In most cases, breathing difficulties are caused by deviation of the nasal septum and hypertrophy of the turbinates. Many deviations of the nasal septum are attributable to trauma, although the majority have congenital origins or follow microtraumas, often unrecognized, which occurred in childhood. A fall from the tricycle can in fact cause a deformation that is not noticed at the time but as it grows it leads to obstruction of the nostrils and can contribute to the formation of the hump. The turbinates are small offshoots inside the nose that humidify and heat the air before sending it to the upper airways and from there to the lungs. They can enlarge and occupy a large part of the space, hindering the flow of air and often the hypertrophy of the turbinates is compensatory, it develops on the opposite side to the deviation of the septum: little air enters from one side, a lot of air enters from the other and, with time, the turbinate swells because it is subjected to an excessive workload.
Rarely, breathing difficulties are encountered that are not caused by septal abnormalities but by allergic or vasomotor factors, or in which the turbinates occasionally swell and then return to normal. In this case, surgery is not indicated. If the respiratory obstruction is instead caused by nasal polyps, then an accurate diagnosis via CT scan is required.
Aesthetic-functional rhinoplasty
Before undergoing rhinoplasty surgery, blood chemistry tests, an electrocardiogram and an x-ray of the nose, possibly completed by a CT scan of the skull, must be carried out. Diagnostic rhinosendoscopy and rhinomanometry are sometimes useful.
Aesthetic-functional rhinoplasty lasts from one to two hours, under general anesthesia. The hospitalization usually takes place during the day (in day hospital) while sometimes an overnight stay is necessary.
It is important that the facility where the operation is carried out guarantees overnight hospitalization if necessary.
Post-operative course
After the operation, the so-called cast must be worn for 5/7 days, a brace that serves to protect the nose and consolidate the nasal bones in the correct position. Once the cast has been removed, the bridge of the nose is covered with plasters for another 3/5 days. Although after about 10 days the shape of the nose is already acceptable, the swelling will subside over the following months. The nasal swabs are not inserted if the rhinoplasty had only aesthetic purposes, while they are removed after 2/4 days if the septum has been modelled. Modern swabs have small tubes that allow you to breathe through your nose.
The first checks after the operation must be carried out after a week, after two, after a month, after two months, after six, after a year.
Complications from rhinoplasty
Complications due to rhinoplasty surgery are very rare (hemorrhage, hematomas, etc.) in the immediate post-operative period.
In very few cases it is necessary to re-operate due to persistent respiratory problems.
A particular precaution to follow after the operation is not to sunbathe on the nose for at least 3/4 months if not protected by full-screen sun creams. It is advisable to do the surgery in the cooler months.
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