Some may view rhinoplasty as a luxury, but many cases require some solutions from a medical point of view, not just for aesthetic purposes. How are these surgeries performed? Let us know the answer in this article.

 

The objectives of nose plastic surgery are to reshape the nose, either to reduce its size, improve its appearance, get rid of deformities, improve some structural defects in the nose that cause some health problems, such as breathing difficulties. It can also achieve:

• Balancing out the facial features.

• Adjusting the size, shape, or nostril openings of the nose.

• Beautifying the crooked or significantly low-bridged nose.

• Correcting the wide, long, droopy, or inverted nasal tip.

• Beautifying the inverted, wide, or large nostril openings.

• Dealing with any nose asymmetry.

Functional rhinoplasty procedures are performed to correct structural deformities or defects in the nasal structure that cause breathing problems, including:

The nasal septum is a barrier that separates the nasal cavity into two passages and connects to the skull and the nasal tip. It is made up of bones and cartilage. The deviation of the nasal septum occurs when the septum is tilted to one side of the nose in an S or C shape, leading to blockage of the airway in the nose and destruction of the soft nasal tissues. Therefore, surgery may be required to correct the upper bony part of the nasal septum or the lower cartilaginous part.

 

Functional rhinoplasty procedures can correct a deviated nasal septum to improve blocked airflow and require an evaluation of the nasal structure to assess its relationship to normal airflow in the nose. A deviated or blocked nasal septum is the most common cause of shortness of breath, which requires adjusting the nasal structure to improve normal breathing.

Rhinoplasty procedures can correct enlarged nasal bones inside the nasal cavity, known as turbinates, which are thin bones inside the nasal cavity that end in small, curled shapes. There are three types:

- The first type: the enlarged bone is at the top of the nasal cavity, which is high inside the nose and between the eyes.

- The second type: the enlarged bone is in the middle of the nose and is less swollen than the first type.

- The third type: the enlarged bone is the least severe in terms of swelling and is located above the nasal line.

 

These bones are covered with soft nasal tissues that moisturize the air during inhalation. The procedure aims to reshape the enlarged bones without reducing or removing the soft tissues from the swollen inner bones. The function of these bones is to moisturize and warm the air during inhalation, which is essential for breathing. Removing them may lead to what is known as atrophic rhinitis, which can cause infection and excessive mucus secretion. However, the inner bones can be moved outward and corrected away from the nasal septum to create a wider air passage that helps improve breathing and maintain nasal functions.

 

Nasal polyps are extra tissues that resemble a bulb and become swollen due to allergies. Dr. Wael Ghanem removes them from the nasal openings.

 

Many forms of fractures can occur in the nose, and they can cause nasal obstruction, which impedes breathing. They can occur in multiple places, including the fracture of the lateral bone of the nose and the nasal bridge, which results in the fracture of the nasal septum and cartilage. The fracture appears as a prominent bone in the middle of the nose when viewing the face from the side. These fractures are repaired by restoring the broken parts, and cartilage can be removed from the ribs to restore the broken cartilage. Cases of refraction occur in cases of severe trauma or osteoporosis.

 

Many types of rhinoplasty target the cosmetic aspect of improving the overall appearance of the nose to make the facial features more symmetrical, including:

The bridge is the bony part at the top of the nose. Correction may be required in cases of a large nasal bridge, the underlying cartilage of the nose, or when the bridge causes a droopy nose or the presence of masses at the front. Dr. Wael Ghanem removes the excess parts with great precision and fills the low areas in the nose with parts of the cartilage of the nose, ear, or ribs to obtain a straight nose.

In some cases, the nose may be slightly crooked or curved, appearing as a protrusion when viewed from the side. Dr. Wael Ghanem removes some tissues or changes their location to adjust the nose shape and correct the curvature to make it more symmetrical and straight. He also puts a splint on the nose after the surgery to stabilize it.

Dr. Wael Ghanem reshapes the tip of the nose and adjusts its upward rotation by reducing or lifting the cartilage at the tip of the nose. He may also reduce the nose's top or base to achieve proportionality with the face features.

 

A drooping nose is an extension of the nose tip that approaches the upper lip, which requires restructuring the nasal cartilage by either removing part of it, separating and reshaping, or connecting new cartilage that enhances the nose shape with the rest of the facial features.

The nose angle is between the nose tip and the upper lip. Dr. Wael Ghanem adjusts this angle to suit the facial shape and the degree of nose droop. In most cases, he creates a nasal angle of 90 to 95 degrees in males and 100 to 105 degrees in females. Dr. Wael Ghanem can adjust the nose's droop with the nasal angle in the same surgery.

Dr. Wael Ghanem reduces the nose's width by narrowing the lower nasal openings and making the nose's three edges sharper.

It is a surgical technique that aims to reduce wide nostrils, usually done with narrowing the nose width by removing some of its tissues. A special surgical incision is made in this technique to minimize the edges of the nose.

Each ethnicity has unique features. Rhinoplasty can change some features, such as, wide African or Asian nose. Therefore, people perform plastic surgery to change some ethnic features, such as reducing the nose width or opening.

 

The following cases can be considered good candidates for rhinoplasty:

• Completed facial growth.

• Good physical health.

• Non-smoking.

• Positive outlook and realistic goals towards the surgery.

 

The average total cost of rhinoplasty, according to the American Society of Plastic Surgeons for the year 2023, is about $5,125. The cost can vary according to many factors, including the doctor's experience, and the geographic location where the surgery is performed. In Egypt, The cost ranges from 55,000 to 65,000 Egyptian pounds and includes:

• Anesthesia fees.

• Medical examinations.

• Medications.

• Surgeon's fee.

• Hospital costs.

 

Before performing rhinoplasty, several points are discussed, including:

• The goals of the surgery regarding appearance and breathing.

• Knowledge of the patient's medical conditions and any allergies, previous medications, current medications, herbal supplements, vitamins, alcohol, and tobacco.

• The patient's medical history of previous surgeries.

 

• Evaluate previous general health conditions and potential risk factors.

• Study available options for rhinoplasty.

• Take detailed measurements of the face.

• Discuss alternatives, side effects, and the risks and complications associated with the surgery.

 

• Ask the doctor about pictures of previous successful surgeries he had performed.

• Is the patient a good candidate for the surgery?

• What is the recommended surgical technique?

• How long is the recovery period, and how to prepare for it?

• The specific risks and complications for the patient.

• How to deal with potential side effects and complications?

• How will the nose look over time?

• Available options and alternatives if the results are unsatisfactory.

 

Before the surgery, Dr. Wael Ghanem will make some preparations, including advising the patient to:

• Stop smoking.

• Avoid taking aspirin, herbal supplements, and anti-inflammatory drugs, as they may increase the risk of bleeding during surgery.

• Risks of anesthesia and infection, skin discoloration, and swelling.

• Poor wound healing.

• Numbness and pain in the nose occur due to changes in skin sensation.

• Breathing difficulty.

• The appearance of the nose after surgery may be unsatisfactory.

• Perforating the nasal septum is rare but may require additional surgery that is not guaranteed to have successful results.

• Corrective surgery may be required later.

But all of these risks can be avoided by choosing an experienced doctor in rhinoplasty, such as Dr. Wael Ghanem, who guarantees you will get the best results without any complications.

 

The patient is given some medications that help him feel comfortable during surgery, and the appropriate choice is made between local or general anesthesia depending on the patient's condition.

 

The incision can be made in more than one way, either through a closed procedure where the surgical incision is hidden inside the nose or through an open procedure by making an incision through the narrow strip of tissue that separates the nostrils. Through these incisions, Dr. Wael Ghanem gently lifts the skin covering the bones and cartilage of the nose until he reaches the nasal structure that he will reshape.

 

When reshaping the nose, Dr. Wael Ghanem removes the nasal bone or cartilage in the case of a large nose, and the surgery may require adding nasal cartilage, which is usually taken from the nasal septum. Sometimes it is taken from the ear or rib cartilage.

A deviated nasal septum can be straightened, and the obstruction caused by the nasal septum can be corrected to improve breathing.

 

After adjusting and reconstructing the nose structure, the skin tissues are repaired, and the surgical incisions are closed cosmetically.

 

Dressings and splints are placed on the nose at the beginning of the recovery stage, and a splint may be placed inside the nose to support and protect the new structures during the healing phase. Then the swelling subsides within the first few weeks, but it may take a year for the final results to appear. During this period, the results appear gradually, and the swelling may continue to appear and subside, especially in the morning hours during the first year after surgery. Dr. Wael Ghanem will provide some instructions during the recovery period.

• Avoid strenuous activities and exercise, including running.

• Avoid getting close to the nose while showering and wearing clothes.

• Do not touch or scratch the nose.

• Eat fiber-rich foods such as vegetables and fruits to avoid constipation, which may cause stress and pressure on the surgical site.

• Avoid strong facial expressions such as smiling and laughing.

• Avoid moving the upper lip vigorously while brushing your teeth.

• Avoid tight-fitting clothing that may put pressure on the nose while wearing it.

• Avoid wearing sunglasses or eyeglasses for at least four weeks.

• Use broad-spectrum sunscreen, especially on the nose, as the sun may affect the surgical results.

• Avoid sodium in food, as it can lead to swelling.

• Avoid applying ice or cold compresses to the nose after surgery.

 

The results are long-lasting, but swelling may persist for several weeks until it gradually subsides, and it may take up to a year for the final results to appear. During this period, some changes can be observed, which improve over time. Although the results are long-lasting, they may be affected by aging factors, and exposure to excessive sunlight after surgery should be avoided.

 

Dear reader, we have learned about the medical reasons for rhinoplasty and how it is performed. In the end, we hope that we have been able to answer all your questions and inquiries. For further questions, you can book an appointment at Dr. Wael Ghanem's center.