Rhinoplasty and how to achieve the perfect nose
Rhinoplasty or nose job: one of the top – if not the top – plastic surgery procedures. It is a safe surgical procedure with one of the highest levels of post-operative satisfaction, since the results are permanent and when successfully performed by an experienced plastic surgeon, it can bring about great and dynamic changes in the lives of the patients.
Rhinoplasty alters the shape of the nose, reducing or increasing the length, removing the pubis, changing the angle of the nose with the upper lip and most importantly changing the shape of the nasal tip with the use of sutures, modifying the cartilage memory. It is a procedure-challenge for the plastic surgeon, firstly because the diversity in the anatomy of the nose makes each procedure unique and secondly because alongside the aesthetic result it is important to achieve the absolutely functional one, which is free nasal breathing and a good sense of smell. Thus, at the same time as creating a more attractive nose, possible scoliosis of the nasal septum and hypertrophic conchas are corrected and other anatomical problems or congenital malformations (e.g. cleft lip) are restored, because… a nose that doesn’t breathe, no matter what beautiful!
Rhinoplasty can improve a person’s appearance and self-confidence, but it is not in itself a panacea for their perfection (especially if there are other imperfections, such as a hypoplastic chin), nor can it change the way they are treated the others. So the person who is interested in improving – and not necessarily perfecting – their appearance, who is emotionally stable and has realistic expectations, is a good candidate for rhinoplasty.
Judging by the interest of the people who visit my office in Athens and based on the annual statistics from the American Society of Plastic Surgeons (ASPS) and the International Society of Aesthetic Plastic Surgery (ISAPS), rhinoplasty is one of the most frequently in demand aesthetic procedure, winning the preferences of both the female and male population.
The goal of rhinoplasty: new image, better breathing
The variety of types, sizes and quality of sutures, the use of grafts and the evolution of plastic surgery techniques today make it possible to correct all nose imperfections, from the smallest to the largest – and indeed with great precision and predictability . By reshaping the nose, reducing or increasing the length, removing the pubis, changing the angle of the nose with the upper lip and above all changing the shape of the tip of the nose with the use of sutures – modifying the cartilage memory – rhinoplasty dramatically improves the overall image and facial expression, bringing about great and dynamic changes in the lives of the subjects.
The value of the preoperative session for the success of the result
The selection of the appropriate plastic surgeon, with experience in performing the procedure and the correct pre-operative evaluation are the beginning of a successful rhinoplasty. During the first visit, the plastic surgeon analyzes the face and assesses the nose as well as the individual features that may need to be corrected. At the same time, the factors that can affect the result of rhinoplasty are explained. These factors include the shape and size of the face, the convergence of the upper and lower jaw, the structure of the bones and cartilages of the nose, the thickness and type of the skin, the age and of course the expectations of the candidate.
Realistic expectations, excellent cooperation between the rhinoplasty candidate and the plastic surgeon and their productive communication are of major importance for the success of the procedure.
Appropriate age
The medical assessment for rhinoplasty is possible after the completion of the size and shape of the interested party’s nose, which is why the completion of the development of the visceral skull is a necessary condition. This fact means that younger applicants need to be in their late teens before they can undergo rhinoplasty. Thus, for boys the procedure is recommended from the age of 18 onwards, while for girls from the age of 17 onwards.
Apart from age, of course, the candidate’s emotional maturity is also of great importance for experiencing high post-operative satisfaction from rhinoplasty. Especially in recent years, the popularity of sharing photos through the social networks Instagram, Snapchat and Facebook push many young women and men to undergo cosmetic surgery on the face. Of critical importance, therefore, for the success of the surgery is, through the pre-operative session with the candidate for rhinoplasty, to highlight their free, conscious decision. The plastic surgeon must objectively examine all the data and clearly define the margins of change, setting realistic expectations for the candidates.
As for old age, this is not a contraindication for rhinoplasty. It is a fact that over time the skin loses its elasticity due to the decrease in collagen production: thus, very mature skin cannot have the same reaction as young skin. This makes achieving the perfect result more challenging, but not impossible. The progress of plastic surgery and the evolution of techniques are “on the side” of the more mature age interested parties, since the respect for the tissues of the nose, which governs plastic nasal memory surgery (nasal memory surgery), ensures a natural and predictable aesthetic result with improved functionality of the nose.
Personalized rhinoplasty: focus on your own face
Even if you have in mind a certain style of nose or a nose that belongs to someone you admire, you should not forget that this nose is attractive only because it “ties” with the facial features of that person. So forget the standards: there are no “molds” or one size of nose that fits all. The ideal nose for you is the one that suits your own face. Customization and achieving harmony of the nose with the rest of the facial features will determine the success of your rhinoplasty.
Achieving the harmony of the nose with the rest of the facial features highlights the necessity of personalization in order for rhinoplasty to be successful. To the people who come to the doctor’s office holding a picture of a celebrity and ask to have the same nose, we say that the nose might be perfect for that person, but it might not suit them. Therefore, good communication between the rhinoplasty candidate and the plastic surgeon is very important throughout the entire procedure.
Open rhinoplasty: the precision method
Rhinoplasty can be performed with the open or closed method. In open rhinoplasty the cartilages of the nose are exposed by detaching the nasal skin, which is achieved through a small external incision on the stylet, i.e. at the point of the nose located between the two nostrils. In this way, the plastic surgeon obtains a wide visibility of all the anatomical elements that he is going to reshape. It becomes possible to fully visualize the internal structures of the nose and to place the sutures in the exact places, while even the most difficult problems, which may have arisen from a previous failed rhinoplasty, are repaired. In other words, nothing is left to chance, unlike the closed rhinoplasty method, where all the work of the plastic surgeon is guided by touch. In addition, the lifting of the nasal skin together with the membranes, which carry vessels and nerves, ensures a more atraumatic procedure and therefore less pain and less edema (swelling) postoperatively compared to the closed method. In any case, the method chosen to perform rhinoplasty depends on your individual needs, which are assessed during the pre-operative session.
The modern trend in rhinoplasty: Non-traumatic and with faster recovery
The respect for the tissues with which one was born and the discreet handling of the nose by the experienced plastic surgeon make the rhinoplasty procedure painless, since they minimize pain, allow a short return to activities – with constant optimization of the aesthetic result – while swelling and bruising are minimal to non-existent.
Nasal memory surgery: natural, predictable and permanent result in rhinoplasty
The innovative nasal memory surgery technique consists in avoiding exaggerations and makes sophisticated tissue removals belong to the distant past of plastic surgery. It takes into account the fact that the tissues that make up the nose are dynamic, having a memory: so, in essence, we intervene and modify the memory of the cartilages so that they “forget” to return to their original position. The hitherto classic opinion that in the majority of rhinoplasty cases mainly tissue removal was required is not true, since this procedure resulted in a skeletonized nose, with an unnatural, artificial and above all unpredictable result that was visible to any neutral observer.
With nasal memory surgery, the minimally necessary amount of the precious tissue of the nose is removed and the rest is reshaped using specialized microscopic sutures, which are placed at key points, allowing the cartilage memory to be redefined. In this way, a natural, personalized, predictable – with millimeter precision – and permanent result is achieved, without the risk of returning the cartilages to their original position.
The advantage of nasal memory plastic surgery is that the minimal necessary amount of precious nose tissue is removed and the rest is reshaped using specialized tiny sutures, which are placed at key points, allowing the cartilage memory to be redefined. This avoids the risk that a few months after its implementation, the cartilages will return to their original position, so that the aesthetic result is, in addition to being natural, also permanent. This not only avoids the risk of postoperative breathing problems, but can also correct any existing aesthetic problems from previous failed rhinoplasty (corrective rhinoplasty).
The procedure is absolutely painless, lasts one to two hours, is performed under general anesthesia, and is usually discharged on the same day (day hospitalization). The return to work takes place in one week, while to dynamic sports after 5 weeks. The complete subsidence of the swelling occurs in 1-1.5 months.
Rhinoplasty with the nasal memory surgical technique ensures the absolute functionality of the nose and a new attractive shape, while it can correct problems left by previous failed rhinoplasty.
Nasal tip plastic surgery
The tip of the nose is the lower third of the nose, which includes the central lobe, the lateral parts and the style. It is the most sensitive anatomical element of the nose: even a minimal intervention on the tip of the nose can create an impressive change in the face.
Despite the fact that there have been researches related to the achievement of the aesthetic perfection of the nose and attempts to objectively capture the ideal projection of the tip of the nose, these have been illusory, since there is no internationally recognized aesthetic standard. Thus, for everyone, the ideal tip is the one that harmonizes both with the other anatomical elements of the nose and with the rest of the facial features. That is why the surgical plan, drawn up by the plastic surgeon after the pre-operative evaluation of the person concerned, is completely personalized: it depends on the configuration of the soft tissues and cartilage of the nose, factors responsible for supporting the nose and the way they are correlated, the weight that each surgical manipulation or combination of surgical manipulations will have on the final result.
The modifications that can be made to the tip of the nose with rhinoplasty concern the correction of its volume, projection and angles. More specifically, nose rhinoplasty can correct droopy nose, reduce bulky nose, improve wing-pillar relationship.
The unnatural, artificial and unpredictable results, which were visible to any observer, belong to the past of cosmetic surgery, since the modern trend in rhinoplasty is the most non-traumatic and fast recovery technique possible. In this context, nasal memory surgery allows for absolute precision and predictability of the result, since it is carried out by removing the minimally necessary amount of nose tissue and placing highly specialized microscopic sutures, which ideally shape the tip of the nose . In cases of minor problems, nose tip rhinoplasty can also be performed with local anesthesia or intoxication.
Rhinoplasty: aesthetics and functionality combined
The nasal septum is the anatomical part that internally supports the nose, separating the right from the left nostril, i.e. dividing the nose into two equal parts, the nasal chambers.
Scoliosis of the nasal septum (crooked septum) is a very common condition, which can be due to heredity or injuries and injuries to the nose. Thus, a large percentage of people with a crooked diaphragm suffer from difficulty breathing, experience frequent headaches or even migraines and poor sleep quality (snoring, even episodes of sleep apnea) and are prone to rhinitis, sinusitis, pharyngitis.
Rhinoplasty can correct all functional problems of the nose, with its success consisting of accurate and detailed preoperative planning, since the diversity in the anatomy of the nose makes each procedure unique. The procedure consists of either removing the scoliotic part of the septum and fixing it in the center of the nasal cavity or, in more severe cases, removing the entire septum, reshaping it on the operating table and repositioning it in the nose.
However, even in the event that there is no problem with the diaphragm and the rhinoplasty is performed solely for aesthetic reasons, it is often necessary to adapt the diaphragm to the modified nose (e.g. taking cartilage grafts to support the tip of the nose) so that problems do not arise breathing in the future.
Therefore, in rhinoplasty…aesthetics and functionality “go together”, since breathing belongs to the body’s vital functions
Correction of a failed rhinoplasty
Rhinoplasty, as shown by the medical literature, has one of the highest rates of repeat procedures: this fact highlights on the one hand the demandingness of the procedure from a surgical point of view and on the other hand the importance of the research of those interested in the choice of the plastic surgeon. However, even with a successful choice of doctor, sometimes, unfortunately, the necessity for corrective rhinoplasty arises due to unforeseen factors e.g. poor healing from the first procedure or accident;
A failed rhinoplasty is characterized by a standardized and unnatural aesthetic result, blemishes such as dorsum defects and asymmetry in the lateral lines of the dorsum, nasal tip deformities, and unresolved or new nasal functionality problems such as worsened rather than improved breathing.
In the case of secondary rhinoplasty, the nose has already been anatomically modified once, so the procedure is even more technically demanding. The goal is to improve the aesthetics of the nose, achieve functionality and minimize additional scarring.
Corrective rhinoplasty can only be done using sutures if the problem is limited to the tip of the nose. In more extensive problems, reconstruction is performed using diaphragm grafts, which are considered the best “material” for creating a stable nasal structure and addressing a wide range of aesthetic and functional issues. In cases where the diaphragm has been damaged, donor areas are the auricle of the auricle or – in rarer but existing cases – the ribs.
An experienced, specialized – with a large number of rhinoplasty procedures to his credit – a certified plastic surgeon, is able to make a full assessment of the nose and previous surgical techniques, designing the surgical plan to achieve satisfactory results from the secondary rhinoplasty.
With the nasal memory surgical technique, which I apply, not only is the possibility of needing a repeat procedure minimized, but effective correction of a previous failed rhinoplasty is also achieved, both aesthetically and functionally. Additionally, because this particular technique maintains great anatomical continuity in all the actions of the plastic surgeon, even any micro-correction that may be required is very easy and can be done under local anesthesia.
High levels of postoperative satisfaction
Rhinoplasty is the operation that gives the most impressive change in the appearance and expression of the face, bringing about the most spectacular changes in the lives of those undergoing it. People who underwent rhinoplasty with the rhinoplasty memory plastic technique report about their experience: “The first thing that rhinoplasty gave me was my smile, which I held back almost permanently – because when I smiled my nose protruded more – or when I dared to I used to put my hand in front of my nose”, “my nose has kept its elasticity, it doesn’t look “frozen” or with stretched skin…I don’t feel anything unnatural or foreign about my face”, “the confidence I gained through rhinoplasty has positively affected my life, improving my personal and professional path”, “my communication skills have improved, the way I speak and look at my partner has changed…my entire facial expression has changed”.
When will the result be visible?
The result of rhinoplasty is visible from the moment the nasal splint is removed, i.e. approximately one week after the operation. However, the nose after the operation needs the appropriate time to heal sufficiently and any edema (swelling) to subside. Therefore, after 2-3 weeks you will be able to make an even better evaluation of the result with your plastic surgeon. This, of course, does not mean that you cannot have a full social activity after the initial recovery. In the following months the result continues to improve and stand out more and more until its finalization. The fact that its aesthetic result has long time margins for optimization is one of the strong advantages of rhinoplasty, which should “supply” candidates with optimism.
But how can you contribute positively to the final result of your rhinoplasty? Adherence to the pre-operative and post-operative instructions given to you by your plastic surgeon is of crucial importance in order not to risk the success of your operation. It is also important to avoid, in the immediate post-operative period, actions that can cause bleeding and to protect the operated nose from blows, especially when you are in crowded places. It is good for the first month and a half after surgery to avoid vigorous sports and to take appropriate protective measures when engaging in activities that expose the area.
Cost of the procedure
The cost of rhinoplasty for cosmetic purposes is not covered by the insurance funds, except when there is co-existing deformity of congenital or traumatic etiology and at the same time a respiratory problem due to scoliosis of the nasal septum. Therefore, the type and size of the problem, the method and technique that will be chosen, the cost of the clinic and the anesthesiologist, will determine the exact cost of rhinoplasty, about which you will be informed by the plastic surgeon in the pre-operative session. In any case, the cost is not disproportionate to the unique and lasting benefits that a successful rhinoplasty procedure provides.
Rhinoplasty without a scalpel
Many interested in changing their nose ask the plastic surgeon about non-surgical rhinoplasty. The non-invasive ways in which we can achieve a “camouflage” of small deformities of the nose are hyaluronic acid and, for a longer period of time, the use of our own fat (autologous) – which is a source rich in stem cells (micro fat grafting technique ). In no way can these methods be compared to surgical rhinoplasty, since they cannot drastically or permanently change both the appearance and the function (breathing) of a nose, nor can they restore anatomical problems, fractures or particular deformities of the nose. They are simply a useful alternative method for correcting small problems or some imperfection, which can also arise post-operatively. And of course, the only one who is suitable to carry out rhinoplasty without surgery and to judge the absolute indication is the plastic surgeon, since he has the ability to apply the whole range of treatment options.
Rhinoplasty FAQs
Are there different options for surgery? What is open and closed rhinoplasty?
Rhinoplasty, both primary (first time) and secondary rhinoplasty is a large part of my work. Open rhinoplasty, first practiced in America in the 1990s, is a rhinoplasty technique where the cartilage of the nose is exposed by detaching the nasal skin. This is achieved by a small external incision on the stylet, i.e. on the point of the nose between the two nostrils. The biggest advantage of open rhinoplasty is the wide visibility given to all the anatomical elements that the plastic surgeon is going to reshape. It becomes possible to fully visualize the internal structures of the nose and to place the sutures in the exact places. It all depends on the particular needs of each candidate, which are assessed during the pre-operative session. Usually the open method is chosen to correct more difficult cases, while the closed method is used for those cases where the soft parts of the nose, such as the tip of the nose, do not need special changes.
How careful do I need to be after my rhinoplasty?
In general, rhinoplasty is a safe surgical procedure that yields excellent results in a person’s appearance and life. As in any surgical procedure, in the immediate post-operative period it is recommended to avoid actions that increase possible bleeding and in the medium term, for a period of about a month, to avoid boring (hitting) which can initially cause pain and in rare cases damage the post-operative result. That is why it is good for the first month and a half after surgery to avoid vigorous sports and rhinoplasty patients to take appropriate protective measures when engaging in activities that expose the area.
Can rhinoplasty be combined with other procedures?
Many times it is combined with chin surgery, which restores chin problems and helps to further enhance the aesthetic effect of rhinoplasty. Also, minimally invasive intervention on the upper lips with hyaluronic acid or fat may be needed to achieve symmetry. The combination of all these offers women and men a spectacular improvement in the overall image of their face and a new profile.
I am concerned about the scar that may be left from having rhinoplasty with the open method. Is this a problem?
The scar formed by the incision created in the stylus, contrary to what many people think, heals completely and rarely creates aesthetic problems. If the incision is properly planned and well sutured – tiny sutures, etc. – in a few weeks after the procedure is completed it is no longer visible.
How successful is rhinoplasty in old age?
If rhinoplasty is done at older ages, it should be taken into account that the skin loses its elasticity due to the reduction in collagen production, which makes achieving the excellent aesthetic result more demanding. Skin elasticity is not the same at twenty and fifty. When we reduce a large nose and after a week we remove the splint that holds the bones, we will see that the young skin has “picked up” thanks to its elasticity. Conversely, very mature skin will not have the same reaction, resulting in a disproportion with the frame and a puffy nose. Of course, in order not to discourage some older people from carrying out an procedure that they may have had a burning desire for all their lives, we tell them that with the new open method of nasal memory we can ensure them the desired aesthetic result.
What is non-surgical rhinoplasty?
Essentially, it is an application of injectable implants (“fillers” of hyaluronic acid), with which we achieve a camouflage of small deformities of the nose. It is in no way comparable to rhinoplasty surgery, because it cannot drastically or permanently change both the appearance and function (breathing) of a nose, but it can hide small bumps and create a better-looking ridge, changes which they can make the nose look more attractive. This minimally invasive technique is performed in the doctor’s office and has immediately visible results. After the application of local anesthesia, the plastic surgeon injects the fillers with small injections into the nose and shapes them, giving a more beautiful shape to the nose. The entire procedure takes about half an hour and the return to daily activities is immediate. Fillers are not, of course, the solution for everyone who considers their nose unattractive, nor can they restore anatomical problems, fractures or particular deformities, but they are a useful alternative method for correcting small problems, as well as some small imperfection that may occur postoperatively. And of course, the only one who is suitable to perform rhinoplasty without surgery and to judge the absolute indication is the plastic surgeon – and not another specialty – because he has the ability to apply the entire range of treatment options.