The nose reshaping, also known as rhinoplasty, is a procedure used to change the shape of the nose. And ‘it indicated, as well as for aesthetic purposes, in the correction of congenital or acquired deformities, in trauma outcomes and in the treatment of certain respiratory problems.
The size and shape of the nose are genetic and develop in their final form in the teens. It usually decides to change its shape if you feel that is too large or irregular, or you can choose to restore its form after an injury. Because your nose may still be growing, the re-shaping is not recommended before age 16.
The nose should be seen in ‘whole face and integrated harmoniously in relation to its proportions. The goal of Dr. Grassetti is the correction of the defects, trying to get natural results, so in no case a nose that belongs to someone else!
During the same operation you can proceed to the correction of the nasal septum and turbinate, if respiratory mechanical problems so require.
Before proceeding to corrective action Dr. Grassetti can recommend to submit to a visit otolaryngologist to evaluate lung function. Sometimes you will be required to perform a sinus CT scan to assess the state of the turbinates and the nasal septum, especially in patients with respiratory problems.
The intervention must be avoided in pregnant patients.
It’s very important to point out the intake of nasal vasoconstrictors and other substances, even forbidden, inhaled, because it may seriously threaten the ‘surgery.
It should be discontinued at least 3 weeks before the intake of acetylsalicylic acid-based drugs.
At least 1 month before going suspended the use of smoke, which undermines the viability of the tissues and interfere with the healing process.
The previous day should be made a thorough washing of the hair and remove nail polish hands and feet, as well as cosmetics from her face.
Make fasting 8 hours before the solids and at least 3 hours from liquids.
A rhinoplasty operation is performed under general anesthesia or local anesthesia with sedation. It lasts one to two hours, depending on the technique used and the type of remodeling to be made.
It involves small cuts through the nostrils so that the scars are as little visible as possible. Your nose is re-shaped by removing and repositioning the bone and the underlying cartilage. If the nose is very flat, Dr. Grassetti can use a cartilage graft from the nasal septum or the pinna to build the size of the nose. Sometimes also the nostrils are remodeled to fit the shape of the new nose.
The intervention ends with the suturing of surgical wounds and generally with the placement of nasal swabs that will be removed on the second day. They should always be necessarily applied when you perform a septoplasty. Have the dual aim is to avoid postoperative bleeding with a mechanical compressive effect, but also because they are soaked with a chemical anesthetic solution (hence the local analgesic effect) and vasoconstrictor; both contributing to keeping in position the structures of the nose reshaped just at the moment in which is forming the most of the scars.
On the bridge of the nose is placed a restraining arch to avoid involuntary mobilization of bone and cartilaginous structures, which will be removed after 10 days.
Usually it remains in the hospital at least one night for the patient’s safety and the surgeon.
In the early days post operators can experience a mild throbbing pain or stinging, well controlled with standard analgesics. Sometimes there is headache.
And ‘it recommended for the first 4 days post-operative stay in a cool place and keep the head raised with more pillows during bed rest to facilitate the resorption of any edema (swelling) post operators. Also it should be avoided to lower the head during the first week (to pick something up from the ground, to tie his shoes, etc.) And perform physical effort and thrust maneuvers as in the case of constipation.
Of great benefit and relief, refer patients, is the application on the forehead of ice while avoiding direct contact with the forehead.
During the first 24 hours, because of anesthesia, you can experience a temporary reduction of the mobility of the upper lip which is accompanied by a sense of anesthesia of’ upper teeth.
Following the intervention you will experience bruising and swelling around the eyes for a couple of weeks, especially if we proceeded to do the basal osteotomy.
If applied nasal swabs, you will experience some discomfort in breathing. Once these are removed, there will be told to cleanse the nostrils with sprays of saline or hyaluronic acid, gels or nasal creams to facilitate healing and improve breathing.
After a week we will remove any non-absorbable sutures.
It would be appropriate for a month NOT blow your nose, but wipe it up using a cotton swab soaked in hydrogen peroxide and applying several times a day ointments, gels and aerosols above.
Already after two days is permitted provided that a shower is not hot ecessivamente, is prompt does not drop his head and not face down the ‘water on the dressing.
After a week you can resume work, provided they do not involve physical exertion.
For the first two weekdays at you should not drink alcohol, foods and drinks too hot and medicines based on acetylsalicylic acid .. Sneezing speechless and avoid pushing maneuvers, physical effort and still smoking.
Trivial tricks sometimes underestimated, but profits in the first settimani are: avoid trauma to the nose and then to get up at night without turning on the light, playing with large animals, take small children in their arms, attending crowded places, do not get in situations controllable.
Also should be avoided glasses with heavy frames on the nose for at least a month, as well as the exposure to the sun or intense heat.
The sport can be resumed after 3-4 weeks, provided they do not expose their noses at even minor trauma.
All operations involve risks and uncertainties.
Among the complications of a general nature, common to all surgeries we include:
a modest bleeding from the nose is normal, though more abundant may require replacement of nasal swabs. Only in very rare cases of bleeding it is necessary to return to the operating room to stop.
Bruises: subcutaneous blood collected can be drained by suction, most often serves the evacuation.
Infections are rare in the nose because very vascularized and however you treat with antibiotics. If you therefore occur it is important to recognize and treat them to prevent changes in the tip shape.
In case of allergic rhinitis? The intervention does not produce any change in the condition or in a pejorative sense, neither for the better way.
Among the specific complications of rhinoplasty are:
respiratory pattern: in the first weeks are normal and due to tissue swelling. In the long term they can be determined by scar alterations, inadequate treatment of the turbinates or anatomical changes as a result of intervention.
Dry mucous membranes: is treated with nasal emollient gel.
Nasal septum perforation is a possible complication of this surgery and may require a surgical reparative gesture. The risk is greatly increased in patients who use and vasoconstrictor drugs such as cocaine.
Damage to the nose lacrimal duct: Although rare, can cause tearing continues.
Alterations of smell: Because the olfactory nerves pass into the roof of the nasal cavity, it is difficult, but possible lesionarli. More frequently however is the development of infection that can damage them. Usually the deficit is temporary.
Delay in healing of wounds and, more rarely, skin necrosis of the operated areas.
Red nose, although rare, is possible due to the dilation of the capillaries of the skin of the nose when this is particularly thin.
Wrinkling of the skin of the nose: due to ‘abnormal healing of internal scarring with formation of adhesions and also feedback.
Irregularities to the touch delleo skeleton bone and cartilage: two to improper healing of bone fractures or non-alignment and imperfect welding of cartilage reshaped edges.
The result is immediately visible after the removal of ‘restraining headband with the patient’s immediate satisfaction. Further improvement will be obtained when the swelling will be completely gone and the final effect will appreciate not before 6-9 months, when sealing of bone fractures.
It ‘possible that the result is not satisfactory Institute or was not perfectly correct the defect. The extent of the improvement depends on the initial situation, regardless of the technique used, and by a number of individual variables such as the thickness and the shape of the nasal bones and cartilage, the thickness and the quality of the skin, the shape of the face, the age, general physical condition, the quantity and the quality of the defects to be corrected, hormonal influences, hypertrophic scars that can be internally formed during the healing phase and so on. secondary corrective measures are possible to a year later, and in the international literature are necessary in 15-20% of cases.
The results achieved will be permanent, but it should be noted not stable due to the natural aging of tissues.