Rhinoplasty

In rhinoplasty operations, the nasal hum can be reshaped and reduced, the nasal tip can be reduced and lifted, the nostrils can be reduced or made symmetrical, with intent to obtain an aesthetically more beautiful appearance. In addition, the angles between the nose and forehead, and between the nose and lips can be arranged. Besides these, rhinoplasty also involves the elimination of polyps and deviated septum that cause breathing problems, as well as problems such as concha bullosa, also colloquially known as sinusitis.

WHO ARE ELIGIBLE FOR SURGERY

Anyone complaining of the deformity in any part of his/her nose is a candidate for rhinoplasty.

FROM WHAT AGE PEOPLE CAN HAVE SURGERY

The surgical procedure can be performed in women older than 16 years old and men older than 17 years old. It would not be appropriate to perform an operation on younger people because bone growth does not stop before these ages. In addition, without parental consent, no surgical procedure can be performed on patients who have not turned 18.

WHAT KINDS OF CHANGES ARE NEEDED IN MY NOSE

Rhinoplasty is not a surgical procedure performed with intent to treat a health problem, but a surgical procedure requested by patients for a change in their appearance. Therefore, the patient has the best idea about what kind of shape change is required; however, the surgeon will of course guide you regarding the nose shape that would be the most suitable for your face. Consequently, the operation is planned as a result of a good and realistic communication between the patient and surgeon. 

CAN I SEE THE NEW (PROPROSPECTIVE) SHAPE OF MY NOSE?

I think simulation studies would be very helpful during preoperative planning. It is difficult to promise a tangible result with descriptions such as saying "let your nasal hump be removed like this", "let your nasal tip be lifted like this", or "let it be natural" etc. However, with the simulation studies to be performed, the surgeon and patient will be able to concretely understand what is in each other's minds.

WILL YOU USE THE CLOSED OR OPEN TECHNIQUE?

I use the both techniques in my patients. If my patient does not have a special request, I decide between them after the examination. I use the closed technique in roughly more than half of my patients. I can easily use it in patients, who do not need a significant change, and those who have no advanced deformity or deviation (curvature) in their nose. However, if these conditions are present, and if the operation is a revision surgery, I use the open technique. If my patient particularly wants the operation to be performed with the closed technique, I of course mostly observe this request. 

WILL I HAVE LESS SWELLING AND PAIN WITH CLOSED TECHNIQUE?

There is no difference between the closed and open techniques in terms of post-operative healing process. The swelling and nasal discharges that will occur, the pain you will feel, and the time required for the subsidence of swelling are the same in the both techniques. 

WHAT IS THE DIFFERENCE?

The greatest advantage of the closed technique is that it involves no incision on the nasal tip. This contributes to a more natural appearance. However, the incision heals by leaving almost no scar in a long period. In the closed technique, it is also possible to perform the surgical procedure in such a way as to provide more preservation in terms of the nasal ligaments, nerves and vessels. This accelerates the healing and reshaping processes, and enables the patient to regain the nasal tip sensation sooner. 

WHAT IS THE LET-DOWN TECHNIQUE?

The let-down technique is a newly spreading innovative technique used mostly by young, innovative plastic surgeons. It is actually the modified version of the Push-down technique used and published in the 1970s.

With this technique, the nasal ridge is reduced or reshaped as desired, with no need to remove any bone or cartilage from the nasal ridge. The advantage of this is the preservation of the natural structure of the nasal ridge. By this means, the patient both maintains his/her naturalness and gains an aesthetically beautiful appearance. 

WHAT IS PIEZO RHINOPLASTY?

With the Piezo technology, it is no longer necessary to use instruments such as chisels, and rasps when doing operations on nasal bones. More bloodless and better controlled procedures are performed on the bones, in such a way as to minimize the risk of bruising and unwanted fractures. The Piezo technology can only be used in the open technology for now, but gives the same results when performed with the closed technique involving the use of micro-motors. 

WILL I NEED TO HAVE AN OPERATION AGAIN?

The most common complication of rhinoplasty is the need for a revision rhinoplasty. Around the world, this risk varies between 3 and 15%, depending on the region or surgeon. In my operations, this rate does not exceed 5%. The best way to reduce this is to ensure an appropriate communication between the patient and surgeon. In this way, the unrealistic expectations of patients are eliminated, the surgeon ensures the patient to adopt the possible result, and the patient undergoes the operation by knowing the prospective result in advance, if he/she decides to have a surgical operation. 

Despite all these, there is always the risk of need for revision surgery. It is because the nose is like a closed box that you can never completely open and control. By accessing from one of its sides, you deal with many things totally independent from each other, which constitute a whole in themselves. Under these circumstances, unexpected situations can occur in the recovery stage. It is definitely not a surgical procedure that produces 100% predictable results. 

WILL I HAVE A TERRIBLE PAIN, AND WILL BRUISING AND SWELLING OCCUR?

Contrary to popular belief, rhinoplasty is not a painful operation. Except for exceptional circumstances, it will only inflict pains that may occasionally become throbbing pains responding well to painkillers.

I experience no bruise in 90% of my patients. However, when the personal characteristics are also taken into consideration, it should be kept in mind that such a risk always exists. 

Swelling tends to increase within the first 3 days, and progresses towards the under-eye regions. At the end of the 72-hour period, the swelling begins to go down, and the post-operative period begins to become less uncomfortable. At the end of the 7-day period, you only have a limited amount of swelling in your mouth and roughly 80-90 percent of these swelling in the next 2 weeks.
 After that, the remodeling process starts. It takes about 6 to 12 months in patients with thin skin, and 2 to 3 years in patients with thick skin. 

WILL I FEEL PAIN DURING THE REMOVAL OF THE NASAL PACT?

Silicone nasal packs placed in the nose are removed on about the 3rd day. Patients who strictly follow my instructions may even not feel the removal of the nasal packs. These instructions are nothing more than cleaning the nose with sprays on a regular basis. 

WHEN IS THE NASAL SPLINT ON THE NASAL RIDGE REMOVED?

The thermoplastic nasal splint that we place on the nasal ridge is removed on the 7th or 10th day, depending on the extent of the intervention. 

WHEN WILL I BE ABLE TO RETURN TO WORK?

I generally advise my patients to take off from school and work for a period of 1 week. However, I give permission on the 4th day to my patients who need to go to work or school. On the 4th day, the patient gets freed from the nasal packs and begins to feel relatively less restricted and more comfortable. If the patient works at a desk job or just listen to the teacher, there will be no problem after this process in terms of continuing such activities. 

WHEN WILL I BE ABLE TO FLY?

I have had patients who travelled by air on the 2nd postoperative day. Of course it has probably been a difficult experience but it has no drawback in terms of health. However, I advise the patient to wait for 1 week after surgery, and then experience together with me the removal of the nasal packs inside the nostrils and the nasal splint on the nasal ridge. This becomes more comfortable and safe for both of us. 

CAN RHINOPLASTY BE PERFORMED UNDER LOCAL ANESTHESIA?

I prefer general anesthesia for even the smallest possible procedures within the scope of rhinoplasty because the nose is a whole and, any change in its any part can affect the entire nose. In such a case, it would be an unnecessary risk to try to perform the surgery under local anesthesia. I have so far preferred general anesthesia for even the smallest surgical procedures, and I have never regretted doing so. 

HOW MANY HOURS DOES THE SURGERY TAKE?

It takes about 2 to 2.5 hours. However, I always tell my patients' relatives that they can see the patient 4-5 hours later. This is because the operation is not started immediately after the arrival of the patient in the operating room, and the patient is kept in the operating room for a certain period of time after he/she comes out of anesthesia. 

CAN I HAVE RHINOPLASTY WITHOUT BREAKING THE NASAL BONE?

Except for nasal tip operations, rhinoplasty operations always involve interventions in the nasal bone. We do not break the nasal bone during the surgery but we cut and shape it. When doing this, we reshape the bones without damaging the tissues, capillaries, and nerves, by using piezo electronic devices or micro-motor devices instead of using instruments such as rasp, chisel, and hammer as in the past. By this means, the risk of postoperative bloody discharges and bruising is minimized.

I HAVE A PROBLEM WITH ONLY MY NASAL TIP

Most patients now reach us via the internet, and want to get our opinion by sending their photos. When a candidate for cosmetic surgery looks in a mirror, he/she may think only his/her nasal tip looks ugly; however, the nose is complete in itself, and usually a complete rhinoplasty operation is needed, except for a small number of patients. 

TECHNICIAL SPECIFICATIONS

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