Rhinoplasty Surgery: types, how it is done, price and FAQ

What is rhinoplasty?

Rhinoplasty is a surgical procedure whose main function is to reshape the shape of the nose. The etymology of the word comes from the two words of the ancient Greek rhinos , which means nose, and plasty , which means reconstruction.

Despite what many believe, rhinoplasty is not always performed for aesthetic purposes only. Many respiratory disorders, such as deviated septum, can be corrected through rhinoplasty.

It is a relatively simple surgery and without great risks. Historically, it is an ancient procedure, being first recorded in ancient India around 800 BC Over the years, it has been adapted and today it is done with strict medical standards that guarantee its effectiveness and safety.

Its postoperative period is almost always painless and, in cases where there is pain, it is easily circumvented through the use of algesics. It costs on average between R $ 7,500.00 and R $ 14,000.00 and must be performed by a qualified professional with a certificate from the Brazilian Society of Plastic Surgery (SBCP).

Although it is a simple procedure and with little chance of going wrong, it can bring some risks, especially if the anesthesia applied is general. Even so, the risks involved with general anesthesia are minimal.

There are two ways to perform the operation: the open method and the closed method. In open rhinoplasty, the doctor cuts the columella (lower part of the nose, just above the lip) and pulls the entire lining of the nose for greater visibility, while in closed rhinoplasty the procedure is done “blindly”.

Both procedures have practically the same results, the main difference being the fact that open rhinoplasty, in rare cases, leaves scars.

Its aesthetic purposes are varied. It can be done both to reduce the size of nasal structures and to increase them. It can be used to correct problems related to trauma to the nose or simply to provide the upturned shape, so desired by many people.

It is important to note that, in nose plastic surgery, the surgeon will make an assessment of the anatomy of the face and plan the surgery to leave the nose so that it is in harmony with the rest of the face.

Many people, including famous people, like Michael Jackson, performed several rhinoplasties looking for impossible results, which made their noses look deformed and with little harmony with the rest of the face.

For this reason, it is very important to maintain realistic expectations about the procedure and not to think that your nose will necessarily look like the celebrity you admire and mirror when it comes to the nasal shape.

The procedure is indicated for anyone who is not happy with the shape of the nose and sees some disproportion in that area of ​​the face. It can also be done by anyone with any anatomical problem that brings complications to nasal breathing.

It is contraindicated for children, people with clotting problems, patients who are facing illnesses and pregnant or breastfeeding women.

The procedure begins to show its results after 30 days of operation, and it is possible to view it in full approximately 6 months after the surgery.

Despite being quite popular, rhinoplasty still generates countless doubts among people who did it and who want to perform it. Ask your questions in the text below and have a good reading!

What is rhinoplasty for?

Rhinoplasty is a surgery that seeks to improve the aesthetics of the nose, as well as the breathing of the individual. In addition to correcting deformities, it can resolve structural problems that affect breathing. Results will vary according to the physiognomic characteristics of each patient.

In most cases, rhinoplasty seeks to produce changes in the appearance of the nose, reducing or enlarging it, improving its contour, narrowing or widening it, or changing the angle between the lip and the nose.

The procedure is appropriate from case to case. No result is the same. Many people say that it is possible to “see from afar” who did rhinoplasty, but this was only true 30 years ago, when the procedures were more standardized.

Nowadays, the doctor will analyze on a case-by-case basis and perform the procedure according to the patient’s wishes and as possible. Therefore, if you are thinking of having a rhinoplasty, talk to the surgeon well so as not to create impossible expectations.

Anatomy of the nose

Before we start to go into the details of rhinoplasty, it is important to understand what the nose anatomy looks like. When reading the text, many technical terms will be used to refer to parts of the nose, so it is important that you know exactly which parts of the body we are talking about.

Check below the anatomy of the nose:

Types

Rhinoplasties can be divided in two ways: by the objective of the treatment or by the way the surgery is going to be done, that is, whether it is open or closed – but this we will see later, in the topic “Open and closed rhinoplasty: what difference?”.

In this topic, we will focus on the different objectives of rhinoplasty, that is, we will analyze the differences between reduction, augmentation, ethnic and other rhinoplasty. Check out the differences between them:

Reduction rhinoplasty

Reduction rhinoplasty seeks nothing more than to reduce size or width, both of the tip and of the bones that form the back of the nose or nasal wings.

People looking for this type of treatment are unhappy with their nose because they think it is disproportionate to the rest of the face.

It is for people who think that there is some aspect in the anatomy of the nose that is very large that the reduction surgery is indicated. For this, there are two types of reduction rhinoplasty: resection of the nasal wings and reduction of the nasal dorsum. Understand the difference:

Resection of the nasal wings

When we talk about resection we are talking about removing a part of a tissue. In the case of this type of rhinoplasty, the tissue to be removed is found on the nasal wings, outside of the nose, also popularly known as “nostril”.

This type of surgery is performed when the patient has nasal wings that are too wide or too thick, to the point of being disproportionate to the rest of the face.

To calculate the ideal width of the nose, it is necessary to take into account the patient’s ethnicity. Caucasoid noses, that is, of white people, have a difference in proportion in relation to black noses, of black people, which are naturally wider.

Reduction of the nasal dorsum

There are several factors that can cause the nasal dorsum to be disproportionate. The most common situations are: very high back, very broad back and back with hump (that bulge, also called the “bump” or “curved”).

When deciding how high the back will be after surgery, male and female standards are taken into account. In such cases, an imaginary straight line should be drawn from the beginning of the nose to the tip.

For women, the nose considered “perfect” has a back that is approximately 2mm apart below the imaginary line. Men who want to maintain the masculine aspect of the nose should not lower the nasal dorsum too much.

Now understand the difference of the most common cases:

• High back and small tip: in these cases, where the back is high and the tip is small, the doctor will usually project the tip upward and, if necessary, make cartilage grafts;
• Back of the nose very wide: in this case, the rhinoplasty is performed through the scraping of the bones;
• Dorsal hump (lump): the dorsal hump is common in Caucasian and Hispanic noses and may be of bone or cartilaginous origin. Its resolution is simple, just remove the bony or cartilaginous excess that forms the protruding region.

Augmentation rhinoplasty

As the name implies, augmentation surgery is done to increase the dimensions of the nose. Augmentation rhinoplasty surgery may be necessary in the following cases:

• Congenital nasal underdevelopment;
• Loss of part of the nose after accidents;
• Unsuccessful rhinoplasty, when too much tissue is removed from the nose, leaving it in the shape of a cell;
• A simple disproportion that the patient believes to have,

Augmentation rhinoplasty is often necessary because of surgeries with poor results. They are very common, only that they do not always happen only due to medical error, but also due to the patient’s obsession with a perfect nose, as was the case with Michael Jackson.

In such cases, a graft is made with cartilage, usually removed from the septum, ear or ribs. Bones can also be used, which are usually extracted from the elbow or skull. Even so, it is also possible to use synthetic fillers, such as silicone.

The technique used will vary depending on the modus operandi of each surgeon.

This type of surgery is usually performed on Asian and African descendants who, due to their genetic characteristics, have low roots and backs and lack of definition of the nose.

Some Asians have the back of their nose so low that they can’t even hold glasses on their nose. In these cases, the surgery is not only aesthetic, but also functional.

Ethnic rhinoplasty

Ethnic surgery, in fact, is the name given to all types of plastic surgery on the nose for aesthetic purposes, since it seeks to change the shape of the nose, which is defined by the person’s ethnicity.

However, this term was eventually adopted to refer to surgeries performed on patients of ethnic groups that are characterized by having noses with smoother curves, such as Africans, West Asians and people from Oceania and their descendants.

The goal of ethnic rhinoplasty is not to lose the patient’s identity, quite the contrary. The truth is that surgery seeks to maintain the genetic traits characteristic of the patient’s ethnicity, and the procedure seeks only and only to soften traits considered coarse or too strong even for the aesthetic pattern of the patient’s ethnicity.

Post-traumatic rhinoplasty

Injuries sustained in the nose area can cause damage to bones and cartilage, causing the appearance and functionality of the nose to be altered. The most common changes are deviations in the septum, which leaves the nose askew and with respiratory problems in addition to nasal congestion, and asymmetries.

It is to reverse the effects of trauma that post-traumatic rhinoplasty is performed. If it is performed between one week and 10 days after the injury, your chances of success are much greater.

Columella correction

Many people cannot say exactly what bothers them on the nose precisely because they do not know the anatomy of the region. One of the most common problems that patients cannot explain is columella’s imperfections.

If you don’t remember what columella is, take a look at the topic “Anatomy of the nose”.

Columella problems usually happen for two reasons, either it is very large (pending), or it is very withdrawn. Understand the difference:

Columella retracted

Columella is considered to be retracted when it is too small and gives the impression that it “hides” inside the nose. This condition is easily corrected by means of cartilaginous grafts.

Columela pendant (large)

The pendant columella, or “hanging”, is the columella that, unlike the retracted one, stands out, presenting a disproportionate size in relation to the nose as a whole.

In these cases, rhinoplasty seeks to reduce the size of the columella by removing cartilage from the region.

Drooping nose while smiling

There are cases where the nose starts to point downwards when the patient smiles. This is easily noticed in profile pictures and is also corrected through rhinoplasty.

The nose “falls” due to the action of a muscle, which is called “nose tip depressor”. Therefore, the procedure simply seeks to break the connection between the tip of the nose and the upper lip.

It is the same technique used to correct the gingival smile.

Tip projection and rotation

This surgery seeks to provide the famous upturned nose that so many women dream of. To obtain this result, it is necessary to make the tip protrude and / or rotate upwards.

The projection and rotation rhinoplasty of the tip is limited to reusing sutures by repositioning, remodeling and symmetrizing the nasal tip. In many cases, especially in patients with black noses, it is necessary to perform a cartilaginous graft on the columella to help give the upturned effect.

Plastic surgery for crooked nose

To correct a crooked nose with rhinoplasty, it is usually necessary to cause a fracture. This, in itself, does not solve the problem. It is a delicate procedure, more complicated than the others, and which requires, in many cases, the placement of a graft on the side that appears to be bulged, in order to disguise the deviation of the nose.

Technique of the New Domes

The New Domes technique consists of reshaping the tip of the nose, rotating it, projecting upward ture and tapering. It is a conservative technique, usually done through closed rhinoplasty.

Open and closed rhinoplasty: what is the difference?

Many of the patients who are going to undergo rhinoplasty surgery wonder which one is the best: open or closed. However, to know which one is right for you, in addition to talking well with the surgeon, it is necessary to understand the difference between them. Understand:

Closed rhinoplasty

When plastic surgery started to become popular in the world, the technique used to perform rhinoplasty was closed. In it, the doctor performed the surgery blindly, through a tunnel formed until the region of the nose to be altered.

In order to better visualize how the procedure is done, we can make an analogy: it is as if a sculptor took a marble block covered by a blanket and, thus, in this way, tried to sculpt the piece.

Nowadays, the closed procedure is a little different, with two variations: classic and partial.

Classical

In classic closed rhinoplasty, the doctor performs the procedure without any field of vision.

Partial

In this technique, some incisions are made more inside the nose, bringing the cartilages of the nasal tip out of the nostrils, in order to leave them exposed, which allows the surgeon to have a partial view of the internal part of the nose during the operation. .

The downside of partial closed rhinoplasty is that the visualization ability experienced by the surgeon does not guarantee a faithful perception of the nasal anatomy, that is, the nose is slightly distorted from its “factory pattern” when observed during surgery. This can be a problem in rhinoplasties that require a greater degree of precision.

Advantages of closed rhinoplasty

Among the advantages of closed rhinoplasty, the biggest is the fact that the incisions are all made on the inside of the nose, resulting in no visible scar.

Another advantage exposed by doctors is that, through closed rhinoplasty, it is possible to have a better idea of ​​how the nose will look in the end, since it is seen normally during the entire procedure.

In addition, it is believed that this technique guarantees a lesser degree of swelling in the postoperative period, providing a faster recovery.

Disadvantages of closed rhinoplasty

The most relevant negative point of closed rhinoplasty is the fact that the surgeon has little visibility during the operation, which makes it difficult to perform more sensitive procedures that require a greater degree of attention.

So if you are going to have a closed rhinoplasty surgery, make sure you are in the hands of an experienced surgeon, as a high degree of professional skill is the biggest requirement for successful surgery.

Open rhinoplasty

Open rhinoplasty, on the other hand, is a little more recent than closed rhinoplasty. Invented at the beginning of the 20th century, more specifically in 1921, by the physician and surgeon A Rethi, this procedure involves the practice of incising the columella so that the entire cover of the nose can be dislocated, which opens the field of vision for surgery. .

When it was invented, the technique was widely criticized by other specialists in the field and it was only used in complex cases and in revision rhinoplasty (in which a second rhinoplasty is done to repair the aspects not solved in the first).

In a second step, the technique started to be accepted in cases that required intense changes in the tip of the nose, until, over time, the tactic was gaining adherents and came to be seen as a procedure also suitable for any case, be it complex or not.

Advantages of open rhinoplasty

The main advantage of open rhinoplasty is the enlargement of the surgeon’s field of vision, which allows the surgery to be performed in the most accurate way possible, with the detection of the exact elements to be corrected in an almost millimeter way.

In addition, open rhinoplasty is especially advantageous with regard to the precise positioning of the structures, that is, the chances of the procedure being unsuccessful are reduced.

The consequence of all this visibility is results that are more consistent with the patient’s desire.

Disadvantages of open rhinoplasty

The main disadvantage of open rhinoplasty is the fact that external incisions are made, which causes visible scars on the columella. However, although this seems like a problem, if done by a good surgeon, the scar is imperceptible in most people.

In addition to the scar, it is very common for this technique to cause more prolonged edema (swelling), making the postoperative period more boring and making the final result take longer to appear.

However, this statement must be considered with caution, since the difference between the recovery time of open and closed rhinoplasty is not very significant.

A comparative analysis of 82 cases showed that 6% of the patients who underwent closed rhinoplasty had swelling after a period of 3 months of the operation, whereas, among the patients who underwent open rhinoplasty, the number was 7.2%, or that is, a minimal and insignificant difference of only 1.2%.

Criteria for the new nose

Before anything, the doctor will evaluate your health conditions and several other factors always following a series of criteria for the shape of the new nose.

It will take into account aesthetic characteristics, such as proportion and facial symmetry, through measurements made on the face, always seeking to understand and respect the patient’s wishes.

In addition to assessing your general health status and your risk factors, you will also take into account:

• The characteristics of your skin (if it is thick, thin, oily, dry, etc.);
• The shape of the face, the distance between the eyes and the relationship of the nose to the eyes, forehead, mouth and chin;
• The competence of the nose for air passage, that is, the functioning of the nasal valves, the condition of the septum and the turbinates;
• The patient’s specific complaint.

Only after evaluating all these factors will the doctor arrive at the ideal nose shape and be able to offer you some kind of preview.

Today, there are 3D software that uses the patient’s own photo to put together a “before and after” version, but it is worth noting that these programs offer only a vague notion of how the result could look.

How is it done?

As we saw earlier, there are, in general, 2 types of rhinoplasty. Its execution will depend on the type of problem that will be solved through the surgery, but, in general, the surgeon will usually make incisions inside the nose in order to reshape it, either for aesthetic reasons or because of functional problems, such as a Deviated septum.

Consultation

First of all, you will make an appointment for a medical consultation to talk about what has been bothering you about your nose. After a quick exam, the doctor will tell you if your procedure is only aesthetic or if you can also try to solve functional problems.

If the doctor is in doubt, he may order some additional tests to ascertain with more certainty the presence of dysfunctions in the functioning of the nose. These exams include:

• Rhinoscopy: in which the doctor examines the inside of the nose with a device that opens the nostril to facilitate its visualization;
• Nasofibroscopy: consists of the insertion of an extremely flexible and thin optical fiber that evaluates the nasal cavity up to the larynx;
• X-ray: examination made with the use of electromagnetic radiation to assess the conditions of internal organs and structures.

When there is no doubt about the existence or non-existence of other problems related to the nostril and resolvable through a rhinoplasty, then you will start to talk to the doctor about your options and wishes.

You must inform the surgeon about everything that bothers you about your nose. Where do you think it is too big, where do you think it is strange and any anatomical aspect that makes you uncomfortable.

It is important to note that, during the consultation, the doctor will not only evaluate the aspects related to your nose, but will make an anatomical study of your entire face, taking into account your ethnicity, the shape and the harmony of the face as a whole. .

He takes all these factors into consideration because plastic surgery on the nose is a procedure that seeks to harmonize the nose in relation to each type of face and not necessarily make the exact nose that the patient wants .

This is done in this way so that the results are the best possible. Many patients arrive at the office saying that they want a nose similar to that of a famous X, but that desired nose shape does not always harmonize with the rest of the patient’s face.

As the nose is known as the “postcard” of the face, a nose out of harmony with the rest of the body can bring disastrous results to the appearance of the face as a whole.

After a lot of conversation, the doctor will show you what the possible changes are and you will evaluate what result you want to have. As previously mentioned, there are several problems that can be solved through rhinoplasty, such as the removal of the hump (a lump on the back of the nose) or the correction of columella (lower part of the nose, located just above the lips).

As soon as you decide which changes you want to make, the doctor will schedule the day of the surgery.

Preoperative exams

Before performing the cosmetic procedure, however, it will be necessary to perform a series of preoperative exams to ensure that the surgery will be successful and in the safest possible way.

The exams ordered will vary from doctor to doctor, but the main ones are:

• X-ray of the chest: to check the health of the lungs and the respiratory system as a whole;
• X-ray of the nasal bones: to check for the presence of deformities or previous fractures;
• Electrocardiogram: which seeks to ascertain the health of the heart, identify the presence of arrhythmias and other pathologies, to ensure the safety of the surgery;
• Blood tests: such as blood count, coagulation test, electrolytes, renal function, among others;
• Computed tomography: to check for the presence of bleeding, nasal breathing changes or recurrent sinusitis.

When you have all the required exams in hand, it’s time to get ready for surgery.

Preparation

Before performing the surgery, you will probably see the doctor again, in a consultation where he will explain in detail all the precautions to be taken before the surgery.

Some examples of the care that the doctor may ask for are:

• Complete fasting (you should not even drink liquids) during the 8 hours before the surgery;
• Avoid drinking alcohol until 1 week before the procedure;
• Prior planning of activities;
• Attention to health problems, such as infections, that can prevent the surgical procedure.

If you choose to have general anesthesia, the day before the surgery you will probably see the anesthetist in charge. He will do a standard exam, where he will ask about your history and compare with the data provided with the previous exams to ensure that the procedure has the lowest possible risk index.

On the day of the surgery, you should preferably arrive just before the scheduled time to ensure that there will be no delay. Once there, they’ll probably ask you to change your clothes and then they’ll take you to the operating room.

Procedure

Already lying on the stretcher, with all the doctors around them, they are going to prepare the surgical procedure. The doctors will talk to you to calm you down and make you as safe as possible.

In cases of local anesthesia, doctors will sedate you and apply local anesthesia, which will allow you to not feel pain while sleeping. In general anesthesia, the anesthetist will inject the solution into the vein and ask you to count from 1 to 10. You will not even be able to reach number 10, because the effect of anesthesia is very fast and you will soon be sedated.

During surgery, doctors will perform the necessary procedures to reshape your nose. In some cases, they will make simple scraping processes in order to decrease certain portions of the nasal structure, in others, they will make grafts to increase certain regions.

It all depends on what you have discussed with your surgeon before and what type of procedure you want to do. For example, there is open and closed rhinoplasty. When closed, there is no presence of external incisions and the operation is almost done “blindly”, while in the open, a small cut is made in the columella and the entire nasal lining is pulled upwards to give more visibility to the surgeon.

In some cases it is necessary to have a fracture of some parts of the nose, but this varies from case to case, being occasionally dispensable. Giba reduction surgeries, for example, in which only sanding of the region is necessary, usually do not need to fracture the structure.

After 2 or 3 hours you will wake up and the surgery will be done. It is possible that, right after the procedure, you will feel some pain in the operated area, after all, it has just been completely modified, but this, in most cases, does not happen, since the effect of anesthesia will still be felt by a time.

Afterwards, you will be taken to the hospitalization room, where you will be under observation for a period that can vary from 12 to 24 hours depending on how the surgery was performed and the doctor responsible for the procedure.

After going through all these steps, the doctor will release you to go home and give you all the instructions with post-operative care, such as how to deal with the cast, the ideal sleeping position, among others.

Rest

Then, you will be at rest, at home, for a period that can be 7 to 10 days to ensure the correct healing of the nose and give you time to recover from the surgical process successfully and safely.

After a week, the immobilizer plaster will be removed and you will be free to resume your regular activities.

The final result of the surgery will appear after about 6 months, during which time you may end up having to make other appointments with the doctor to evaluate the success of the surgery.

Procedures associated with rhinoplasty

It is very common for rhinoplasty to be performed in conjunction with other procedures, both facial, such as blepharoplasty (eyelid surgery), as well as nasal procedures, such as nasal septum correction and turbinectomy.

In the case of nasal surgeries, it is recommended that it be performed with the association of a plastic surgeon with an otolaryngologist. Understand:

Correction of nasal septum

This surgery seeks to correct deviations in the nasal septum, an internal structure that divides the nostrils, which are compromising the patient’s breathing.

Turbinectomia

Turbinectomy is a surgical procedure indicated to relieve chronic nasal congestion. In it, partial or total removal of structures known as the nasal turbinate will be performed.

Mentoplasty

Mentoplasty is a procedure commonly associated with rhinoplasty. It is made to redefine the contours of the chin and leave the face with more harmony.

Indications

In general, it is possible to state that rhinoplasty is indicated for anyone who is dissatisfied with the appearance of the nose. Being unhappy with the shape of the nose is something very common and can cause problems of self – esteem , since it is one of the “noble parts” of the face, being often referred to as the “postcard” of the face.

So, people who are feeling sad because of the shape of their nose should consider performing the surgery.

In addition, people with some type of respiratory problem, such as deviated septum, should also resort to rhinoplasty, as surgery, in addition to aesthetics, can solve these problems, increasing the quality of life.

It is worth remembering, however, that, first of all, it is necessary to choose a qualified professional and have realistic expectations about the result, after all, each case is different.

Contraindications

Every surgery has contraindications, and rhinoplasty is no different. Despite being a safe procedure, it can cause some complications for certain types of patients, such as:

• Kids;
• Who makes use of some type of anticoagulant;
• Patients who have hemophilia or other clotting problems;
• Patients who have some type of disease that is in an acute phase;
• Pregnant women;
• Breastfeeding women.

There are those who say that the surgery can be done from the age of 15. However, it is best to wait until the nasal formation is complete. So, for women, surgery can be done from the age of 18, while for men, from the age of 21.

There is no maximum age for rhinoplasty, but elderly patients should be more cautious, as the chances of complications are greater for these people.

Care before surgery

It is necessary to take some precautions before the surgery is performed, the night before and the day. Understand:

Before surgery

• It is important that, before surgery, during consultations, that you talk to your doctor about the possibilities and the real results. Take the opportunity to clarify the type of incision that will be made and if there is the possibility of scarring, in addition to the type of anesthesia to be used;
• Pay attention to your body’s signals. If there is any type of impediment, such as an infection or illness, notify the surgeon to reschedule the date. Not paying attention to these signs can lead to complications during the surgical procedure;
• Plan your activities so as not to become indispensable to third parties for a period of 2 to 3 weeks, the average recovery time;
• Avoid taking aspirin or drugs that contain AAS (Acetyl Salicylic Acid) and vitamin E during the 2 weeks before surgery. These substances can interfere with blood clotting processes and cause bleeding;
• Do not smoke during the 15 days before surgery, as this habit can delay the healing process;
• Provide a companion to take you and pick you up from the clinic;
• Tell the doctor if there is any case of herpes outbreak;
• Do not drink alcoholic beverages;
• Eat properly, in a healthy way;
• If you are a woman, tell the doctor about any menstrual delays or the possibility of pregnancy;
• Report any signs of a cold, conjunctivitis, herpes or any other infection that may arise in the week prior to surgery. In such cases, the surgical procedure should be postponed until the infectious process is resolved.

On the night before surgery

• Do not eat after midnight;
• Avoid alcoholic beverages or very large meals;
• Keep fasting for 8 hours before surgery, including water, coffee, candies and soda.

On the day of surgery

• Try to arrive at the clinic at least half an hour before the scheduled time, as a guarantee;
• Don’t forget to take preoperative exams and evaluations from other specialists;
• Take the prescribed medication;
• Do not use creams or makeup and keep your nails without enamel or base;
• Wear comfortable clothes, preferably cotton, that do not need to be worn over the head;
• Bring a small bag with objects for personal use;
• Do not take jewelry or valuables;
• When you arrive at the hospital, inform the name and telephone number of the companion or family member who will pick you up at the end of the procedure at reception.

Postoperative: how is recovery?

Care after surgery is not limited and must be strictly followed to avoid future damage. As previously stated, rhinoplasty, when performed poorly, can lead to problems such as deviated septum, so there is little care.

One of the most important factors is to keep the nose immobilized. In the past, in the post-surgery period, doctors used a post-operative plaster to immobilize the nose.

Nowadays this practice has fallen into disuse and a stiff plastic is used, which is more hygienic, in addition to providing greater fixation, allowing the nose to be immobilized for longer.

Therefore, in addition to avoid touching the operated region, you should also take other precautions, such as:

Keep home

During the first seven days after surgery, rest should be absolute and moderate until the fifteenth day. After this period, it is already possible to return to routine activities and work as long as physical efforts and exercises are not carried out.

Shake the body? Only after a period that varies from 2 to 3 months.

Breathing

During the first 7 days, breathing becomes more difficult. This is normal due to the formation of clots in the nose area. The surgeon will probably recommend decongesting serums to help you breathe during this period.

food

The entire region of the face, from the nose to the throat, usually gets quite inflamed during the first 7 days after surgery. Therefore, it is recommended to maintain a diet based on pasty foods, since the region is more sensitive and painful.

So don’t eat foods that require a lot of chewing, okay?

Pain Relief

In most cases, the postoperative period is painless. However, if necessary, the doctor will recommend the use of some painkillers to relieve it.

Use of sunscreen

As in the day to day, after the operation, it is very important to use sunscreen. This prevents the appearance of possible blemishes on the skin, especially if there are evident scars.

Sleeping position

During the first 5 to 7 days after surgery, it is recommended that the patient fall asleep keeping his head high with the help of pillows while sleeping.

This position prevents possible bleeding, which is natural in the post-surgical period, from being aspirated and going to the lung. Another advantage of sleeping seated is that the air flow improves, facilitating mouth breathing.

It is also important to avoid sleeping on your side or face down, as in these situations the nose can hit the pillow, causing pain and inflammation.

Other care

In addition to all these precautions, the patient must also avoid raising and lowering the head too fast, to avoid bleeding, in addition to not being able to blow his nose.

Wearing glasses can only be done after medical clearance.

Results

After 30 days, it is possible to see approximately 90% of the final result. The definitive may be perceived after approximately 6 months or 1 year.

Even so, it is possible to make a new correction through another surgery called secondary rhinoplasty.

A curious fact related to rhinoplasty is that many patients with rhinitis who underwent the procedure also reported significant improvements in their condition.

There is no scientific explanation for rhinoplasty to “cure” rhinitis, since the cause is genetic, which makes these cases even more curious.

What can affect the results?

Although it has not yet been scientifically proven, many doctors believe that the lack of necessary care in the postoperative period can affect the results.

Because of the complexity of treatment after surgery, the patient must take all necessary precautions, the main one being avoiding contact with the nose and its effort.

One of the major concerns of people who have undergone rhinoplasty is time to sleep. After all, what if I move in my sleep and rub my nose in several regions?

Well, any type of nasal contact can affect the results. So sleeping on your stomach or on your side, in a fragile position where you can turn, is out of the question!

Many doctors, then, indicate that you sleep on your back and with your head elevated, so that there is no pressure being imposed on the bones and cheeks, which can displace the nasal bones repositioned in the surgery.

Skin thickness

One of the factors that is directly related to the results of the rhinoplasty is the thickness of the skin of the patient undergoing the procedure.

First of all: the thinner the skin, the shorter the swelling time (edema). This is because the area to be healed is smaller, making recovery time faster.

In addition, thicker skin has more subtle results than thin skin. Therefore, however correct and efficient the techniques used by the surgeon, the work done on the nose is often not apparent. On the other hand, the thin-skinned nose cannot hide the most obvious imperfections in the underlying nasal skeleton.

An extremely thick nasal skin is one of the most difficult obstacles to be overcome by a surgeon in aesthetic rhinoplasty. If combined with a fragile cartilage, the surgery becomes even more complicated, because the creation of a defined tip becomes more complicated.

Patients with very thick skin take an average of 12 to 18 months to get rid of the surgical swelling completely. These delays are even greater for patients undergoing secondary surgery or for those with a history of nasal inflammation due to acne , allergic rhinitis or previous nasal injury.

Scratchs

Rhinoplasty is generally considered a safe surgery. In most cases, it is done with local anesthesia and sedation. It can also be done under general anesthesia. In these cases, the risks increase due to the anesthetic procedure, which is always more risky.

In addition, there are other risks related to surgery, such as:

• Bleeding;
• Septum injuries;
• Skin problems, including necrosis and irritation due to the immobilizer plate;
• Infection – easily preventable by using antibiotics after surgery;
• Severe nasal block caused by swelling of the region;
• Swelling around the eyes.

Risks of general anesthesia

If done correctly by a qualified anesthetist, general anesthesia does not present any major risks. The medical complications that can lead to death and that normally frighten patients are relatively low, affecting about 4 seeds per 1 million patients without serious illnesses.

Still, general anesthesia can cause some side effects, such as:

• Nausea and vomiting: occur shortly after the patient wakes up. They are frequent, but easily treatable;
• Difficulty concentrating and memorizing: they may manifest themselves in the days following anesthesia, disappearing spontaneously.

Still, there are more serious risks related to general anesthesia, such as:

• Marked drop in blood pressure;
• Convulsions;
• Cardiac arrest.

In addition, there is a chance of so-called residual paralysis. It is caused by muscle relaxants and is characterized by an inability to breathe deeply and cough, in addition to difficulty swallowing (swallowing). This condition can obstruct the upper airways, cause pneumonia and even lead to death.

It is worth remembering that the risks are closely related to the patient’s health status and that they are not the same for everyone. They are often related to pre-existing conditions and the complexity of the surgery itself.

When a more serious complication occurs during general anesthesia, it is rarely the fault of anesthesia alone, but of a number of factors.

Therefore, it is important to talk to the anesthetist about your entire medical history, as the chances of complications are increased by some factors, such as:

• Previous history of anaphylactic shock;
• Obesity;
• Smoking;
• Allergy to drugs and food;
• Habitual alcohol consumption;
• Use of illicit drugs;
• Sleep apnea.

It looks scary, doesn’t it? But don’t worry, as stated earlier, in healthy patients, the chances of severe complications happening are very rare . However, as all care is little, talk to the anesthetist a lot before surgery to avoid any kind of problem.

Price: how much does a rhinoplasty cost?

The prices of a rhinoplasty vary widely. Everything will depend on the quality of the surgeon who will assist you, the equipment and the technique used. However, we can say that the average price of a rhinoplasty is between R $ 7,500.00 and R $ 14,000.00.

This average is equivalent only to surgery for aesthetic purposes, that is, if you also seek to correct any functional problem through rhinoplasty, the prices may be higher.

It is very important to emphasize that one should not choose the cheapest surgeon ! The ideal is that you have contact with ex-patients and that the doctor is recommended by the Brazilian Society of Plastic Surgery (SBCP).

It is very easy to know if the surgeon is recommended by the institution. Just enter the website and search for the doctor’s name.

Common questions

Do you have to break your nose?

Not always. When the changes are subtle and do not require a reduction in the width of the nasal dorsum, the surgeon will need to perform only reduction procedures or with the use of grafts.

However, if the procedure requires changes to the back, there is a chance of bone fracture that, although it promotes edema and swelling, does not cause much discomfort or pain.

Patients who undergo procedures in which it is necessary to fracture the nose should only use plaster or plastic material to immobilize the nasal region during the first postoperative week.

Does the post operative hurt?

In most cases not . In practice, plastic surgery on the nose is painless. When an eventual pain occurs, it is easily treated by the use of analgesics that are prescribed by the doctor responsible for the procedure.

Pain, when it occurs, usually happens when changing dressings, removing the plaster or removing the nasal plug.

Is the result of the surgery immediate?

No! There are several characteristic phases in the postoperative period of rhinoplasty. After a week, with the removal of the plaster, there is still a swelling that decreases as the days go by. It tends to disappear around the 6th month.

There are patients who reach the final result a little earlier, as well as others who take a little longer. It is important to emphasize that the persistence of an edema for a longer period of time does not usually interfere with the result.

Open or closed rhinoplasty, which is the best?

Taking as basis the same study mentioned in the topic “Disadvantages of open rhinoplasty” (LINTZ, Jose Eduardo – Comparative analysis between open and closed rhinoplasty on tip treatment ) we can reach some conclusions.

In this study, among the several factors observed, it was found that about 85% of patients operated by the open method said they were highly satisfied with the results of the procedure. For patients undergoing the closed technique, this number was approximately 72%

Another interesting factor concerns the proportion of patients who underwent another rhinoplasty, that is, who underwent secondary rhinoplasty. About 6% of patients who underwent open rhinoplasty reoperated, while the rate was approximately 18%, that is, triple, in patients who underwent closed rhinoplasty.

Taking these data into account, we can affirm that, having as priority the degree of patient satisfaction, open rhinoplasty is better than closed rhinoplasty in most cases.

However, it is worth remembering that everything depends on the case that is taken to the doctor. In simpler cases, closed rhinoplasty may be more appropriate , as it can provide the same results in a less aggressive manner.

A good example of cases in which closed rhinoplasty is a better option is when the only problem to be solved is the hump, which only needs to be sanded, without opening the nose.

Ideally, all surgeons should be good at both techniques, but that is not what is seen in everyday cosmetic surgery rooms. On the contrary, each surgeon has more affinity with one type of operation, with the one he is most trained on.

So, the best thing to do is try to find the best surgeon possible within your financial conditions and talk to him a lot. A good conversation can help you to have realistic expectations and idealize a result that even the best plastic surgeon could not achieve.

The market shows that closed surgeries show good results with very experienced surgeons, that is, if you want to have quality closed surgeries and are sure that you will be satisfied, you will have to spend more money. On the other hand, if you want more affordable surgery, opt for open surgery.

Another interesting tip is to check if the doctor belongs to the Brazilian Society of Plastic Surgery . Just enter the website, click on the “Find a Surgeon” button and search for your doctor’s name. If he is not there, be suspicious.

Is it possible to choose the format I want?

No! Although it seems true that you can choose exactly the shape of the nose, this is not possible. This is because there is an aesthetic balance between the nose and the rest of the face and it is necessary to maintain it in order to preserve the naturalness and authenticity of the face.

Each case will be studied and discussed in detail with the patient, in order to give the nose the best shape possible within the requirements of the face.

If your choice coincides with the type of nose planned, your desire will undoubtedly be met, within the possibilities that the surgery offers, of course.

Does surgery help relieve with chronic coryza?

In some cases, yes . Ideally, you should talk to your doctor about it for more information.

Does rhinoplasty cause breathing problems?

Rarely . As long as it is conducted by a good professional and with all the necessary care, the risks of rhinoplasty resulting in respiratory problems are low.

How long does the obtained result persist?

The result of a rhinoplasty is practically definitive. However, it is important to emphasize that, after the fifth decade of life, any nose begins to show morphological changes due to the transformation of the quality of the skin that covers it.

How long does the surgery take?

The duration of a rhinoplasty varies a lot, however, we can say that it varies from 1 to 3 hours, depending on the complexity of the case.

There are techniques that are advertised as fast, lasting only 40 minutes, but it has been found that they bring artificial results and, therefore, are falling out of use.

Secondary rhinoplasty cases, on the other hand, can be more complicated and the operation can take up to 5 hours. Another factor that prolongs the duration of the surgery is the need to perform septoplasty (correction of the nasal septum) or turbinectomy (removal of the nasal turbinates).

What is the length of stay?

This will vary from surgeon to surgeon. Some release the patient on the same day while others prefer to leave the patient in hospital for a period of 24 hours.

Can you sunbathe after the surgery?

It is recommended that patients only begin to expose themselves to the sun after the third day after surgery.

For extended exposures, such as going to the beach or swimming pool, however, it is different. In such cases, it is advisable to wait a period of at least 15 days to avoid any stains.

Still, even after the expected time, it is recommended to use sunscreens.

How old is rhinoplasty possible?

The opinion of experts varies considerably in this regard. Some surgeons say that the ideal age for a girl is from 13 years old and for boys 17 years old, due to facial development.

However, others say that the best thing to do is to wait, for the girl, until 17 years old, and for boys, until 19, also for the same reasons.

It is recommended to talk to more than one surgeon before making the decision.

Can I have surgery with an otolaryngologist?

It is even more interesting to have surgery with an otolaryng instead of a plastic surgeon, because many patients, in addition to aesthetic discomfort, can also have functional problems, such as septal deviations, turbinate hypertrophy related to rhinitis, chronic sinusitis and other problems that otorhin is more qualified to treat.

What is the best time of the year to have a rhinoplasty?

There is a preference of patients to perform rhinoplasty in winter. However, it can be done at any time of the year. Still, the preference for the colder months has an explanation.

As in other surgeries, complications can arise caused by heat and exposure to the sun, such as the development of edema (swelling), pain, redness and discomfort in the operated area.

As avoiding exposure to sunlight is something recommended by surgeons, since it can make recovery difficult and leave spots on the face, postoperative care is another reason for this preference for winter.

The need to use dressings can be another annoyance in the heat, which is also a determining factor in the preference for the colder season.

Safe and effective, rhinoplasty surgery is a procedure that has made many advances in recent years. Even so, many people are frustrated with it because they have unrealistic expectations about the possible results and start operating again. Help these people better understand rhinoplasty by sharing this text!

Have you ever had a rhinoplasty? Do you think about doing it and still have doubts? Tell us more in the comments!