OF THE NOSE
The nose is the central point of the face. The rhinoplasty
searches the aesthetic balance of the face, without leaving
apart the functional aspect of the nose. Technically, a proportion
between the nose subunits and their balance with the face
is searched. Before anything, the doctor must tell the patient
each and every possibility and guide her/him about which type
of nose would fit better on her/his face, always warning that
the aim is an improvement, not perfection. It is usual to
use computer programs in order to project on the patient´s
face the more adequate nose, giving her/him a previous idea
of how her/his profile could be after the surgery. One of
the benefits of rhinoplasty is not leaving visible scars.
It is indicated from the age 14 or 15, because before this
age the nose is still growing.
The rhinosculpture is a new philosophy on the approach of
rhinoplasty, as it doesn´t follow the classical methodology.
It is a technique based on multiple procedures, associated
to grafts, rasps, resections, among others. The combination
of these procedures varies according to each patient´s
needs and it is determined after a careful photo and computerized
study of each case. The planning is always made after doctor
and patient come to an agreement. The rhinosculpture is a
complex technique , but it allows more natural results than
conventional rhinoplasty does, because it personalizes the
patient´s nose. The aim is to scape from the nose called
surgical nose, as artificial as easily identificated.
For patients over 40 years of age, for example, a radical
change of the nose format is not recommended as, besides being
too evident, it may affect the person´s own identity.
In those cases, rhinosculpture guarantees a natural aspect,
only improving the imperfections and keeping the patient´s
self image. Besides that, in the majority of cases where the
rhinosculpture philosophy is used, there is no need of breaking
the nose bones, a rhinoplasty usual procedure. Like that there
is less aggression to the organism and the recovery is faster
and more comfortable.
Ten days prior to the surgery the patient must stop taking
any medication based on acetylsalicylic acid, such as aspirin.
The doctor must be informed about any medication that the
patient is taking, as well as about being a smoker. On the
eve of the surgery, it is necessary to carefully wash the
hair followed by a careful cleaning of the face and the inner
part of the nose. The patient must have a soft diet and it
is not allowed to drink alcoholic beverages.
Each type of nose asks for a different technique. The most
common surgeries aim for reducing the size of the nose, reshaping
the tip, removing the dorsal hump or correcting anaesthetical
angles between the nose and the superior lip. The first step
of the surgery is the correction of the nose functional deficiencies,
like deviated septum and turbinate bones. After that the aesthetic
corrections are started. The most complete rhinoplasty consists
in removing the bone prominence of the nasal dorsum, lifting
and narrowing the tip and also the lateral narrowing. There
are more simple cases where only the dorsum scratch and the
tip narrowing are performed. Others where only the tip is
lifted. In the majority of nasal surgeries, the work is done
through internally placed incisions. It takes from 40 minutes
to one hour and half. The rhinosculpture is a more detailed
and individualized procedure, which length varies depending
on the complexity of the case. Anesthesia may be local or
general. This decision is taken together between the patient
and the doctor. The length of hospitalization depends on the
type of anesthesia chosen.
An adhesive tape protection and a plastic splint will be placed
to help keep the format of the bone and the cartilage on the
desired position. Packing is necessary for 12 hours, or for
72 hours if the septum was treated. The patient must sleep
with her/his head lightly raised avoiding lying down over
the nose. Ice compresses may diminish the swelling. The postoperative
period is normally painless and infection is rare. Physical
efforts and sun exposition must be avoided for the first weeks.
After 72 hours the patient is allowed to use make-up in order
to disguise ecchymosis that may last 15 days. It is usual
that the swelling of the nose lasts sometime, but the edema
disappears gradually and around the sixth month it is possible
to verify the final result.
"The Regional Medicine Council doesn´t allow the exhibition of pre and postoperatory images".