All rhinoplasty procedures are not the same. This is to say that the procedure differs depending on your needs and requirements as a patient. After the initial decision to undergo a rhinoplasty surgery, the next step is that your plastic surgeon should evaluate what types of rhinoplasty procedure is best for you.
Iranian surgery is an online medical tourism platform where you can find the best Rhinoplasty Surgeons in Iran. The price of a Rhinoplasty in Iran can vary according to each individual’s case and will be determined based on photos and an in-person assessment with the doctor. So if you are looking for the cost of Rhinoplasty in Iran, you can contact us and get free consultation from Iranian surgery.
An open rhinoplasty is used to treat the nasal tip and middle portion of the nose. It involves the use of a small bridging incision to link 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 generally recommended in situations where patients display the following characteristics:
. Thick or thin nasal skin
. Septal perforations or a deviated nasal septum
. Cleft lip and palate involving the nose
. Nasal tumors
. Failure of an earlier rhinoplasty procedure, whether open or closed
. Internal dysfunction of nasal structures
. Extensive augmentations to the various structures of the nose, especially internally
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Preparing for Open rhinoplasty
Before scheduling Open rhinoplasty, you should send your medical records to rhinoplasty surgeon. The most important question your doctor will definitely ask you is about your motivation and goals of surgery. Your doctor will also ask questions about your medical history — including a history of nasal obstruction, surgeries and any medications you take. If you have a bleeding disorder, such as hemophilia, you may not be a proper candidate for nose job surgery.
1. Get lab. It is important that we ensure our patients are healthy enough to have surgery so we should ask our patients to have a hemoglobin test.
2. Take certain medications or adjust your current medications.
3. Stop smoking 2 weeks before and after surgery.
4. Avoid taking aspirin, anti-inflammatory drugs and herbal supplements as they can increase bleeding.
5. Limit sun exposure for 2 weeks
6. Do need eat or drink anything 6 hours prior
7. Purchase all recovery items beforehand
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. Open rhinoplasty has some advantages over the closed approach, which are as follows.
. Since the nasal structure is completely revealed, the surgeon has better access to the underlying structure and thus more freedom to reshape the nose as the patient desires.
. The stabilization of the nose after surgery is easier in open rhinoplasty than closed rhinoplasty.
. Most surgeons practice open rhinoplasty. Therefore, your chance to find a good surgeon for open rhinoplasty is greater.
What are the Disadvantages of open rhinoplasty?
The main drawbacks of open rhinoplasty are as follows:
. Open rhinoplasty is lengthier and more invasive than closed rhinoplasty, so the recovery time will be a little longer and it takes more time for the swelling and bruising to disappear.
. A very small scar might remain on your nasal columella, though only visible when you tilt your head back.
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Am I a Good Candidate for Open Rhinoplasty?
Good candidates for open rhinoplasty include:
. An ideal candidate for open rhinoplasty is a person with a complex anatomy and the reconstruction is carried out using multiple tissue and cartilage grafts to the tip of the nose.
. Open rhinoplasty benefits someone with significant deformities of the nasal soft tissues and cartilage.
. Open rhinoplasty candidates are people with a bridge or bulbous tip on their nose or someone with breathing issues because of the structure of the nose.
. The ideal candidate for open rhinoplasty will most likely require more gentle finesse procedures or more dramatic adjustments to structure and shape their nose.
Open Rhinoplasty Risks and Side effects
Open Rhinoplasty surgery risks include:
. Anesthesia risks
. Infection
. Poor wound healing or scarring
. Change in skin sensation (numbness or pain)
. Nasal septal perforation (a hole in the nasal septum) is rare. Additional surgical treatment may be necessary to repair the septum but it may be impossible to correct this complication.
. Difficulty breathing
. Unsatisfactory nasal appearance
. Skin discoloration and swelling
. Possibility of revisional surgery
How is Open Rhinoplasty performed?
An open rhinoplasty procedure allows for the best visualization of the nasal structures when correcting both cosmetic and functional concerns of the patient.
During an open rhinoplasty, an incision will be made at the columella, just beneath the tip of the nose. The nose will then be retracted backwards, dissecting the nose cartilage with care being taken to not incise the medial crura, the cartilage that separates the nostrils. The flap will be raised off of the nose for maximum exposure and work can now be done to reshape the nasal tip, bridge, nostrils, or septum repair. Once completed, the flap will be redraped over the bone framework and external contouring and shaping is completed. The incision will be closed with sutures and an external splint or cast will be placed over the nose.
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Recovery timetable
Approximate recovery after Open rhinoplasty is as follows:
. Day 1 Return home. Use cool compresses for 24 hours. Some swelling and bruising, mild discomfort. Change mustache dressing as needed (often 10 to 20 times).
. Day 2-3 maximum bruising and swelling.
. Days 5-14 External stitches removed or dissolving. Internal and external nasal dressings removed by Doctor. Bruising going away.
. Week 2-4 much of swelling has begun to go away. Breathing better.
. 1 Year Enjoy your final result
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A patient must not fly for at least 5 days after the surgery. While unlikely, the possibility that you will have a nosebleed during the flight, which could be an emergency situation, is avoided. It is still not recommended to fly for an additional week (in total 2 weeks), but many patients cannot stay in town for that long of a period. If you must fly during the second week of your recovery, it is important to take Sudafed and spray a nasal decongestant (Afrin or other) prior to taking off. If not, the pressure changes during the flight may be very painful. It is also typical to have renewed swelling after the flight, which will last about 1-2 days. All of these issues are not concerning if you are planning to travel by car or train.
Out of town patients should plan to stay a few days after the surgery at a hotel. They can travel and fly back home after splint removal at 5-7 days. Physical activity should be limited for 10-14 days. It usually takes about 6 weeks before the patient can exercise again without discomfort. High-risk contact sports should be avoided for 3 months.
4 Ways to clean your nose after Open Rhinoplasty are as follows:
. Q-tip and hydrogen peroxide
. Saline rinse
. Removing blockages
. Use a moist towelette
What is Closed Rhinoplasty?
A closed rhinoplasty is the most common type of rhinoplasty. All incisions are hidden inside the nose with no external scars. Lifting the soft tissue slightly upward, the bone and cartilage is accessible to perform the necessary changes.
Closed rhinoplasty is suitable for any type of nose surgery depending on the surgeon’s skill. If this is your first operation, closed rhinoplasty is likely to be recommended. Closed rhinoplasty is an effective method for patients who are opting for simple surgery to thin the nose or remove lumps or bumps, rather than having work done on the tip. Moreover, closed rhinoplasty is suitable for those who need small changes to their nose and want to heal faster.
Preparing for Closed rhinoplasty
Before scheduling closed rhinoplasty, you should send your medical records to rhinoplasty surgeon. The most important question your doctor will definitely ask you is about your motivation and goals of surgery. Your doctor will also ask questions about your medical history — including a history of nasal obstruction, surgeries and any medications you take. If you have a bleeding disorder, such as hemophilia, you may not be a proper candidate for nose job surgery.
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1. Get lab. It is important that we ensure our patients are healthy enough to have surgery so we should ask our patients to have a hemoglobin test.
2. Take certain medications or adjust your current medications.
3. Stop smoking 2 weeks before and after surgery.
4. Avoid taking aspirin, anti-inflammatory drugs and herbal supplements as they can increase bleeding.
5. Limit sun exposure for 2 weeks
6. Do need eat or drink anything 6 hours prior
7. Purchase all recovery items beforehand
. Closed rhinoplasty is less invasive and leaves no scars and less swelling and bruising after surgery, so there will be a shorter recovery time and downtime.
. Closed rhinoplasty procedure takes a shorter time to be completed that open rhinoplasty does.
. Reduced nasal tissue irritation (due to the lack of a columellar incision)
. Reduced likelihood of the nasal-tip support reduction
. Smaller likelihood of post-operative edema
. As there is limited visibility of the tissues and cartilage, the surgeon can make limited changes, with less delicacy.
. There are fewer surgeons who are skillful at closed rhinoplasty than open rhinoplasty.
. Incisions made in the nose weaken the nasal structure, undermining the stability of the shape of the nose in the future.
. There is a higher chance of nasal cartilage distortion during the operation as accessing the nasal framework requires intense stretching of the skin.
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Good candidates for closed rhinoplasty include:
. The best candidate for closed rhinoplasty is someone who requires minor work — the removal of a dorsal hump, for instance — but whose nose tip and overall structure of the nose is good.
. An ideal patient for closed rhinoplasty is someone who wants to make changes to the nasal dorsum, the nasal side walls and some minor changes to the nasal tip.
. An ideal closed rhinoplasty patient hasn’t had a lot of nasal trauma or previous surgery.
. Closed rhinoplasty candidates are people with a bridge or bulbous tip on their nose or someone with breathing issues because of the structure of the nose.
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Closed rhinoplasty is a safe surgical procedure with a high satisfaction rate if performed by a qualified plastic surgeon. However, there is always the possibility that complications or unwanted results may appear.
The risks of closed rhinoplasty include:
. Bruising
. Swelling
. Scarring
. Infection
. Asymmetry
. Numbness
. Hematoma – Blood collecting under the skin
. Breathing difficulties
. Burst blood vessels
. Possibility of revisional surgery
How is Closed Rhinoplasty performed?
Closed rhinoplasties are done as an alternative to the open technique. Instead of exposing the nasal structure, incisions are made on the nasal membrane in varying locations to access different parts of the nose framework. By not opening the nose, patients are able to have reduced recovery times and non-visible scars. Whatever your goals may be, whether for an ethnic rhinoplasty or rejuvenation nose job, a closed technique can most likely be utilized.
During a closed rhinoplasty, incisions will be made on the inside of the nose. The nasal structure will not be exposed which means decreased visualization for the surgeon, however postoperative scarring will be hidden and discreet. The addition of an endoscope may be used during a closed rhinoplasty to increase visualization. When repair has been completed, sutures will close incisions and an external splint or cast will be placed over the nose.
The goal of a closed rhinoplasty is to achieve facial harmony by changing the shape, size or angle of the nose. Closed rhinoplasty can also be used to correct breathing problems resulting from irregularities inside the nose.
Recovery
Since closed nose surgery is less invasive than the open method, there will be less swelling and bruising after this surgery and the nose will heal faster. There might even be no bruising after closed rhinoplasty in some patients. Therefore, the recovery time in closed rhinoplasty is shorter than in open rhinoplasty and patients usually need a shorter time to be able to return to their normal life.
The full results of a closed rhinoplasty become visible within approximately one to two years of treatment because it takes this long for all of the swelling to go away completely. However, downtime after a closed or open rhinoplasty generally lasts about two weeks. A nose splint is typically removed within five to six days of a closed rhinoplasty procedure. At this point, post-rhinoplasty bruising and swelling is usually minimal, too.
What is Nonsurgical Rhinoplasty?
A nonsurgical rhinoplasty also called “liquid nose job” or “15-minute nose job.” is actually 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 who aren’t ready for a permanent solution, or are worried about the risks and recovery time involved in a traditional rhinoplasty.
Going under the needle is certainly less complicated than going under the knife for a nose job, but modifying the nose’s shape is never risk-free.
Preparing for treatment
Different filler ingredients have different guidelines for how to prep for your procedure. Your provider should give you detailed instructions on what to do before a nonsurgical rhinoplasty.
The suggestions below are broad guidelines:
. Avoid aspirin, anti-inflammatory medication (such as ibuprofen), vitamin E supplements, and any other blood-thinning supplements in the week before the procedure. If you’re on any blood-thinning medication, make sure your doctor knows it.
. Be aware of your vitamin K levels to reduce the risk of bruising. Eat lots of green, leafy vegetables to boost your vitamin K in the weeks before your procedure.
. Drink plenty of water and eat a meal before your appointment. Don’t overeat, as you may feel nauseous during or after the appointment, but do make sure you’ve eaten something with starch and protein.
For most people, the only side effect of liquid rhinoplasty they’ll see is a little redness and sensitivity in the area of the injection in the day or two after the procedure.
Other possible side effects include:
. Bruising at the site of the injection
. Swelling
. Filler migration, meaning the injectable ingredient migrates to other areas of your nose or the area under your eyes, creating a “wavy” or “overfilled” look.
. Nausea
The nose is a sensitive area. It’s filled with blood vessels and close to your eyes. That’s why liquid rhinoplasty is somewhat more complicated than other kinds of injectable filler procedures.
A trained and careful plastic surgeon will tend to err on the side of using less filler in your nose rather than overfilling the area.
. Tissue death
. Vascular complications
. Vision loss
Speak to your doctor right away if you experience:
. Fever
. Blurred vision
. Redness or bruising that spreads and gets worse
. Hives or other symptoms of an allergic reaction
Advantages and Disadvantages of Nonsurgical Rhinoplasty
Advantages
. Nonsurgical rhinoplasty allows you to avoid going under general anesthesia.
. You’ll have a quick recovery.
. After this procedure, you can return to work and your regular activities as soon as the same or next day.
. Results aren’t permanent, so if you’re not pleased with how it looks, it’s just a matter of time before the fillers metabolize.
. The cost of nonsurgical rhinoplasty is much lower than a traditional rhinoplasty.
Disadvantages
. If you’re looking for a dramatic, permanent change to your appearance, this procedure might be disappointing for you.
. There are side effects, such as bruising and swelling.
. There’s the possibility that a misplaced needle could result in visible bleeding under your skin or damage to your vision.
. This is a relatively new procedure, so long-term side effects aren’t well studied yet.
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How does it work?
Nonsurgical rhinoplasty uses dermal filler ingredients to change the shape of your nose. A gel-like injectable ingredient (usually hyaluronic acid) is inserted underneath your skin in the areas where you wish to create smoother lines or volume. Sometimes Botox is also used.
The filler ingredient settles into where it’s injected in your deeper skin layers and holds its shape. This can change the look of your nose for anywhere from 4 months to 3 years, depending on your skin, your desired results, and the ingredient used.
What’s the procedure like?
The procedure for liquid rhinoplasty is fairly simple, especially compared to surgical rhinoplasty. After a consultation where you discuss your desired results, your doctor will have you lie down with your face tilted up. You may have a local anesthesia applied to your nose and the surrounding area so you won’t feel pain from the needle.
After the anesthetic takes effect, your doctor will inject the filler into the area around your nose and maybe the bridge of your nose itself. You might feel a slight pinching or pressure while this is done. The whole process can take from 15 minutes or less to 45 minutes.
Targeted areas
A nonsurgical rhinoplasty targets the bridge, tip, and sides of your nose. Fillers can be injected around any part of your nose to modify its shape.
This procedure works well if you want to:
. Smooth out small bumps in your nose
. Make the tip of your nose more prominent
. Add volume to your nose
. Lift the tip of your nose
Additionally, if you have a mild prominent bump of the bridge of your nose, it can camouflage it and smooth the contour of your nose profile. Liquid rhinoplasty won’t be able to give you your desired results if you want your nose to look smaller or if you’re looking to smooth out more prominent bumps.
What to expect after treatment
After liquid rhinoplasty, you may see pain, swelling, and redness where your injection was inserted. Within an hour or two, the injection should start to settle. The redness should start to subside, and you’ll be able to better see your desired results.
. Bring an ice pack to use after your appointment. Ask your doctor if it’s ok to use it to minimize redness and inflammation.
. Results should be fully visible within a week or two. Redness or bruising should completely subside by then.
. As far as downtime, people who swear by liquid rhinoplasty love that there’s practically no recovery time. You can be back to work and your normal activities the very same day.
. Most filler ingredients will dissolve into your skin layer within 6 months. Some filler ingredients will last up to 3 years. No matter what, results of a liquid nose job aren’t permanent.
What is revision rhinoplasty?
Revision rhinoplasty is a surgical procedure to repair form and function of the nose after an inappropriate nose surgery (bad rhinoplasty). The demand for the secondary surgery is high, due to the fact that rhinoplasty is one of the most difficult plastic surgeries. After initial (primary) rhinoplasty surgery, patients may be unsatisfied with the appearance of their nose or have difficulty in breathing, or both.
As a secondary surgery to correct primary rhinoplasty, revision rhinoplasty can be even more complicated procedure compared to initial one. For patients who need revision rhinoplasty to fix the problems of previous nose surgery, it is essential to find a rhinoplasty surgeon who is qualified enough, experienced and knowledgeable which are the main features of our surgeons.
What important factors should I notice before doing revision rhinoplasty?
If you are considering revision rhinoplasty then make sure your board-certified plastic surgeon has substantial experience with rhinoplasty. Experienced rhinoplasty surgeons are more likely to see revision cases than those who do this operation infrequently.
Look at your prospective surgeon's website to see how many rhinoplasty cases are in their photo gallery. Computer imaging may be helpful for your surgeon to visually communicate what potential outcome you may expect from surgery. Previous rhinoplasty patients are also a great resource for prospective patients; your plastic surgeon should be able to supply you with patients who have offered to speak with you and others and discuss their experience in some detail.
In the end, your decision to undergo revision rhinoplasty is a personal one. Choosing an experienced, board-certified plastic surgeon who has "connected" with you and earned your trust will offer the best chance of a successful outcome. Most patients who are unhappy with the outcome of primary rhinoplasty are pleased with the final result from revision rhinoplasty if they follow these simple recommendations.
If you are going to perform revision rhinoplasty, it is suggested to choose professional rhinoplasty surgeons. Your nose is one the main parts of your face which play a pivotal role in improving your beauty. Thus, we can help you by offering a list demonstrating top six revision rhinoplasty surgeons.
Revision rhinoplasty is one of the most challenging operations the facial plastic surgeon performs given the complex 3-dimensional anatomy of the nose and the psychological impact it has on patients. The intricate interplay of cartilages, bone, and soft tissue in the nose gives it its aesthetic and function. Facial harmony and attractiveness depends greatly on the nose given its central position in the face.
In general, revision rhinoplasty surgery carries the risks of:
. Adverse reactions to anesthesia and infection.
. These risks are minimized by patients divulging their full medical histories, including any allergies to medications, and by keeping the area clean prior to and following the revision rhinoplasty.
. Unforeseen events like trauma to the nose can affect the final look of the nose. Side effects can include issues breathing through the nose, asymmetry, and swelling, which may only be temporary but can be permanent. In some cases, revision rhinoplasty can correct these issues.
. Advanced complications may lead to the loss of cartilage and bone.
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Common problems that require secondary Rhinoplasty are as follows:
. Nasal airway obstruction
. Collapse of cartilage or nasal bones
. Artificial cosmetic appearance to nose (“Overdone nose job”)
. Internal and external nasal valve collapse
. Worsened asymmetry
. Over reduction or inadequate reduction of dorsal height (bridge height/hump)
. Incomplete shaping (not enough of a cosmetic change)
. Excessive or inadequate tip projection
. Excessively narrowed nasal tip (“pinched tip”)
. Excessive internal and/or external scarring (thickened scar tissue)
During Revision rhinoplasty surgery, the experience and expertise of the surgeon becomes even more important. Revision rhinoplasty is usually performed under general anesthesia. Incisions are primarily internal, though a small external incision is sometimes used.
The bone and cartilage of the nose is reshaped, and care is taken to preserve the breathing function of the nose. Our surgeons are able to improve nasal breathing for the patients. Revision rhinoplasty generally takes anywhere from 2-5 hours.
Revision rhinoplasty is a premium surgery to re-evaluate the nose shape and to alleviate previous functional problems. This surgery uses natural materials to prevent further side effects and tissue damages. Mainly, using 100% natural rib cartilage which is highly recommended for the revision rhinoplasty. This is because the vast majority of people who have problems with the primary rhinoplasty experienced foreign implant side effects and used up remaining septal cartilage already.
Revision rhinoplasty often requires cartilage for structural support for the tip and/or bridge of the nose. Septal cartilage is often deficient and plastic surgeons often must choose cartilage from elsewhere in the body, particularly the ear and occasionally the rib. Soft tissue irregularities along the bridge of the nose or tip may also require tissue that provides a cover or camouflage and acts as a "natural filler" which is permanent. An excellent source is "temporalis fascia," which can be taken from a remote incision within the hairline and results in no noticeable deficit. Occasionally, scarring within the nose requires the use of skin grafts to reopen a distorted and narrowed nasal airway.
The necessary changes in the secondary rhinoplasty can be done through a “closed” or “open” approach. Typically, if there are major structural changes required, open approach may be preferred. Minor contour corrections can be performed via a “closed” technique. Closed rhinoplasty is performed only when internal incisions (endonasal) are made for access to the nasal structures.
Open rhinoplasty refers to the addition of an incision in the skin bridge between the two nostrils (columella) in order to lift up the nasal skin for more direct visualization of the structures to be altered. The decision to use either the closed or open approach in revision rhinoplasty is based on surgeon preference and each technique has its pros and cons.
Cartilage grafts (portions of cartilage from the septum, ear, or a rib) are often necessary to accomplish the cosmetic and functional goals in revision rhinoplasty. It is very common for the primary procedure to have depleted much of the nasal cartilage. A lack of septal cartilage is the most common indication showing that we need ear or rib cartilage sources for graft material. These segments of cartilage are then shaped into structural and shaping pieces for using in the nose.
As with primary rhinoplasty, there is very little room for error and it is vital that you seek a rhinoplasty expert who is skilled and experienced in the secondary techniques. In order to reduce the rates of further revisions and ensure a successful outcome, it is best to seek a plastic surgeon or facial plastic surgeon who specializes in rhinoplasty and revision rhinoplasty.
It requires restriction of your physical activity for six weeks after rhinoplasty revision surgery. A splint will remain in place for eight days after surgery, and there will be some degree of nasal congestion and swelling for a similar time frame. More details regarding postoperative restrictions will be discussed during your consultation.
Because the complexity and time involved are more than your first rhinoplasty, it also costs more. Generally, revision rhinoplasty costs 50-100% more than a primary rhinoplasty.
After Revision Rhinoplasty, you observe the final results in 6 months, that’s why patients should be tolerant during this period and wait for this much better final look. In Revision Rhinoplasty operations, you spend a night at the hospital and return to your business life in approximately 10 days.
Aside from the usual advice for patients to keep their heads as close to vertical as possible immediately following surgery, and to sustain a liquid diet for 12 hours after the operation, it’s also smart to keep a small zip-lock bag filled with frozen peas on the eyes every 10 minutes per hour for the first 48 hours.
Revision rhinoplasty surgeons mostly uses absorbable sutures that do not need to be removed, they also uses advanced techniques that allow them to avoid packing in most cases.
The average revision rhinoplasty recovery time is one year. That may sound like a long time, but it becomes much more manageable when it’s broken down into a timeline. The following recovery milestones may vary from patient to patient, but generally, it goes something like this:
1 Week: The splint can be removed from your nose and you can go out in public without showing noticeable signs of surgery unless there is bruising around the eyes. This may take 2 weeks to resolve. It is safe to resume activities of daily living.
2 Weeks: The majority of the facial swelling has subsided and most of the bruising should have resolved.
3-4 Weeks: You can safely return to cardiovascular activities such as jogging, swimming and cycling.
6 Weeks: The bones are stable, you can resume resistance workouts (weight lifting), wearing glasses and blowing your nose.
3-6 months: The numbness and abnormal sensations in your nose and nasal skin should be resolved.
1 Year: The healing process is complete – swelling should have