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
- 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.
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 2023
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 2020 rhinoplasty costs or to make an appointment for an examination. You will be given information about the 2020 rhinoplasty prices as soon as possible.
Frequently Asked Questions (FAQ)
In What Cases Should Rhinoplasty Be Performed?
Who Are Good Candidates for Rhinoplasty?
What Are the Types of Rhinoplasty?
In general, there are two main surgical approaches as surgical methods: the “closed” surgical approach, where all incisions are made inside the nose, and the “open” surgical approach that involves a skin incision on the area between the nostrils called the columella, in addition to the incisions made inside the nose. In rhinoplasty (nose job), both the bones and cartilage of the nose are intervened.
In tip rhinoplasty (tip plasty), also known as nasal tip refinement, only the tip of the nose and cartilage structures are reshaped without involving the nasal bones. In septorhinoplasty, the rhinoplasty operation also involve the correction of the nasal septum deviation (curvature of the midline compartment). Rhinoplasty is not a standard surgical procedure. Plastic surgeons use different surgical techniques depending on the condition of the nasal deformities, taking into account their own surgical experiences.
What is Non-Surgical Rhinoplasty?
How to Choose a Physician for Rhinoplasty?
You can get advice from people you know who have had rhinoplasty before and are satisfied with the result. All plastic surgeons receive training on esthetic and reconstructive nose surgery during the long training processes.
First of all, you should read the resumes of the physicians you reach through different channels, learn about the cities where they work and the hospitals where they perform their surgical operations, and you should definitely have an interview with them face to face. Before going to the interview, you should make a list of the topics that you want to learn about in particular, and then you should find out your physician’s answers to these questions and his/her approach to rhinoplasty. After having several interviews in this manner, it will be easier for you to decide which doctor is most suitable for you.
What Are The Dos And Don’ts After Rhinoplasty?
How Is The Postoperative Recovery Period of Rhinoplasty?
In my own practice, my patients spend the night of their rhinoplasty operation in the hospital and are discharged the next day. They are asked to rest with an accompanying person, to clean their noses as recommended, eat as recommended, and to come for a control examination 5 days later. In the first control examination, the silicone stents in the nose are removed, the sutures on the skin are removed, the inside of the nose is cleaned, and the mold on the nose is replaced.
In the control examination performed a week later, the tapes and mold on the nose are removed. It should be noted that the nose seen for the first time in the mirror looks much larger than its actual size due to edema, and that the sensation change in the nasal skin and swelling and stiffness at the nasal tip are normal.
In the next month, the patient can return to his /her daily life, provided that trauma is avoided in order to allow for proper fusion of the reshaped bone and cartilage structures. The recovery process is monitored with control examinations performed 1, 3, 6 and 12 months after the operation. During this process, additional treatments such as massage and cortisone injection can be given. In order to be able to fully evaluate the result of the operation and to make a revision if necessary, at least one year should pass.
How Can People With Concha Hypertrophy And Nasal Deviation (Curvature) Benefit from Rhinoplasty?
If patients who will have surgery for the treatment of concha hypertrophy and septum deviation also want to have rhinoplasty, or if rhinoplasty is also needed (if the external appearance of the nose will change as well), it is very important to perform all these procedures in the same session because the cartilage tissues removed from the middle partition of the nose during nasal deviation surgery are used to reshape the nose in the same session.
At this point, I would like to draw attention to an important detail: since concha hypertrophy and nasal deviation operations can be partially or completely covered by insurance systems, the financial cost to the patient may be lower, but when rhinoplasty is added to these procedures, payment problems are experienced with insurance companies.
It may seem logical to have nasal concha and deviation surgeries and then rhinoplasty in order to avoid these problems, but it is not the right approach because if the cartilage tissues removed in the deviation surgery are not used and are discarded, problems may arise in the subsequent rhinoplasty operation.
Is It Necessary to Make an Incision Outside the Nose For a Rhinoplasty Operation?
Is It Necessary to Use Stents in Rhinoplasty Operations?
If stents are not used after rhinoplasty, the intra-nasal structures would swell and the patient would be unable to breathe through the nose, contrary to what is thought,
However, when silicone stents are used, which are nasal packings with tunnels for air to pass through, it will be possible to breathe through the nose, and thanks to these stents, the middle compartment of the nose and the nasal bones, which will be mobile at that time, will remain more stable. Since the such silicone stents do not adhere to the surrounding tissues, their removal causes no pain or bleeding.
Is It Necessary To Stay In The Hospital After Rhinoplasty?
In my own practice, I ask my patients to definitely spend the first night in the hospital after surgery. This is because their all the vital functions are closely monitored and the required treatments are performed in the hospital.
A hospital bed is better for keeping the patient in the semi-sitting position for the control of postoperative swelling and blood leakage from the nose, and cold application can be performed better in the hospital. Antibiotics, painkillers and fluids administered intravenously are more effective.
In a hospital setting, it is possible to notice any complication and intervene it in an appropriate and timely manner. During their discharge the next day, I also recommend my patients to stay under the supervision of a companion, especially for the first five days.
Which Season Is The Most Suitable For Rhinoplasty?
In fact, rhinoplasty can actually be performed in any season. However, people do not prefer hot summer season, when people go on vacation and more intensely participate in out-of-home activities such as swimming in the sea or swimming pools. On the other hand, many students, teachers or working people may prefer having a surgical operation in the summer vacation period.
For this reason, I recommend my patients, who are considering surgery during the summer period, to go on vacation first and then plan the surgery for a later date. The availability of an air conditioner in the environment where the patients will stay after the surgery would be helpful. I especially state that they should be very well protected from the sun and avoid sports activities in the first postoperative month. The spring and winter months can be more comfortable because of the reasons mentioned above.
When Can The Patient Return to Normal Life After Rhinoplasty?
After a week, the patient can go out, and after two weeks, all the tapes are removed and the patient can return to work. It is necessary to wait for the 6-week period required for bone union to start completely normal activities.
Is It Possible To Known In Advance What Kind Of Nose Will Be Obtained With Rhinoplasty?
With the help of some simulation programs used before rhinoplasty, it is possible to have an approximate idea of the appearance of the nose after surgery. Especially the side view can give more realistic results.
However, such 2- or 3-dimensional programs don’t take into account the skin thickness and wound healing properties of patients. It should be noted that it is not always possible to surgically obtain the exact same images obtained with such preoperative simulations.
What Can Be Done For Those Who Have Had Rhinoplasty Before But Are Not Satisfied With the Result?
The condition of the patients who are not satisfied with the result after the first rhinoplasty operation is re-evaluated at least one year after the primary surgery, and then a revision surgery is performed if necessary.
While these revisions can sometimes be a simple intervention or just a retouching, sometimes they can be an operation that necessitate cartilage grafting from other parts of the body and require more effort than primary surgery. Such operations are called “secondary” or “revision rhinoplasty”.
Does Nasal Tip Ptosis Develop After Tip Rhinoplasty?
What is the Difference between Local and General Anesthesia in Rhinoplasty?
General anesthesia allows much better control of the blood pressure and other vital functions of the patient while he or she is completely asleep, and the operation becomes more manageable and comfortable for both the patient and the surgeon.
In local anesthesia, it will be much more difficult to perform the procedure, because the patient will be conscious and will breathe on his own. More bleeding and bruising will occur, especially due to the inability to lower the blood pressure or control it to the desired degree. General anesthesia is today essential in rhinoplasty, except for limited surgical interventions.
Are Nasal Packings Used in Rhinoplasty Surgery?
When Can I Sleep on My Side After Rhinoplasty?
Does Rhinoplasty Cause Any Harm?
Let’s not say “harmful” but rhinoplasty carries a risk of complications as with all other surgical procedures. These risks may be associated with anesthesia or surgery itself.
I recommend that you request your physician to give you the written consent forms explaining all these risks, read out them carefully in a quiet environment at home, and talk to your physician again about the questions in your mind.