Frequently Asked Questions
Which noses need cosmetic surgery?
One of the frequently ask questions by many patients is, “Doctor, do I need to perform cosmetic surgery on my nose?”
One who wants to have a cosmetic surgery should know that making decision about whether s\he needs an operation or net is mostly be his own. The surgeon can only tell him/her that the surgery can be done or not, and how much of his demands can be achieved through surgery. Since, not being beautiful is not a physical illness that the surgeon can order the patient to perform the surgery. However, not being beautiful can sometimes cause mental health problems for an individual indirectly.
Up to what age, rhinoplasty can be done?
Although in older age, even over 60-65 years, rhinoplasty can be done, but as mentioned, earlier, skin quality significantly affects the result of rhinoplasty. The quality of skin, and even cartilages and bones varies with age increase. In other words, the older age group will get lower rhinoplasty results.
With increased age and appearing of aging symptoms in the face such as developing wrinkles around the eyes, forehead, around the mouth and creating a double chin, the second factor that is the rest of the person’s face would be affected.
As mentioned above, in addition to the quality of skin, the beauty of the rest of the face is another important factor influencing the outcome of the operation. Usually, both of these factors undergo negative changes in an elderly person.
In elderly patients, the surgeon must inform them about these issues, and probably suggest the patients’ other complementary surgeries such as facial and forehead lifting, eyelid surgery, fat injections, etc.
Which season is more appropriate for doing nose surgery?
There is no priority in seasons for doing rhinoplasty. However, in summer (warm seasons), bearing bandages and nasal plaster cast nose as well as more need to bathing may cause some problem. But in general, performing rhinoplasty in all seasons is possible. Thus, the rumors that operating in the winter is more problematic than other seasons are not true.
Does the patient require to do a secondary surgery or retouching?
According to statistics from the famous American surgeons’ books, about 10-20% of patients undergone rhinoplasty would need a second operation. These statistics seem to be somewhat exaggerated. As based on my own experience since 2000, a maximum of 1 to 1.5 percent of my patients have been made to do secondary surgery or retouching after rhinoplasty. However, retouching does not necessarily mean the failure of the previous surgery. It may mean that the surgeon could have not resolved all the solvable problems in the first surgery and some partial problems have still remained. In the hands of a good surgeon, the nose should never become worse than what has previously existed. Then, the need for retouching a nose surgery may refer to correct a part of problems failed in correction in the first surgery or done incompletely. Therefore, the surgeon needs to do them in a second stage, which does not mean the surgery has worsened the patient’s nose condition. It is sometimes done to correct the breathing problems. It rarely occurs that the surgeon deliberately postpones the correction a part of a difficult nasal surgery to the next stage. However, it is basically preferred to correct all nasal problems, whether respiratory or rhinoplasty, in the first stage as much as possible. Even in cases of minor problems, do retouching requires to wait for a while. Depending on the problem, retouching may be delayed 6 to 12 months so that the problem can be detected more accurately to take action for fixing. Also, the nasal tissue need enough time to get ready for another surgery. The surgeon may rarely decide to manipulate the nose in the first weeks, and the issue is very rare.
Can nasal surgery help to correct the rest of facial components?
Sometimes, we can see expected changes in the rest of face after nose surgery. For example, if a nose with broad bones is well narrowed by a skilled surgeon in the right place, usually the cheeks become more prominent and the eyes look larger. However, if the narrowing does not occur at the correct location, it can adversely affect the facial form. In some cases, by heading off the nose, very positive impacts can be created in the patient’s lips form. Sometimes, through properly correcting the nose, the form of laughing and viewing the gums while laughing can be corrected. However, usually if there is a strongly negative factor in the rest of the face, even the best nose surgery cannot bring an extraordinary beauty for the person. One of the most effective surgeries, unfortunately little known by the public, is chin surgery that is done in most cases easily with local anesthesia, which is less troublesome for patients than the nasal operation. But, it is sometimes far more effective than nose surgery, since the backward chin makes nose come forward to be seen too much snub. The problems considered by a person with his nose can be much more corrected with chin surgery rather than nose surgery. In ordinary and not-so-small chins, through enlarging the chin, a more beautiful nose surgery can be sometimes offered to the patients.
Dose breathing through the nose get worse after rhinoplasty?
Although the nose usually become smaller in rhinoplasty surgical operation, but if the surgery is done carefully and with proper technique, such shrinking does not occur in the air pathway and the breathing would not be affected. However, normally until 1-3 months after the surgery, a small amount of nasal congestion may be existed due to swelling inside the nose, which should be then improved. Otherwise, the problem must be followed up and fixed. In patients with allergic rhinitis, the allergies aggravate sometimes up to a year after rhinoplasty, which may need to take more medicine. However, the breathing must be improved by using proper anti-allergic drugs. Sometimes, remained deviation inside the nose, and sometimes previous enlarged turbinates or nasal inward movement or escalated turbinates enlargement could be the reason for such obstruction. Rarely, cartilages overlapping may cause such breathing difficulties. All of these rarely occur in hands of a good surgeon, and even if happening, they can easily be fixed. In fact, after a good rhinoplasty, the patient’s breathing condition becomes better than before (of course, after 1 to 3 months) or does not change at all. Worsening is not normal in any way, except in cases of allergies, which can be relieved with medication.
Is rhinoplasty surgery done with projected laser as well?
Simply put, laser is a strong light beam, which can vaporize tissues by generating heat, and almost acts like a scalpel, while it burns the veins and causes less bleeding.
Its work can be analogized to a soldering iron. In any case, there is no report around the world on performing rhinoplasty by using laser. In other words, rhinoplasty has performed nowhere in the world by using laser, and it is not basically possible; even if done, there would be no benefit in it. It is unclear that why such a rumor on performing rhinoplasty with laser by some nose surgeons has been widespread. The reason may be due to less bruising and swelling caused by the surgeon or the type of plastic mold that is sometimes used instead of plaster cast. However, we should know that laser has no place in doing rhinoplasty.
Where should nose surgery be done?
In today’s developed world, there is tendency to perform light surgical procedures like rhinoplasty and most of cosmetic surgeries in surgery centers or clinics. This is true in our country, Iran, as well. Since, the cost would be more affordable than regular hospitals. Features and conditions of the operating room and surgical ward in surgery centers have no differences compared with normal hospitals. Heavy surgical procedures that may require long term hospitalization are not done at surgical centers. Most of cosmetic surgery procedures seem to be performed now in surgery centers, and the ratio of performing such operations in hospitals is far less. Unfortunately, we have heard that some surgeons do rhinoplasty in their own office, which (except for few outpatient minor things) does not appear to be a good idea.
How long a nose surgery lasts? How much is the hospital stay?
Depending on the difficulties and complexity, doing a nose surgery may need from 1 to 3.5 hours. However, the surgeon obsession, action speed and the type of surgical technique (open or closed) can also affect the operation time. But on average, a good and accurate operation on a normal nose takes about 2 hours. Meanwhile, a period of time is also spent on anesthesia and recovery (full recovery) arrangements of the patient. Considering these times, the patient may spend even 6 or 7 hours in the operating room. Usually after leaving the operating room and patient transport to the ward, the patient will rest about 3 to 6 hours in the ward. In case of proper general conditions, the patient will be discharged on the same day and goes home.
Do you put tampons (use packing) in the nose after surgery?
What scares many patients from undergoing nose surgery (Rhinoplasty) is the use of tampons inside the nose. Since, the type of tampons use by some specialists buffering for their patients has unfortunately caused unpleasant experiences for the patients after surgery at the time of removing tampons. However, in many patients, we have the chance of not using tampons. But, given the limited benefit of not using it, in case of absence, it can cause the patient facing the risk for bleeding, which is mild, but still annoying for the patient. Thus, I sometimes put a soft and smooth tampon into the nasal cavity. However, in most cases of nose surgery, even without packing, the patient would somehow have an uncomfortable breathing for 3 or 4 days due to f swelling inside the nose. Due to using soft material tampons, their removal is usually done easily and almost painless
Do you perform packing the nose after surgery or use something else?
Usually after nose surgery, the nose is glued and plastic mold is then put on it to limit the swelling and help its immobilization. Only in rare cases where little work has been done on the nose, we can just use the tapping. Like any body organ dealing with swelling, cooling, immobilizing and upper placing are constant principles that reduce inflammation and swelling. In case of nose, putting cast on the nose and tapping help to immobilize and fix the organ, meanwhile through pressure mechanism prevents the accumulation of blood and inflammation of the tissue in the nose. Usually, the cast remains about one to two weeks on the nose. Then, depending on conditions, the patient’s nose is glued between 2 to 5 weeks, which is merely done to help reduce inflammation and swelling of the nose and usually plays no role in the main form of the nose.
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