Rhinoplasty - what is it?
Rhinoplasty is surgery on the external nose to change its shape. Rhinoseptoplasty is Rhinoplasty with one-step septoplasty (a surgery performed specifically to improve nasal breathing). There are two techniques of Rhinoplasty / Rhinoseptoplasty - open (without) and closed (with a cut of the skin under the tip of the nose) type. Positive aspects of Open Rhinoplasty: good access, visualization and adequate examination of the structures of the nose during surgical intervention, for more accurate modeling and changing its shape. Negative: presence of a cut of skin under the tip of the nose. The positive and negative sides of Closed Rhinoplasty - on the contrary. The suture after the surgery is not visible in 1.5-2 months, and visualization with Open Rhinoplasty for more accurate work with the structures of the nose is much higher. Besides, Rhinoplasty can affect different parts of the nose (bone and cartilage). It is possible to perform surgery only on cartilage, or bone and cartilage sections, depending on the anatomy and patient’s wishes.
Rhinoplasty preoperative preparation
- Before the surgery, it is necessary to warn about the previous surgeries, nose injuries, and general diseases. You should inform if there were any scars, stitches. It is necessary to show them. It is important to tell how quickly bruises go off after strokes and injuries and abrasions are healed.
- Before the surgery, you will be photographed in different angles (the face and neck will be photographed), so it is recommended to come with least make-up or without it. After photographing, the modeling can be done if needed. This modeling does not mean exactly such a final result. Modeling is a computer-modified photo (a concept) towards which we aim for better understanding the patient’s wishes.
- It is recommended to undergo a standard set of laboratory examinations before the hospitalization and anesthesiology. The minimum set of tests: general blood test, blood biochemistry, simple urine test, coagulogram, blood group and Rh factor, chest X-ray, electrocardiogram. Other tests may be also necessary: CT of the nose and paranasal sinuses, consultation of a pulmonologist or cardiologist. The surgery is performed under general anesthesia, so you need to exclude alcohol; smoking must be reduced to a minimum, do not overeat the night before surgery. It’s necessary to take comfortable clothes with you to hospital:, a few t-shirts, panties, changes or slippers, provisions for personal hygiene, something for leisure (books, laptops), assuming that it will be 2-3 days in hospital. Valuable things are better to give to relatives or warn the medical staff about their existing on the day of the surgery.
Day of Surgery:
If the surgery is scheduled for the first half of the day, you are not allowed to eat or drink on that day, as having an empty stomach is important during a surgery and anesthesia induction. If the surgery is scheduled for lunch or after lunch, you should calculate that the last meal of light food should be 6 hours before surgery, the last intake of clean water in the amount of 100 ml should be 4 hours before the surgery. In the ward, you need to change clothes and expect the time you will be called. In the case of surgery under general anesthesia, the most unpleasant thing for you will be one injection in a vein. And that's all. There will be no more discomfort and painful sensations. You will be put on the table and tied, but not in order that you do not run away, but for you not to fall off the table when you are under anesthesia. In case of local anesthesia, you are conscious.
Immediately After Surgery:
After the end of the surgery, when you wake up, you will have a plaster cast or Thermo-Splint on the nose and forehead. The facial expression should be minimized in order not to shift the cast. There will be dressing in the nose. Dressing is different (with and without tubes, laminated and with the addition of hemostatic), but you should not think about nasal breathing until they it is in the nose. A bandage can be under the nose, which performs exclusively hygienic function. Until full awakening, you will be under the anesthesiologist's supervision and only after that, you will be transferred to the ward. So, if you were told, that the surgery lasts approximately 2,5 - 3 hours, it does not mean that immediately on its termination you will be transferred into a ward. This can take another 1-2 hours. Once you arrive in the ward, you will be allowed to drink in 2-3 hours.
Postoperative Clinic care:
Dressing in the nose are usually removed on the 3-4-th day. Splints are removed on the 6-7-th day. Sutures are removed on the 7-8th day. Thermal splint is removed on the 6-7-th day and is put on again for another 5-6 days. Stitches under the nose should be treated with an antiseptic (40 °) every day.
You should lie and sleep with your head raised. Minimize salt intake!
Liquid - In the morning, drink as much as necessary. In the afternoon - moderately. In the evening - a minimum water intake.
Antibiotic therapy lasts from 5 to 10 days in different cases, depending on the surgery and the patient.
Saline water - after dressing removing. Irrigate your nose 2-3 times a day for 2 weeks.
Lyoton / SinyakOff with a tonal effect - lubricate under the eyes after the surgery. Swelling and bruising are possible.
Polidexa nasal drops for 7-10 days.
(Detralex) Venotonics are needed for 2-3 weeks after the surgery.
Stratoderm / Dermatrix / Contractubecs - After removal of stitches, treatment with antiseptic continues, the next day start using silicone - containing creams for 2-3 weeks.
If it is necessary to wash your head, it is better to do in the hairdresser. (All the recommendations and preparations mentioned above may be different, in connection with your individual characteristics and the type of surgery performed).
Postoperative Care at home and recommendations:
After removing dried gypsum and sticking the plaster, the plaster will need to be glued on the nose for a week, and for another week at nights. It is necessary to massage lateral nasal wall and bone part for proportional bone callus for 10 days after the surgery. You can take a warm shower but avoid taking hot baths for 1-1,5 months. Do not sunbathe for 1.5 months. Do not wear glasses for 2 months after the surgery or use special forehead holders. Consultation after 1 month, 3.6 after surgery. The final result can be evaluated no earlier than 6 months after the surgery. Sports activities- after 20 days easy physical load / fitness, after 1.5 months other loads.