The Rhinoplasty

The operation (which is called rhinoplasty) is performed for correction of congenital or acquired defects of the nose form. The history of this operation extends back over more than 3000 years, in the ancient times it was practiced in India, Persia, and Arabia.The beginning of modern rhinoplasty is dated 1887. Rhinoplasty is made only after the age of 18, when the growth of facial tissue ends.

Nose occupies a median position on the face, and the deviation of his size and shape from the classical canons is the reason for seeking to a plastic surgeon.In addition, the reason may be not only aesthetic but also functional impairment associated with the deformation of the nasal passages and the inability of full nasal breathing.The deformity of nose may be either congenital or acquiredbecause of injuries. In those and in other cases the only possible radical solution is to conduct operations.

Thus, rhinoplasty is performed in the following cases: the asymmetry of the nose, "hump" of the nose, a massive tip of the nose, hooked nose tip, doubling the tip of the nose, saddle nose, long nose and other changes of the nose, causing disharmony in general appearance; functional disorders such as curvature of the nasal septum accompanied by impaired nasal breathing; absence of nose fragment or nose completely missing as a result of injury or congenital abnormality.

Severe somatic diseases, cancer, mental illness, inflammation in the area of ??operations could be the contraindication for surgery. It is necessary to inform the doctor during the consultation about all existing diseases, allergies, medication received. It is also a must to take into account the phase of the menstrual cycle during surgery in women (preferably to have the operation made several days after menstruation, up to the middle of the cycle). During the consultation, it is also possible to carry out computer simulation that gives a general idea about the appearance of the patient after the operation.

However, even the most modern techniques do not take into account the individual characteristics of the postoperative course and scarring.

During rhinoplasty both cartilage and bone structures can be applied. The degree of using them depends upon the initial requirements of the patient and the desired result. For example, if a patient is concerned about "meaty" tip of his or her nose, it is possible to limit the medical and surgical interference to the remodeling of cartilaginous structures. If a patient draws attention to a broad nose as a whole, including the broad back of the nose, it is necessary to carry out the correction of bone and cartilage. The rhinoplasty can be performed using open and closed submerged methods or techniques. Close method is often less traumatic, but has its own limitations and restrictions in using. Some changes in the shape of the nose can be achieved only by remodeling of bony-cartilaginous basis at open rhinoplasty. At applying the close method, small incisions in the nasal passages (quite invisible from the outside) are carried out that makes it possible to perform the necessary manipulations through small incisions. Applying the open method, a small incision across the columella ("column" between the right and left nostrils) is performed, which also becomes completely invisible after a short period of time. In the process a skin flap is peeled off, which is then replaced back after remodeling the bone and cartilage matrix of the nose to the full extent.

If a patient is completely satisfied with the existing form of his or her nose, and he or she is anxious about a irregularities and disturbance of nasal breathing, then the operation septoplasty is conducted, when only the nasal septum is adjusted. Such an operation doesn`t give way to external changes.

As a result of various injuries (often it occurs after an animal bite) there can arise the defect in the wing or tip of the nose. In such cases it is possible to conduct a plasty when the defect is substituted with the internal tissues obtained most often from the area of the ear. In case of complete absence of a nose (congenital or traumatic), it is required to make a complex multi-step operation, in the course of which there can be used the internal tissues of a body, as well as a donor's tissues and artificial fragments.

Rhinoplasty is performed under the general anesthesia combined with the local infiltration anesthesia. The duration of the operation consists on average about 2 hours. After the surgery, swabs are introduced into the nose, which are removed after 3-5 days.They perform two basic functions: it helps to stop bleeding and maintaining the new shape of the nose. It is recommended to wash the nose in saline solution and to drip oil and vasoconstrictive drops after removing tampons.

Also a nose is covered with a special plaster splint for 5-7 days. Duration of inpatient stay in hospital depends on the volume and complexity of an operation, postoperative course, and can range from 1 day to 1 week. In the postoperative period it is recommended to carry out physiotherapeutic procedures (magnetic therapy, electrophoresis, ultrasound, light therapy, etc.) and massage that considerably speeds up and accelerates healing and promotes the "correct" scarring. Major swelling and bruising disappear after 1-3 weeks, depending on the volume of operation. All recommendations are based on the individual characteristics of the operation and the postoperative course, and it is aimed at early rehabilitation. Preliminary results of the surgery can be seen after removal of plaster, the final result can be seen only after the completion of the healing process (after 4-6 months).

Many people, are dissatisfied with their appearance, seek the help of a plastic surgeon. Motivation of patients with congenital or acquired defects can be easily understood. Such people have a keen interest in changing their appearance. However, there are those who seek to change not only appearance, but also interpersonal relationships by means of an operation.These people are convinced that there is a relationship between failures in love and their appearance. Is it really so?

Psychological aspects are certainly observed and felt in the practice of a plastic surgeon. Patients from the group of "hidden motivation" find it hard to articulate the desired results from the plastics. They are looking for a therapist in a surgeon subconsciously. They crave for love and alleviate the mental pain by means of an operation or medical interference. Application of psychological knowledge in the practice of plastic surgery everyday becomes more and more urgent. Cosmetic surgery in an integrated approach can be an excellent tool not only for the purpose of altering the appearance, but also for improving the quality of life.

 

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