Nose Aesthetics: Essentials I
Plastic operations on nose, which are also called rhinoplasty, are surgical interventions by which the rough, curved, asymmetric, deformed parts of the nose are corrected and re-shaped. Septorhinoplasty, on the other hand, is the corrective operation, where, in addition to the above mentioned procedure, the structure of the cartilage structure, which is called septum, is corrected in order to facilitate breathing.
The septum starts from the back of the line separating the nostrils as a thin cartilage and then ossifying towards the back and ending at the back of the head by unifying with other bone structures. If septum tends to bend, at the front side, towards right or left side, this is called as deviation. If the septum is deviated towards right side from the central line, this will result in a situation where the tipoff the nose is also deviated towards right side.
The intervention made on septum could be either the correction of the deviation, that is, Septoplasty or the removal of the deviated part, which is called “SMR”. The purpose is to facilitate breathing either by correcting the deviations or by removing the deviated section. Besides, overgrowth of the spongy tissues, which are called as concha, could also cause shortness of breath. The barriers before breathing could be removed either by removing these tissues in the same session or by reducing their size with Radio Frequency (RF).
The nose shaping operations are “holistic” interventions made on bones, cartilage, skin-mucosa (nasal skin), soft tissue, fat and muscles in the nose. If we make a comparison, the procedure could have a domino-type effect rather than Lego. A excessive or missing part not be inserted removed like a Lego. In Rhinoplasty, each surgical touch would affect all the tissues that have connection with each other and hence, have an effect for the whole nose, like the relationship between dominos. The final shape of the nose shall be finalized after 6 months with the completion of this interaction. The complaints such as “my nose has fallen” would start e-6 months after surgery. For the very same reason, we, surgeons would take our patients to secondary corrective operations, at least 1 year after the first operation, which is period that is necessary for the completion of the recovery, that is the domino effect.
The earliest recovery after rhinoplasty is completed in intranasal mucosa (intranasal splinter is removed on the 2nd day. This is followed by recovery in skin (sutures and external nose cast / splint are removed after 1 week); soft tissue (The edema completely retracts between 10-15 days.) and finally in bones ( 12-18 months depending on the degree of fraction). Nose takes its permanent/final, shape at the end of this time. In summary, correction for aesthetic purposes should be performed at the end of the first year at the earliest.
