Rhinoplasty has been performed for at least 5,000 years, with the first treatment to repair a broken nose first mentioned in the Edwin Smith Papyrus, the world’s oldest known medical work dating back to ancient Egypt from 3000 BC. This procedure has also been recorded in ancient India, the Roman and Byzantine empires, through the Middle Ages and into the modern era. A variety of surgeons had significant contributions to the development of rhinoplasty techniques at the turn of the 20th century.
Rhinoplasty has steadily increased in popularity since the 1950s, and as the procedure evolved, it became more accessible. In fact, recent statistics compiled by the American Society of Plastic Surgeons show that more than 210,000 people underwent rhinoplasty in 2015, while that number increased by 33.2% in 2018.
The physical and functional benefits of rhinoplasty
The procedure’s popularity is due in large part to the variety of functions it performs to improve the appearance and symmetry of the face. Rhinoplasty can reduce or increase the overall size of your nose, straighten a crooked nose, change the shape of the tip or bridge, narrow the opening of the nostril, or even change the angle between your nose and upper lip. Rhinoplasty can also help patients who need nasal reconstruction to improve their breathing and the airway in the nose.
Some of the most common reasons to undergo rhinoplasty:
- cosmetic goals
- Correction of a crooked or prominent nose
- Improve the width of the nose
- Correction of a pointed, upturned or drooping tip
- Correction of extremely wide apertures
- Smoothing the bump and protrusion of the bridge of the nose
- Correction of an asymmetric nose
- Correction of damage caused by nose accidents
- Correction of respiratory problems, such as a deviated nasal septum
- Correction of sinus problems such as sinusitis
How does aging affect the shape of the nose?
As we age our noses tend to undergo some expected changes, as the skin starts to sag in the nose tip area and starts to fall off due to gravity. This can give some people a not-so-good appearance in their nose. But in most cases, this is not an actual bump, but rather an appearance that just occurs as the tip slowly moves away from the tip of the nose.
This begins to manifest as the attachments and support structures inside the nose begin to fall off, as well as the elasticity of the skin on the outside begins to weaken. This can happen around the time people reach their fifties or sixties. In addition, the bone under the tip of the nose and the teeth can begin to lose volume, which encourages the tip of the nose to retract further.
Add to this the usual appearance of lines and wrinkles in the skin as we age, and the overall shape of the nose simply deteriorates over time. Remarkably simple rhinoplasty can correct the symptoms of an aging nose. This minimally invasive surgery is performed only on the tip of the nose, using cartilage grafts and most patients recover in only about 5 days.
There is no upper age limit for rhinoplasty. However, to avoid certain risks you will need to be in good health in general. Also, for best results you should have good skin elasticity on your face, particularly around the nose.
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What to expect before rhinoplasty
Although rhinoplasty in Turkey usually lasts only a few hours, the entire process from booking your initial consultation to the end of the recovery period requires a much greater commitment of time. The first thing you will do while preparing for rhinoplasty, well before any surgery is performed, is meet with your surgeon to discuss a variety of important factors. This will determine if you are a good candidate for the procedure you should start with. Your consultation is likely to include a frank discussion about your motivation for the surgery and what you can expect from it.
Your surgeon will need to know if you have any chronic medical problems, as some conditions may make you an unsuitable candidate for surgery. As such, you will also be asked about your medical history, including any nasal obstructions or previous surgeries you have had as well as any medications you are currently taking.
This initial meeting will likely include a full physical exam, including a series of lab tests. The lining of the skin inside and outside the nose will be examined. This test helps give the surgeon a better idea of what needs to be changed and how unique facial features might affect the results.
Sometimes this physical exam also includes taking pictures of your nose before rhinoplasty from different angles. Your surgeon may use a computer application to manipulate these images to show you potential results along with your specific features after rhinoplasty. These images do not provide any guarantee of how the surgery will be performed. Instead, they simply provide a prediction of the kind of results you might expect.
Realistic expectations before rhinoplasty
Before you decide to undergo rhinoplasty, it is important to understand the limitations of the procedure so that you can go into it with realistic expectations. Rhinoplasty has a higher dissatisfaction rate than most other cosmetic procedures usually due to three reasons:
- The surgeon misunderstands the patient’s aesthetic goals.
- The patient has impossible expectations.
- Failing to meet these expectations.
While many surgeons encourage patients to submit pre-rhinoplasty photos they don’t like as a starting point, it’s essential to understand that rhinoplasty doesn’t make you look like someone else or present you with a completely different nose. Everyone has their own unique facial structure which plays an important role in determining the shape and size of the nose that will work best for them.
When considering rhinoplasty, it’s helpful to make sure you fully understand what the procedure is and what it can’t do that way. Rhinoplasty requires such a high level of surgical precision that even a change of 1 millimeter can greatly affect the results. Your goal should be to subtly adjust your nose to better fit your face, not to alter your appearance to a different person.
Preparing for rhinoplasty before and after
The following tips will help you ensure that the procedure runs as smoothly as possible and avoid any risks or complications that may result from rhinoplasty. Some simple instructions must be followed before rhinoplasty in order for the operation to go according to plan.
Avoid blood thinners About two weeks before rhinoplasty, you should stop using any aspirin, ibuprofen, vitamin E, or other herbal supplements that you may be taking. These medications can interfere with your body’s natural ability to improve blood thinning and overall healing.
If you are a smoker, you will need to stop smoking at least two weeks before rhinoplasty. Nicotine in the bloodstream can negatively affect healing, prolonging bruising and swelling. Quitting smoking is the best way to ensure that your nose heals well and without unnecessary complications.
Consider stocking up on household supplies and filling your prescriptions ahead of time so you don’t have to go out in public before your recovery is complete. Compared to many cosmetic procedures, the recovery period for rhinoplasty is relatively short. However, many people feel self-conscious about the necessary facial dressings immediately after the procedure.
See if you can ask a relative or friend for help in the first few days and nights after rhinoplasty. You may still feel queasy after surgery so it’s nice to have someone around to help you continue taking your medication. After rhinoplasty, you will breathe through your mouth for a short time. Because of this your mouth will get very dry and possibly a bit uncomfortable and a humidifier would also be a good idea. You will not be able to drive yourself after the operation. In fact, you’ll likely need to have a trusted friend or family member with you until you are discharged from the surgical facility.
After rhinoplasty
The recovery time from rhinoplasty is usually about two weeks, but because each surgery is tailored to meet your facial structure and goals, the actual recovery time will vary from patient to patient. The length of your recovery depends on a number of factors, including:
- Extent of surgical changes to be performed
- Follow up on post-op instructions regularly
- The state of your general health before surgery
The first 24 hours after the operation For many patients, the first 24-48 hours of recovery are the most difficult. You will likely still feel some effects of the anesthesia and may experience some mild discomfort. Your nose will feel achy, you may get a severe migraine, your face may feel swollen and some bleeding will also be normal.
Swelling is an expected side effect immediately after rhinoplasty. To help reduce this swelling and keep your recovery improving, it’s best to spend the first 24 hours comfortably in bed with your head elevated. Sleep promotes healing, so if you have the opportunity to take a nap that would be a good thing.
Your surgeon can give you a prescription to treat the pain if it’s too bad, but most people only need over-the-counter medication. Either way you should keep your medication schedule on top. Pain after rhinoplasty is usually fairly mild, but it may worsen quickly. If you don’t stay on schedule with your doctor, it can be difficult to get it back under control.
Remember not to pick at your nose for some time, as this forceful action so early in the recovery process can have a detrimental effect on your results. Also avoid air travel immediately after surgery, as changes in pressure can affect the results.
About a week after surgery, you’ll likely have a follow-up appointment so that the surgeon can keep track of your progress. If your procedure involves packing the nose it will be removed at this time, along with any splints and stitches. Bruising should begin to fade, and swelling should begin to subside.
Most patients are able to return to work and return to a normal routine about a week after their nose job. Even if you are able to resume most normal activities, it will still be important to remain cautious and avoid strenuous exercise for at least two weeks. It is also important to avoid bumping your nose while being treated. This means keeping an eye on pets, young children and anyone you share a bed with. Note that you may still experience some discomfort and pain emitting from your nose, mouth, and jaw. Stick to bland foods for the first week or two to help ease this pain.
For most patients, the relief they feel after their rhinoplasty far outweighs any pain or discomfort they may experience during the healing process. Almost all of the side effects of this procedure fade relatively quickly. However, it is important to remember that some minor swellings may persist for several months. Ultimately, it can take up to a year for the full final results to be revealed. Keep your nose out of direct sunlight for a few months after surgery. Sunscreens and hats help promote healing and reduce swelling.
Results after rhinoplasty
Rhinoplasty often leads to very minor changes in the structure of your nose, sometimes by a few millimeters. But these small changes can make a big difference in the shape of the nose. However, the results of rhinoplasty are often more difficult to predict than other cosmetic procedures, and the results of rhinoplasty surgeries tend to have a higher dissatisfaction rate.
In up to 20% of cases, additional modification of the nose is necessary to achieve the desired results. Be sure to stay in contact with your surgeon during and after your recovery to ensure that you are completely satisfied with your new nose. Just like all surgeries, there is always the possibility of scarring after rhinoplasty. In the case of a closed rhinoplasty, all the scars will be inside the nose, making them not very visible. In the case of open rhinoplasty, the only external incision is usually very small, through the nasal septum that is between the nostrils. Because this incision is so small and on the underside of your nose, even if it doesn’t completely fade away it will generally be unnoticeable.
Some things in life are guaranteed but surgical results can never be completely guaranteed and most likely won’t fall into this category. The most common reasons for revisions are breathing problems due to poor nasal structure, asymmetry and depression that appears as swelling subsides, insufficient support for the nasal tip causing it to retract, unresolved problems, and poor healing. Most of these cases may be beyond the control of the surgeon, especially since the results are often from the patient not properly adhering to the postoperative instructions.
However, the reason behind the majority of repeated operations is unrelated to the success of the procedure, and the responsibility must be shared between the patient and the doctor. Bad or inadequate communication will always lead to unrealistic goals and expectations. This is considered to be one of those rules in life that creates problems in relationships on every level.
For no specific reason, the goal of any surgery, cosmetic or otherwise, should be to do it once and achieve the result the patient expects when the swelling goes away. Clearly, good communication from the client expressing all that is hoped for and the surgeon explaining what is possible and what can be expected will go a long way in eliminating the need for secondary surgery.