What Is Rhinoplasty?

Rhinoplasty also known as nose job, is surgery that changes the shape of the nose. The motivation for rhinoplasty may be to change the appearance of the nose, to improve breathing, or both. In other words, Rhinoplasty can change the size, shape, or proportion of your nose. It may be done to repair deformities caused by injury, correct congenital defects, or improve some breathing difficulties.

Types of Rhinoplasty

1. Open Rhinoplasty

An open rhinoplasty is used to treat the nasal tip and the middle part of the nose. It involves using a small bridging incision to connect the incisions to the right and left nostrils. The bridging incision allows the nasal skin to be folded upward, thereby providing full access to the lower nasal skeleton.  

Open rhinoplasty is usually recommended in situations where patients have the following characteristics:

. Septal perforations or a deviated nasal septum

. Thick or thin nasal skin

. Cleft lip and palate involving the nose

. Failure of a previous rhinoplasty surgery, whether open or closed

.  Extensive augmentations to the various structures of the nose, especially internally

. Internal dysfunction of nasal structures

. Nasal tumors

2. Closed Rhinoplasty

A closed rhinoplasty is the most common type of rhinoplasty. All incisions are hidden inside the nose without any external scars. By Lifting the soft tissue slightly upward, the bone and cartilage are available for the necessary changes.

Closed rhinoplasty is suitable for any type of nose surgery depending on the skill of the surgeon. If this is your first surgery, a closed rhinoplasty is probably recommended. Closed rhinoplasty is an effective method for patients who choose simple surgery to thin the nose or remove lumps or bumps instead of working on the tip of the nose. n addition, closed rhinoplasty is suitable for those who need minor changes to their nose and want to recover faster.

3. Nonsurgical Rhinoplasty

Non-surgical rhinoplasty, also known as liquid nose job or 15-minute nose job, is a dermal filler procedure that changes the shape of your nose for up to 6 months.

This procedure is ideal for people who are looking to smooth out bumps in their nose or make it look less angular but aren’t ready for a permanent solution, or are concerned about the risks and recovery time of traditional rhinoplasty.

Going under the needle is certainly less complicated than going under the knife for a nose job, but reshaping the nose is never without risk.

4. Revision Rhinoplasty

Revision rhinoplasty is a surgical procedure to repair the form and function of the nose after an inappropriate nose surgery (bad rhinoplasty). The demand for secondary surgery is high since rhinoplasty is one of the most difficult plastic surgeries. After initial rhinoplasty surgery, patients may be dissatisfied with the appearance of their nose, have difficulty breathing, or both.

As a secondary surgery to correct a primary rhinoplasty, revision rhinoplasty can be a more complicated procedure compared to the primary procedure. For patients who need revision rhinoplasty to correct previous rhinoplasty problems, it is essential to find a qualified rhinoplasty surgeon.

Common Rhinoplasty Styles

Before undergoing Rhinoplasty in Iran, you can talk to your surgeon about your expectations and desired nose model. In choosing a nose model, the shape of your face is an important factor. The shape of the face (round, oval, diamond, square, heart, and pear), chin, forehead, and cheeks significantly affect the final shape of the nose. In general, after a nose job in Iran, you will have one of the following nose styles; natural, fantasy (Doll/Barbie), or semi-fantasy.

. Natural Style

In this style, defects such as deviated septum, nasal dorsal hump, broad nasal bridge, etc., are removed, but in the end, the nose has a regular shape. In this type of nose surgery, if someone meets you for the first time, they will not realize that your nose has been operated on. Depending on how natural you want your nose to be, the surgeon can raise the tip of your nose, make the nostrils symmetrical, cut the nasal bone, and reduce the width of the nose. If you have medical problems such as noisy breathing (stridor), respiratory defects, nasal deviation, etc., this nose style is suitable for you.

. Fantasy Style

To have a fancy nose, the surgeon focuses on the tip of the nose. In this method, the nose is significantly smaller and its tip is upward from the angle of the profile. People who have a bony nose, thin nasal skin, and strong cartilage can choose this style. On the other hand, the skin of fleshy noses is usually thick, so they are less qualified for fantasy style.

When choosing the fantasy style, keep in mind that the size of the nose must be in proportion to other parts of the face. Therefore, making the nose too small without considering other parts of the face is not thoughtful. Moreover, the size of the nostrils should not be reduced too much because this can cause respiratory dysfunction.

. Semi-Fantasy Style

This style is a combination of fantasy and natural styles and has both features. In this model, the nose becomes smaller, but not as much as in the fantasy style. The tip of the nose is also lower than the fantasy style.

Male Rhinoplasty

Rhinoplasty is not just for women. An increasing number of men undergo rhinoplasty every year to change their nose properties and achieve a better appearance. This cosmetic surgery has become more popular with both genders and an increasing number of males are undergoing a nose job; however, male rhinoplasty is not exactly the same as female rhinoplasty. Although plastic surgeons use the same surgical techniques during surgery, the results of male rhinoplasty surgeries are different due to differences in anatomy and preferences.

Men’s noses are different from women’s. They tend to have straighter and wider bridges, have thicker skin, and their tips are often more bulbous and wider than women’s noses.  Since men’s nose tips are less elevated, they tend to create an angle of 90 to 95 between the nose and the upper lip.

While women prefer to get a small and fantasy nose, most men like to have a natural nose that is characterized by a more prominent nasal structure with a straight-angle nose.

When to consider Rhinoplasty

. If your nose is too small, too large, or not in proportion to the rest of your face.

. If you are unhappy with the size, shape, or angle of your nose.

. If you have a nasal hump or a nasal tip that is drooping, too elevated or wide.

. If you have breathing problems caused by irregularities inside your nose.

In Fact, rhinoplasty can help address:

. Enlarged, bulbous, drooping, upturned or hooked nasal tip.

. Nasal asymmetry.

. Removing a hump on the nose.

. Large, wide or upturned nostrils.

. Straightening the bridge.

. A broken nose.

. Reshaping the nose’s tip.

. Opening breathing passages.

. Correcting the nose after an injury.

. Making the nose bigger or smaller.

Who Is an Ideal Candidate for Rhinoplasty?

Although rhinoplasty is popular with both men and women, more women choose to have a nose job. The best candidates must meet these general qualifications:

. Good physical health and without serious medical conditions or illness.

. Complete facial growth.

. Non-smoker.

. Patients who have realistic aesthetic goals and expectations.

. Patients who have A positive outlook on life.

. Patients who have a deformity which needs correcting.

. They have reached the right age, which means that young people have to wait to reach physical maturity and then undergo this procedure. Women usually reach physical maturity earlier at the age of 16, while men have to wait until the age of 18. The reason for this is that the nose stops growing and changing significantly at this age.

However, we may advise you not to undergo the procedure if:

. You have skin or nasal cartilage that lacks structural integrity.

. You have unrealistic expectations and you are looking for perfection, which means you are looking for something to transform you into another person.

. You have bleeding disorders, high blood pressure, diabetes, high cholesterol, lung disease, and severe allergies.

. You suffer from depression or another psychological issue such as body dysmorphic disorder.

. You are a heavy drinker or smoker.

How Long Does a Nose Job Take?

Rhinoplasty is an outpatient surgery and can take about 1 to 2 hours. After the surgery, you will be transferred to the recovery room and gain consciousness within an hour. 

How to Prepare for Rhinoplasty

Before scheduling a rhinoplasty, you need to meet your surgeon to discuss the important factors that determine whether the surgery is likely to work well for you. This meeting generally includes the following:

Your medical history:

The most important question your doctor will ask is about your motivations and goals for surgery. Your doctor will also ask questions about your medical history, including the history of nose obstruction surgery, and any medications you are taking. If you have a bleeding disorder, such as hemophilia, you may not be a candidate for rhinoplasty.

Physical exam:

The doctor will perform a complete physical examination, including any laboratory tests, such as blood tests. He or she will also lose your skin and inside and outside the nose. A physical exam helps your doctor determine what changes need to be made and how your physical characteristics—for example, the thickness of your skin or the strength of the cartilage at the end of your nose—affect your results. A physical examination is also important to determine the effect of nose-nose surgery on your breathing.

Photography:

Someone from the doctor’s office may take pictures of your nose from different angles. The surgeon may use computer programs to simulate images to show you possible results. Your doctor will use these images for previous, subsequent and referral evaluations during surgery and long-term reviews. More importantly, the images allow for a specific discussion of the surgical goals.

Discuss your expectations:

You and your doctor should talk about your motivations and expectations. It is important to have realistic aesthetic goals and expectations. You will be told what you can and cannot do for your nose and what your results might be.

Food and medicine

Avoid taking medications containing aspirin or ibuprofen for 2 weeks before the procedure of nasal and nasal mobilization. These drugs may increase bleeding. Take only medications that have been approved or prescribed by your surgeon. If you smoke, stop smoking. Smoking slows the healing process after surgery and makes you more susceptible to infection.

Rhinoplasty Postoperative Care

You may be eager to see the results of your rhinoplasty right away, but the recovery process takes time, most patients will notice results when the swelling starts to go down, but it may take up to a full year for the final results to become apparent.

Postoperative care is very important. Unnecessary pain and the complications of swelling and infection may be minimized if the instructions are followed carefully. Sometimes the complications of surgery are minimal, so not all of these guidelines may apply. Common sense often dictates what you should do. However, if in doubt, follow these instructions or contact us at any time for clarification.

Rhinoplasty is a common surgery that not only can have a great cosmetic result but also can improve nasal breathing.  The success of the surgery is in the hands of the patient as well as the surgeon. The best surgeon on earth will not achieve satisfactory results if patients do not take proper care of themselves after surgery. To take advantage of all the positive changes related to rhinoplasty, the patient must pay close attention to the recovery process.

Immediately Following Surgery:

. An adult should stay with you for at least the first 24 hours after surgery. Rest is absolutely necessary.

. For at least the first week after surgery, you should rest with your head elevated on a support or with at least 2 pillows. Try not to sleep on the side of your face but rather sleep with the back of your head on the pillow. Some patients prefer an airline- type pillow for comfort.

. Take the prescribed pain medication before you start to feel discomfort. It is easier to prevent pain than to control it.

. Limit your activities on the day of surgery and for a few days afterward. It is not unusual to need 10 to 14 days before returning to normal and resuming physical activity.

. Caution: You may feel dizzy if you suddenly sit or stand up from a lying position. If you are lying down after surgery, be sure to sit for a minute before standing up. If you feel dizzy while sitting or standing, you should lie down immediately to minimize the chance of fainting.

. Packing: A nasal packing is sometimes placed into the nostrils, especially if your surgery is also to relieve a nasal breathing obstruction. This packing is removed a few days after the surgery. Your doctor will usually see you within a few days to help remove the packing and review the instructions.

. A small bandage is placed between the bottom of the nose and the upper lip. This is changed as often as needed throughout the day. A small amount of oozing is normal and expected. It should not concern you. The bandage may be changed one or a dozen times. The loosely closed incision allows blood to escape rather than flow back up into the nasal tissue. Most of this oozing stops by the evening of surgery or the next morning. The drop pad placed under the nose is usually removed the morning after surgery. A small amount of red-pink serum is to be expected.

. After rhinoplasty, a small silicone splint is placed on the upper two-thirds of the nose. This splint acts as a protector for the newly operated nose and helps to maintain the position of the newly sculpted nasal bones. The splint is removed in a week. Do not allow it to get wet or it may separate prematurely.

. After general anesthesia or IV sedation, clear fluids should be taken initially. Over During the next few days, high calorie and protein intake is very important. Nourishment should be taken regularly. You should avoid dehydration by drinking fluids regularly. Keeping the body hydrated also prevents nausea and vomiting. Try not to miss a single meal. If you keep eating, you’ll feel better, have more energy, have less discomfort, and heal faster. Decreased activity can cause constipation, so you may want to add more raw fruits to your diet and make sure to increase your fluid intake. Avoid straining when going to the restroom. Getting a laxative or a stool softener may help.

The First Week after Surgery:

. Ice: During the day and evening of surgery, cold compresses are used continuously over the nose and eyes to minimize swelling and control bruising. Ice compress should be used as much as possible in the first 2-3 days. A good way to do this is to crush ice and place it into a zip-lock bag. Wrap a thin towel around the ice pack and place it over the nose and eyes.

. Puffiness: Puffiness or swelling of the eyelids is always most noticeable on the second morning after any facial cosmetic surgery (i.e. surgery on Monday, most swelling on Wednesday). It usually regresses quickly over the next few days. This normal observation is nothing to worry about.

. Bruising: Bruising and discoloration around the eyes is very variable. However, most patients experience minimal black and blue. It is necessary to strictly follow the recommended medication instructions before the operation. Despite taking all precautions, a small number of patients develop marked bruising in the eyelids. Even this bruising usually resolves by the end of the first week.

. Nasal Stuffiness: There is always some nasal congestion during the week after surgery. External edema (swelling) is reflected internally, but mild obstruction steadily improves. Applying a small amount of prescription ointment twice a day just inside the nostrils will lubricate the surgically stitched area and prevent crusting.

. Any crusting that forms can be gently removed with a peroxide dampened Q-tip. However, it is necessary to avoid extensive manipulation in this area. Do not blow your nose. Do not use nose drops.

. Nasal Discharge: For the first few days after surgery, you may expect a small amount of pink nasal discharge. Usually, a facial tissue touched to the nostrils is all that is required. Sometimes, it may be more convenient to reuse a small gauze bandage under the nostrils.

. Bleeding on the third, fourth or fifth day occurs in less than 1% of cases. First aid for such a rare occurrence is as follows: Lie down and elevate head. Place cold compress on the nose. If available, saturate a piece of cotton with nose drops or Visine, and place it in the bleeding nostril.

. Pain: Discomfort after rhinoplasty is usually limited to the first two or three days after surgery. In most cases, it is moderate in nature. Severe pain is rarely the result of facial plastic surgery. The prescription for pain pills you received should be used on the first day after surgery and then as needed thereafter.

. Nasal Appearance with Cast: During the first week, you may notice that the nasal tip is slightly elevated. This is a constant, temporary factor after all nose surgeries. The position of the nasal tip at this time has little relationship to the final result. The tip will slowly drop to its new lower position over a few days or weeks. The nasal splint is removed at the end of the first week.

. Exercise: While gentle walking around the house is recommended: any lifting, pulling or straining should be avoided as it may cause bleeding.

. Avoid Blood Thinners: Do not use aspirin for the first week. Alcohol is a strong dilator of blood vessels, and in post-operative conditions, it can cause swelling of the surgical area and even bleeding. It is best to avoid drinking alcohol for at least one week after surgery.

. Stiches will be removed in 1 week.  After all stitches are removed, the scar will appear deep pink color. There will be varying amounts of swelling in and around the scar. Over time, the pink color will whiten, the firmness of the scar will soften and they will become less noticeable. Everyone’s recovery is different, but it takes about a year to see these changes in most scars. Beginning 6 weeks after surgery, application and gentle massage with vitamin E, cocoa butter, or Mederma may result in smoother, less obvious scarring. 10 days after surgery, the incisions can be covered with makeup.

After the First Week:

. Nasal Appearance: When the nasal splint is removed, you will have the chance to see the new nose. It looks quite swollen, but in most cases, even in this condition, improvement is visible.

. In most cases, the appearance will be closer to the final shape within six to eight weeks. Many factors determine how quickly or slowly a nose takes on its final appearance. The most important determining factor is skin type. Skin that is thicker and oilier is sure to retain edema and swelling for a longer period of time than skin that is drier and thinner. Individuals differ in their healing potential. The nose continues to heal over a long period of time with the subtle changes that occur over the years of surgery. Our goal is to provide a long-term result which will last the person’s entire life.

. Activity: In the second week, the nose should not be bumped. Although the bones are fixed firmly in place, even a slight blow can cause movement. Avoid any situation where a potential for ‘nasal trauma exists. Exercises that increase the heart rate can be started 14 days after the operation. Exercising in the first week after surgery can cause bleeding. In the second week after the operation, edema or swelling increases. At 14 days, you can start fast walking and light weights. At 21 days, you can start running and heavier weight. At 30 days, full exercise can begin.

A common question is when to resume sexual activity. As a moderate activity (caloric expenditure), sexual activity can be safely resumed 12-14 days after facial plastic surgery.

. Wearing Glasses: You should not wear glasses for about a month. If you have to wear glasses, taping the central bridge of the glasses to the forehead will reduce the pressure on the nasal bones as much as possible.

. Sun Exposure: It is wise not to sunbathe for about 60 days. A sunburn will cause the nose to swell and delay the final result. Walking or sitting with a hat is allowed. If you are exposed to strong sun, it is always better to use SPF 25 for the nose.

. The skin of the nose is somewhat insensitive after rhinoplasty. This can be felt by touching the skin, which feels slightly numb. Full sensation always returns within three months.

The recommendations for sun exposure also apply to the winter cold. Prolonged exposure to subfreezing air during activities such as skiing can cause frostbite. Both sun and the winter cold are natural enemies to the skin and prolong the usual postoperative period.

. Skin: The natural reaction of all types of nasal skin to this surgery is a significant increase in nasal oiliness. Even skin that is normally dry should be wiped with an astringent on a cotton pad once or twice a day for two weeks or more. Another universal observation is the presence of flaking or peeling of the skin, much like that caused by sunburn. This also subsides in about two weeks. Most discoloration resolves within 7-10 days. Although uncommon, it may remain mostly as a pigment under the eyes. Sometimes, patients with olive skin may retain this pigmentation for several months.

. Small irregularities may be felt under the smooth skin, especially on the nasal bones. These irregularities are common. Most noses, even without surgery, have a palpable bony irregularity beneath the smooth skin.

Additional Information:

. A slight increase in temperature immediately after surgery is not uncommon. Inform your doctor if the temperature persists. Tylenol should be taken to reduce fever.

. In case of nausea and/or vomiting after surgery, avoid taking the prescribed medication orally for at least one hour. You should then sip on flat coke, tea, or ginger ale.  You can also purchase coke syrup over the counter which can have a soothing effect on the stomach.  You should drink slowly over fifteen minutes. Once the nausea subsides, you can start taking solid foods and prescribed medications. Please call if the nausea does not subside within 3 hours. 

. If you are taking antibiotics, take the pills or liquids as directed. Make sure you finish the antibiotic even if you feel completely better and don’t need it. In case of skin rash or other side effects, stop taking the antibiotic and inform the doctor about the reaction. Sometimes taking antibiotics with yogurt can help prevent diarrhea. If you are taking birth control pills, birth control may become ineffective. Use a backup form of birth control.

. Do not drive or operate machinery until you stop using narcotic pain relievers. Avoid alcoholic beverages because it increases the effect of drugs. This is a dangerous combination. Pain or discomfort after surgery should subside after the first two to three days. If the pain persists, it may require attention and you should contact your doctor. Do not routinely take Tylenol with pain medications. Many prescription pain medications already contain Tylenol.

. Your case is individual because no two people are alike. Do not accept well-intended advice from friends. Discuss your questions and concerns with your doctor.

. Mild post-operative depression is not uncommon. Most patients are shocked when they see their face swollen and discolored. Be realistic and understand that this is a very temporary condition that will subside soon. The best treatment involves preoccupying yourself with the details of post-operative care and trying to divert your attention to other thoughts. Just rest and relax and let your face heal.

. Do not smoke for at least 2 weeks after surgery because smoking significantly delays healing and increases the risk of complications.

Risks and Complications of Rhinoplasty

All surgical procedures, including rhinoplasty, carry some degree of risk. Potential complications after rhinoplasty include:

. Infections.

. A hole in your nasal septum (nasal septal perforation).

. Poor wound healing or scarring.

. Bleeding.

. Problems breathing through the nose.

. Skin discoloration.

. A bad reaction to the anesthesia.

. The possibility of an uneven-looking nose.

. Unsatisfactory appearance.

. Alteration of your sense of smell.

. Pain.

. Scarring.

. Permanent numbness in and around the nose.

. A need for additional surgery.

What Is the Recovery Time for Rhinoplasty?

Full recovery after rhinoplasty may take up to a year. You will have swelling for about four to six weeks after surgery, which will slowly decrease after three months. Between three months to a year, your nose is still healing and swelling may still be present. After the nose is completely healed, which is usually after a year, you will see the full results. The recovery timeline is different for each person.

What Are the Stages of Swelling After Rhinoplasty?

Immediately after rhinoplasty, you will experience swelling. Swelling occurs when your nose is larger than usual because fluid accumulates within and under your skin. The stages of swelling after a nose job are:

. Four to six weeks after surgery: Your nose will be swollen for four to six weeks after surgery. It looks and feels bigger than normal. You may experience bruising or discoloration of the skin around your nose as it heals.

. Three months after surgery: Swelling slowly subsides between one and three months. After three months, most of the swelling is gone (about 90%).

. One year after surgery: You may still have minimal swelling in your nose up to a year after surgery. You will not see the full results of the procedure until the swelling is completely gone.

Each person’s recovery after rhinoplasty is different. The amount of swelling and the time it takes to see your results may vary. Follow your doctor’s treatment plan after surgery and stay up to date on follow-up appointments to make sure your nose is healing properly.

When Will I See the Results of Rhinoplasty?

You should notice a difference in the appearance of your nose about a week after rhinoplasty when the splint is removed. It may take up to a year for your nose to completely adjust to its new shape. During this time, some facial swelling is normal. Most people who have functional rhinoplasty to correct a deviated septum see improvements within six weeks. About 15% of people need a follow-up (revision) surgery to make minor changes after the initial surgery.