoperative examination with analysis, ECG, X-rays and pre-anesthetic assessment.
Like other cosmetic or reconstructive surgeries, this is performed in a clinic with a fully equipped operating room and a room suitable for postoperative recovery.
The intervention usually lasts between 1 and 2 hours. It is usually performed under general anesthesia, although it can also be performed under local anesthesia and sedation.
On leaving the operating room, during recovery, patients normally wear endonasal plugs (which are removed between the first and third postoperative day) and an external nasal splint (which is removed about a week after surgery).
There are discomforts derived from rhinoplasty (packing, bruising and swelling) that diminish rapidly within the first 8 – 10 days. Daily life is usually resumed within a week, although caution should still be exercised during the first month in performing activities with risk of hitting the nose.
Although improvement is usually seen as soon as the cast is removed, definitive results cannot be assessed until 6 – 9 months.
The nose as a medial structure in the face is one of the most decisive in the facial appearance together with its important function in breathing. The fact of undergoing this intervention is always linked to aesthetic, emotional and functional factors, so the plastic surgeon must correctly interpret what the patient’s aspirations are and explain in detail the steps and aesthetic and functional results so that they are understood by the patient.