Rhinoplasty and profileplasty

Preoperative exams for rhinoplasty

It is essential to carry out some blood tests, an electrocardiogram and some radiological films of the nose before the operation. In some cases, skull CT, rhinomanometry or airway endoscopy may be useful.

Anesthesia for rhinoplasty

The operation can be performed under local, assisted local or general anesthesia depending on the type of operation.
The intervention is carried out in equipped structures designed to guarantee maximum reliability and safety.
The first criterion to be pursued is in fact that of safety.

Rhinoplasty technique

Rhinoplasty is an operation aimed at modifying and reducing a humped, hooked or large nose, bringing it to the right size and a correct aesthetic profile that harmonises with the rest of the face.
If together with the aesthetic problem a breathing defect is revealed, then it is necessary to resort to rhinoseptoplasty in which the structures of the nasal pyramid that cause the obstruction are acted upon, sometimes the turbinates are also acted upon, reducing their size.
To access the osteocartilaginous structures, only internal incisions in the nostrils can be used (closed technique) or access to the columella (open technique) which leads to a very modest scarring outcome but which allows greater control of the structures to be modelled.
At the end of the operation, a plaster cast is placed next to it which will be kept on for 5 days and, sometimes, nasal swabs are placed, which in most cases will be removed after a few hours, although in rare cases they must remain in place for a few days.

Course of rhinoplasty

It is quicker than one might imagine although in the immediate post-operative period the nose and eyelids will inevitably swell a little, to a variable extent depending on the subjective reaction; the swelling will subside within 1-2 weeks and so will the bruising. Sometimes there may be small conjunctival hemorrhages that are destined to reabsorb quickly.
When the bow is removed, the nose will appear swollen, the tip excessively elevated, the base widened when viewed from the front, the nasofrontal angle can give a transitory “Greek profile” appearance.
Over the course of a few days the nose will begin to deflate, following a path that will lead to a result quite close to the definitive one around the second/third month.
The sensitivity of the skin of the nose and in particular of the tip will be altered for some time.
The definitive result that will allow us to appreciate the finest anatomical details is sometimes achieved even a year after the operation. Generally, the thicker and oilier the skin, the longer it takes to achieve the final result.

Precautions

For 2-3 weeks it will be best to avoid placing your glasses directly on the bridge of your nose (a tiny piece of gauze will be sufficient), avoid exposing yourself to the sun and avoid, although the consolidation of the nasal pyramid occurs very rapidly, “dangerous” activities that could cause trauma to the nose.

Complications of rhinoplasty

Never trust a surgeon who fails to talk about it since rhinoplasty is still a surgical procedure and complications, although rare, are always possible. The immediate ones also include serious but very rare anesthetic complications. Possible, although rare, immediate surgical complications are haemorrhagic events which may require the reinsertion of tampons and, very rarely, transfusion. Equally rare are the suffering and necrosis of the pyramidal tissues and infections.
Late complications consist of malpositioning of the pyramid, structural asymmetries and the persistence of respiratory problems.
Sometimes adjustments are therefore necessary which are generally much simpler than the initial operation, both in terms of technique and convalescence.

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