Author: Dr Xavier Tenorio

1. Surgical rhinoplasty
2. Medical rhinoplasty (non surgical)
3. Post-op follow-up
4. Photos
5. 3-D simulator
6. Price

Rhinoplasty Geneva, the service of rhinoplasty is directed by dr Pierre NAHON, plastic surgeon with more than 30 years of experience and thousands of successful procedures.

Definition

Also know as  » rhinoplasty », this operation aims to modify the shape of the nasal pyramid (either partially or totally) and to correct any breathing problem if needed. A rhinoplasty can be associated, if necessary, with other complementary gestures of the face, in particular with a genioplasty (reshaping of the chin).

Objectives

The goal is to obtain a nose of natural shape in harmony with the other features of the face and appropriate for the personality of the patient.

Principles

From incisions dissimulated in the nostrils, the bone and the cartilage forming the solid infrastructure of the nose are reshaped. The skin recovering the nose, will adapt to the new frame thanks to its elastic properties. Thus, the quality of the skin is a major factor to achieve a good final result. When a nasal obstruction impedes the breathing process, then the procedure can be conceived to correct any possible functional problem, this may require a consultation with an associated ENT (ears, nose and throat) specialist.

Cosmetic plastic surgery of the nose can be performed once the facial growth is finished (approximately 16 years old).

Before the surgery, the motivations and requests of the patient will be carefully analysed. Moreover, a study of the nasal pyramid and its relationship with the facial features will be made. The anticipated result can be simulated in preoperative photographs to create an approximate surgical  project.

A usual preoperative assessment is carried out in accordance with the federal regulations. The anaesthetist will check the patient at least 48 hours before the surgery. Any drug containing of aspirin has to be stopped 10 days prior to the surgery.

No food intake is allowed 6 hours before the surgery.

Type of anaesthesia and hospitalisation

This surgery is usually practiced under general anaesthesia. However, in certain cases, a local anaesthesia deepened by sedatives can be possible. The choice between these various techniques will be discussed between you, the surgeon and the anaesthetist.

No hospitalisation is necessarily required. However according to some limitations, a short hospitalisation can be preferable.

The surgery

Incisions: Classically, dissimulated inside the nostrils resulting in a non-visible scar. However, some external incisions may be necessary if the tip has to be resurfaced, nevertheless the scars are nearly unnoticeable.

Correcting the bone-cartilage structure is performed according to the local anomalies and is possible after liberating the skin. The width of the nose, bumps and deviation can also be corrected. Grafts can be employed to achieve an excellent result.

Dressings and splints. The nose is normally draped with a modelating cast for protection, made out of plaster, plastic or metal, and small adhesive strips.

The sometimes the nostrils are plugged with special absorbable dressings. The procedure lasts about one to two hours.

Follow-up

The immediate postoperative period is not painful, but having an obstructed nose (dressings) for two or three days can be uncomfortable. Oedema (swelling) and sometimes bruises can be seen around the eyes and its duration  is variable from one individual to another. We recommended to rest and not to make any  strenuous effort for a few days after the surgery. The nasal plugs are removed between the 2nd and the 5th post-operative day. The splint is withdrawn between the 5th and the 8th day, then it will be sometimes replaced by a new smaller splint for a few days. The marks produced by the surgery will attenuate gradually, allowing the return to a normal socio-professional life after a few days (10 to 20 days according to the extent of the continuations). Sports should be avoided the first three months.

The result

Two to three months are required to have a good outline of the result, knowing that the final aspect will be obtained only after six months to one year. This result is, generally, in conformity with the desires of the patient and rather near to the project drawn up during the preoperative plan. The operation obtains a morphological and aesthetic improvement generally completely appreciable, as well as a considerable psychological benefit.

Imperfections of results. They can result from a misunderstanding concerning the goals or occur because of unusual scaring phenomena or from unexpected tissue reactions such as a bad spontaneous re-adaptation of the skin or a retractile fibrosis. These small imperfections, if they are intolerable, can be corrected by a final surgical improvement, in general much simpler than the initial surgery, both from the technical point of view as the operational continuations. However such a final improvement cannot be performed before several months after the first surgery, given the need to work on stabilised tissue that has reached good scar maturation.

Complications

Minimal corrections–if necessary–should be performed at least one year after the surgery.

Fortunately, the true complications following a rhinoplasty are rare. In practise, the vast majority of the operations evolve without problems and the patients are fully satisfied with the result.

Nevertheless you must know the possible complications: bleedings, possible the first hours but remain usually very moderate. When they are too important that can justify a packing (new dressings in the nostrils). Haematomas can require an evacuation if they are bulky or too painful. Infections are very rare in spite of the natural presence of microbes in the nasal fosse. If necessary, it justifies a suitable treatment. Anaesthetic scars, related only to the external scars (when they exist) and almost never require a surgical reintervention. Cutaneous bruising, although rare, they are possible, often consequence of the nasal splint. The simple wounds or erosions heal spontaneously without leaving traces, contrary to cutaneous necrosis, which fortunately leaves only a small scar.

Conclusion

To resume, the risks should not be overestimated, but it is important to become aware that a surgical operation, even apparently simple, always comprises a small share of risks.

The chose of a qualified Plastic Surgeon ensures you that your surgeon has the competence to know to avoid these complications, or to treat them effectively if necessary.