Nose Aesthetics (Rhinoplasty) Surgery

What is Rhinoplasty?

Rhinoplasty, also known as Nose Job, is one of the most demanded and most common plastic surgery procedures in Turkey and Istanbul. It is the nose that is located in the center of the facial region, which plays a very important role in the interaction and social relations of a person with his/her environment.

In today’s culture, where external appearance gains more importance with every passing day, a nose that falls short of the beauty standards, such as a large aquiline nose, is perceived as a defect by most of the young people and may cause serious self-confidence problems.

During the aesthetic evaluation of the nose, other structures such as cheekbones, forehead and chin that affect the aesthetic proportions and dimensions of the face should be evaluated as well; and if necessary, these regions should be intervened in the same session.

A successful rhinoplasty performed on the face with a holistic aesthetic approach turns a new page in the lives of our patients and enables them to proceed on their ways as individuals with higher self-confidence, who are more at peace with themselves and their environment.

The nose is not only an aesthetically important organ, but also an organ that has vital functions. While breathing through the nose, unwanted particles in the air are trapped, and the temperature and humidity of the air are adjusted to the optimal values for our lungs.

Many factors can make it difficult to breathe through the nose, such as septum deviation, that is, the curvature of the partition inside the nose, or the condition called concha hypertrophy, where the anatomical structures (conchae) colloquially known as turbinates that humidify the air in the nose and regulate its temperature are larger than normal. In the preoperative process, all medical and surgical problems that may cause breathing difficulties are carefully evaluated, and such accompanying functional problems are eliminated during the rhinoplasty operation.

What is Rhinoplasty (Nose Job)?

It is a surgical procedure performed using certain surgical techniques under anesthesia; in order to change the angles and proportions of the nose, in other words, reshape it in such a way as to make it more harmonious with other elements of the face, by intervening in its soft tissue, cartilage and bone structures.

What Can Be Treated With Rhinoplasty?

• The nose size can be made more harmonious with the face.
• A shapelier side-view can be obtained by eliminating the hump or irregularities on the nasal ridge.
• The nasolabial (nose-upper lip) and nasofrontal (nose-forehead) angles can be adjusted according to the aesthetic standards.
• The height of the nasal tip can be changed; a long nose tip can be shortened, and a flat nasal tip can be lengthened.
• The nasal base can be reshaped to appear narrower when viewed from the front.
• The shape of the nasal tip can be changed. A wide, bulbous nasal tip can be reshaped to look thinner.
• The nostrils can be reduced or reshaped.
• The nasal wings can be reduced or reshaped.
• The curvatures of the nose observed when viewed from the outside can be corrected.
• Problems inside the nose such as septum deviation and concha hypertrophy that cause breathing difficulties can be treated during a rhinoplasty operation (Reference 1).

Surgical Procedures That Can Be Performed In Conjunction with Rhinoplasty

• Septoplasty, i.e. correction of nasal septum deviation (curvature of the structure located in the medial portion of the nasal cavity).
• Treatment of Concha Hypertrophy (Turbinate Hypertrophy). Concha hypertrophy is treated using radiofrequency, laser, cautery or surgical techniques.
• By performing the following procedures, it can be ensured that not only the nose, but the entire face gain a more proportional and balanced appearance:
  • Procedures intended for the tip or corners of the lower jaw (chin augmentation, chin advancement, chin reduction). Synthetic implants such as silicone or porous polyethylene or fat grafts are used to accentuate the chin tip or the corners of the lower jaw.
  • Accentuation of the cheekbones area with synthetic implants or fat grafts.
  • Reshaping of the forehead area with fat grafts.

Features that Rhinoplasty Candidates Should Have and Should Not Have

Rhinoplasty is a non-reversible surgical procedure that causes a significant change in the facial appearance and expression, and it is quite individual-specific. Therefore, you should have rhinoplasty only for yourself, not with the desire to meet the demands of others, to be able be liked by them, or to gain the ideal facial appearance featured in the media. Requirements for surgery candidates:

• They should definitely be both psychologically and spiritually healthy. Such problems should not be concealed during the preoperative interview, and rushing for surgery should be avoided. If there are mental and physical problems, they should be treated first and the patient should be operated under the best conditions.
• The patient should have reached the psychological maturity and should have an optimistic mood to patiently and maturely face possible complications or undesirable aesthetic results.
• The physical development of the face should be complete.
• The patient should have desired the change to take place in his/her nose and face for years, and should not have this surgery by making a sudden decision on a whim. The patient should be motivated enough to have no problems in the process of accepting and adapting to the change on the face after the surgery. Patients who are undecided about surgery should not be operated immediately, and they should be given time to think about it thoroughly.
• Their expectations from surgery should be realistic. People who are extreme perfectionists and those who have narcissistic characteristics are very likely to experience serious problems after surgery.
• The deformity of their noses should be noticeable. Those who cannot describe a feature in their nose that they don’t like, and those who overestimate an insignificant deformity are not suitable candidates.
• Patients should not have unrealistic expectations about how their social relations and lives will be after the surgery. Rhinoplasty is not a magic wand.

What Type of Nose Should Be Targeted in Rhinoplasty?

A nose with appropriate angles and proportions in itself does not create a positive aesthetic appearance to every face type the same way. Therefore, it would be appropriate to aim at achieving an aesthetic result that exhibits a natural harmony with other regions of the face, which does not attract attention at first glance but adds charm to the face.

Rhinoplasty and facial aesthetics should be considered with a holistic approach, and if necessary, the rhinoplasty operation should involve surgical interventions intended for other regions of the face, as well.

Surgical Process of Rhinoplasty

Before the operation, the patient who has decided to have the operation and has prepared himself or herself for it, visits the anesthesiologist of the hospital where the operation will be performed and has the examinations requested by the physician. If these examinations do not show any problem that may pose an obstacle to the operation, the operation phase is started.

Rhinoplasty is performed under general anesthesia and fully equipped, licensed operating room conditions. The inside, outside and surrounding areas of the nose are wiped using antiseptic substances, and a solution containing bleeding-reducing and pain-relieving substances is injected underneath the skin of the nose and into certain points inside the nose.

Incisions that may differ depending on the surgical techniques used are made, and the bone and cartilage tissues to be reshaped are exposed by lifting the nasal skin.

Rhinoplasty is one of the most mentally tiring operations for a plastic surgeon, because there is a continuous exchange of data and decision making throughout the surgery. Deciding on from where and how much tissue will be removed or how much tissue will be added to where, where to stop in an operation, during which millimetric changes occur, is an exhausting process that requires a vast accumulation of knowledge and experience. The preoperative surgical plan should be implemented patiently step by step without rushing, using the right techniques during the operation.

When the surgeon leaves the operating room, he should feel comfortable with the surgery he or she has done, and should be able to feel the peace of being sure that he or she has done all the things that need to be done. I would like to particularly point out that the most important factor for being able to achieve a successful aesthetic result is, rather than the surgical techniques and instruments used, the surgeon’s command of the technique and tools he/she uses, his/her experience, and the care he/she shows for his/her job.

At the end of the operation, silicone stents that allow for breathing are placed inside the nose and a plastic mold is placed on the nose to protect its new shape and to prevent excessive swelling and bleeding.

While coming out of anesthesia, it makes everything much easier for the patient to stay calm, not to get into a panic, and to focus on what the anesthetist is saying.

How Is A Rhinoplasty Operation Performed?

There are a variety of surgical techniques in rhinoplasty. Depending on the incisions made on the skin and mucous membrane, these are mainly divided into two groups: “closed” and “open” techniques. In the closed technique, the operation is performed entirely through incisions on the inside of the nose, and with a more limited field of view.

It is helpful particularly in operations that do not require much change at the tip of the nose, which involve only the nasal ridge. The biggest advantage is that it causes less postoperative swelling at the tip of the nose and allows the nose to reach its final appearance faster.

In addition, it does not pose a risk of scarring, as it does not involve a skin incision on the area between the nostrils called the columella. In the open rhinoplasty technique, on the other hand, which involves an incision made in the columella skin in addition to the incisions made in the nose, the nasal skin is lifted completely upwards to expose the bone and cartilage structures where the procedures will be performed.

It is easier to make the desired changes in these structures and to reshape the cartilage with suture techniques. In recent years, the open technique has been more preferred by plastic surgeons because it enables them to make more precise adjustments and achieve more predictable results.

Risks and Complications of Rhinoplasty

• Excessive bleeding
• Infection
• Circulatory disorder in the skin of the nose
• Allergic reaction to the drugs or materials used
• Prolonged swelling and stiffness in the skin of the nose
• Prolonged pain and numbness in the skin of the nose
• Asymmetrical appearance in the nostrils and nasal wings
• Unsatisfactory aesthetic image aesthetic appearance

Tip Rhinoplasty – Tip Plasty– Nasal Tip Refinement

It is a surgical procedure intended to reshape the nasal tip structures without intervening in the nasal bone, in such a way as to achieve the aesthetic sizes, shapes and proportions. With this surgical procedure, it is possible to change;

• The nasolabial angle
• The nasal tip height
• The nasal tip width
• The sizes and shapes of the nasal tip cartilages
• The sizes and shapes of the nasal wings
• The sizes and shapes of the nostrils.

Questions and Answers

• What are the differences between female and male rhinoplasty?

In male rhinoplasty, care should be taken to preserve the masculine aesthetic appearance of the face and not to feminize it. If the nasolabial (nose-upper lip) angle is more than 90 degrees, that is, if the nasal tip is excessively elevated, it causes the face to look more feminine. In addition, the nasal ridge in side-view should be straighter than that in women, and should not be curved inward.

• At what age can rhinoplasty be performed at the earliest?

In general, rhinoplasty can be performed from 17 years of age for women and from the 18 years of age for men. However, rhinoplasty can also be performed at an earlier age in cases of severe anatomical problems that cause breathing difficulties, and in cases where excessively pronounced nasal deformations negatively affect psychological development.

• How many hours does the surgery take?

Depending on the procedures to be performed, a rhinoplasty operation may take 2 to 5 hours. The surgeon who will perform the operation will specify an estimated duration before the operation.

• How should the postoperative care be?

The postoperative care is intended to keep the nose area clean, protect the nose from infection, moisturize it, and help reduce edema. It is important to pay attention to and follow the recommendations of the surgeon who performed the surgery. I recommend my patients to wash their noses with sterile saline solution sprays, abstain from blowing their noses, clean the incision sites and remove blood clots protruding out of the nose using cotton swabs dipped in hydrogen peroxide solution, and apply an antibiotic cream in the first postoperative days. I also recommend them to use nasal washing solutions and nasal moisturizers in the following weeks. Since these practices may vary from person to person and overdoing these may lead to undesirable results, the recommendations of the surgeon who performed the surgery should be taken as basis.

• Postoperative Stiffness of the Nasal Tip

Especially within the first 3 postoperative months, the swelling in the nasal skin gradually subsides, the stiffness on the nasal tip begins to get soften, and the nasal tip begins to get thinner. The nasofrontal (nose-forehead) and nasolabial (nose-upper lip) angles return to normal.

In the first postoperative months, the patient may get different reactions and criticisms, especially from people in his/her immediate surroundings, who are accustomed to the former appearance; so, the patient should be psychologically ready for all these, and should wait patiently for the result.

• Postoperative Massage

After surgery, massage can be applied to reduce the stiffness and the edema that develops during the fusion of the subcutaneous tissues of the nose. I do not recommend massage to my patients for the first 6 postoperative weeks due to the risk of dislocating the bone and cartilage structures before their union in their new shapes. Every physician takes his/her own experience and preferences as a basis regarding when and how to do the massage, so it is best to pay attention to the recommendations of the surgeon who performed the operation.

• When Will I Be Able to Return to Work?

I recommend my patients to spend the first week after the rhinoplasty operation at home, and to have an accompanist who can help them meet their daily needs and provide psychological support. I tell them that they can return to work with a plastic mold in their noses in the second week after surgery, as long as their job does not require much effort. Complete union of the bones takes about 6 weeks, so I tell my patients that they will be able to do all kinds of activities and sports after 6 weeks.

• What is A Natural-Looking Nose After Rhinoplasty, and Is It Possible?

A nose in harmony with other parts of the face, which does not attract attention at first glance, is a natural-looking nose. After rhinoplasty, the patient’s close community will notice the change more easily and make comments. This is normal.

If the eyes of the people you have just met do not focus on your nose, at least 1 year after the operation, it means that your nose is a natural-looking nose. With rhinoplasty, it is possible to achieve a natural-looking nose appearance.

• What Is The Cause Of Nasal Tip Ptosis?

In cases where the cartilage structures determining the projection of the nasal tip are not adequately supported during surgery, the nasal tip remains low compared to the nasal ridge, but this condition is not much noticeable due to the edema that develops in the first postoperative days The final appearance begins to emerge as the postoperative edema in the nasal tip subsides over time.

• Does Rhinoplasty Cause Significant Bleeding?

During rhinoplasty operations, certain precautions are taken to prevent significant bleeding. Drugs, nutritional supplements and herbal teas that reduce blood clotting and have blood thinning effects should not be consumed before surgery. Some blood tests are done to check whether the blood clotting feature is normal or not.

In order to reduce bleeding, a special vasoconstrictor solution (narrows the blood vessels) is injected around the nose, underneath the nasal skin, and into the nose and the blood pressure is deliberately kept lower than normal during the operation performed under general anesthesia. In cases where all these precautions are strictly followed, no significant bleeding is encountered during the operation.

However, an increase in blood leakage from the nose may be observed after surgery if the patient lies in a full lying position instead of a semi-sitting position, if he/she moves excessively, makes too much physical effort, strains excessively on the toilet, talks a lot, consumes blood-thinning teas such as green tea, or if his/her blood pressure rises for any reason. Therefore, it is necessary to remain calm and strictly follow the recommendations during the postoperative period.

• Can Aesthetic Problems In The Nostrils Be Corrected When A Wide Nose Is Narrowed?

The operations in which the nasal tip dimensions are reduced also include the reduction of the nose wings and nostrils in proportion to the nasal tip dimensions. In addition, problems with the side-view of the nostrils are eliminated. The nostrils, which look excessively big or cannot be seen at all when viewed from the side, are corrected to gain a normal appearance.

• How Long Does It Take To Fully Recover From Rhinoplasty?

6 Weeks after rhinoplasty, the bones and cartilages will be recovered with union, and all kinds of sports activities can be performed, but it takes 2 years for the edema and stiffness in the nose to completely subside and the wound to biologically heal completely.

• When Can The Patient Be Exposed To Direct Sunlight?

In the first postoperative month, the skin of the nose should be protected from the sun with precautions such as applying a sunscreen with a sun protection factor (SPF) of at least 50, wearing a hat, etc.; otherwise spots may develop on the skin. In the following months, the patient should keep applying sunscreen especially in the summer months.

• Will The Nostrils Be Equal After Rhinoplasty?

Equality of the nostrils after surgery is something that is targeted and often achieved. In some cases, asymmetries may be observed especially due to the shrinkage of the connective tissue that develops during the wound healing process or due to dislocation of the cartilages.

• Can A Nasal Deviation (Curvature) Be Corrected?

Most of the patients who apply for rhinoplasty have nasal curvature to varying extents, which can be noticed when viewed from the outside or remain hidden inside the nose are corrected using special techniques.

• What Are the Factors That Affect the Rhinoplasty Prices?

One of the factors that determine the prices of this surgical procedure is the pricing policy of the hospital, where the surgery will be performed. Another factor is the nature and difficulty level of the operation. On the other hand, each plastic surgeon or medical center has his/its own specific price scale.

• Will My Breathing Problems Also Be Solved With Rhinoplasty?

With Rhinoplasty, it is possible to solve breathing problems in the same operation. During the same operation, the functional structure of the nose is corrected first, and if a person wants aesthetic touches, then an improvement in appearance can also be achieved. Rhinoplasty operations preferred in this way are quite common.

The Costs of Rhinoplasty in 2024

Rhinoplasty is not a standard surgical procedure, so its cost may change from patient to patient. Other problems causing nasal breathing difficulties can also be corrected during a rhinoplasty operation, and such corrections change the cost. Each individual has a different deformation in his or her nose, and this diversifies the difficulty level of the correction process, so the rhinoplasty cost varies accordingly. On the other hand, it is not ethical and legal to announce rhinoplasty prices on the Internet.

It is not a recommended method to do price research on the Internet and make a decision accordingly. The right method is to first research the physicians who perform rhinoplasty, examine their backgrounds, investigate where they perform the operations, and then get examined by some of the physicians chosen among them. During this examination, the physicians will have the opportunity to evaluate your problems more accurately, answers all your questions, and determines the cost of your operation. This method is more accurate and healthy.

Just because a physician offers the highest rhinoplasty prices doesn’t necessarily mean he or she is the best physician. Every physician encounters a certain percentage of complications or less-than-ideal results. On the other hand, the medical centers offering the lowest rhinoplasty prices should be approached with the same caution. Sometimes, the financial and moral cost of correcting the unsuccessful result of a rhinoplasty operation that the patient has underwent without properly questioning just because it was very cheap may turn out to be considerably higher.

You can fill out a form on our website to get detailed information about the 2024 rhinoplasty costs or to make an appointment for an examination. You will be given information about the 2024 rhinoplasty prices as soon as possible.

REFERENCES

1. https://www.plasticsurgery.org/cosmetic-procedures/rhinoplasty

Frequently Asked Questions (FAQ)