Nose reshaping is the most common type of service provided by plastic surgeons. Many people always perceive even a small lack of a nose as a tragedy. But it can be difficult to decide on surgery - rhinoplasty. Modern aesthetic medicine offers an innovative way to eliminate imperfections. In the presence of minor defects, non-surgical rhinoplasty can improve the appearance and make the face symmetrical.
Types of rhinoplasty
In plastic surgery, it is common to distinguish several types of rhinoplasty according to the technique and goals of the surgery.
All types of operations are divided into primary and secondary (repeated), and can be:
- Reconstructive. This group includes manipulations aimed at restoring anatomical disorders caused by abnormal intrauterine development or as a result of traumatic injuries or disease.
- Aesthetically. Aimed at correcting shortcomings.
According to which problem needs to be solved, there are many types of rhinoplasty:
- Reduction. It allows reducing the size of the osteochondral frame of the nose. These can be shortening of the tip, narrowing of the nasal bridge, width of the nostrils and lateral cartilage.
- Increase. Aimed at correcting defects by increasing the size of the nasal skeleton. It is also used for secondary plastics.
- Septorinoplasty. Removal of nasal septum curvature to facilitate nasal breathing, including solving snoring problems.
- Grafting. The required shape of the nose is created from the patient's cartilage tissue. The cartilaginous tissue of the ears, the nasal septum, can be taken for transplantation.
- Reconstructive rhinoplasty. Aimed at correcting the results of previous operations.
The goal of the intervention can also be a separately hypertrophied nasal mucosa, a columella (bridge between the nostrils). Changing the shape of the tip of the nose (removing a hooked or overturned one) is a separate and most difficult type of surgery.
For any correction, the surgeon can choose an operative or non-surgical type of intervention.
Operating room
It is performed under general anesthesia. The duration of the operation can be up to several hours, and the result is maintained for many years. Prior to surgery, the patient must sign a written consent for surgical intervention, so it is necessary to carefully weigh the advantages and disadvantages and strictly adhere to the rules of preoperative preparation, which includes:
- delivery of blood tests, fluorography, electrocardiogram;
- consulting doctors of other specialties (dermatologist, therapist, psychiatrist);
- adherence to diet.
After the operation, the patient was hospitalized for several days under the supervision of medical staff. After discharge, you should strictly adhere to certain rules and restrictions.
Like any surgery, nose repair surgery has a number of contraindications and can cause side effects and complications.
Non-surgical
Alternatively, plastic without surgery is used. Contour plastic is minimally invasive and does not involve surgery. It allows you to correct asymmetry, slightly reduce the tip, remove the hump, straighten the nose, but it is not suitable for solving complex problems (restoration of respiratory function, removal of congenital damage).
It differs from classical rhinoplasty:
- absence of complex surgery and long period of rehabilitation;
- execution speed;
- short duration of effect (not more than a year);
- the possibility of re-implementation because the result is lost.
These can be injectable plastics using fillers, hyaluronic acid-based gels, hormonally disintegrating drugs, or correction without injections using sutures or splints.
At the price of contour rhinoplasty is several thousand rubles cheaper than traditional.
Classification of operative rhinoplasty
Primary complete rhinoplasty does not include an intervention that corrects the entire nose. This is the most popular type of surgery. Conditionally, the indications for surgery are divided into 2 types, according to which the following will be performed:
Cosmetic plastic. If you want to get rid of the following nose damage:
- protrusions on the back (humps);
- excessive length;
- thickened nose (potatoes);
- saddle back;
- large nostrils.
Functional plastic. In order to eliminate the shortcomings that lead to poor breathing, they interfere with the passage of air through the nose:
- injured septum with curvature;
- Nostril narrowing (congenital defect)
- congenital imperfections of cartilage tissue.
Open up
The technique is used in cases when the assigned task cannot be achieved in a closed manner. The incision is made along the columella (the skin part of the folds between the nostrils) and on the wings of the nose where they merge with the lip. Open rhinoplasty allows you to lift the soft tissues and cartilage upwards, in order to gain access to the internal parts for manipulation. Required for technically complex and large operations:
- severe nasal deformity, including lateral displacement;
- combination of nasal deformity with malformations ("cleft lip" or crack of the hard palate);
- reconstruction using grafts.
Disadvantages of this intervention include damage to the columella arteries, the formation of postoperative scarring, and long-term edema of postoperative tissue.
Re-rhinoplasty is performed only in an open manner. Correcting the shortcomings of primary plastic is a difficult task, so an uncompromising aesthetic result is not always guaranteed.
Closed
The method is less traumatic than the open one. The incision is made from the inside, on the mucous membrane of the nasal vestibule. Such an approach is performed when a small-volume operation is to be performed. This type of intervention is divided into marginal (along the inner surfaces of the nasal wings), transseptal, inter- and transchondral. The closed approach option is endoscopic rhinoplasty using microinstruments.
It allows to exclude damage to the arteries and malnutrition of tissues, postoperative scars are not visible, because they are located in the nasal cavity, and the outside of the skin remains unchanged. The method is often used for cosmetic surgery.
Laser
An operation in which a laser is used instead of a scalpel to cut tissue. The laser incision is gentler because parallel cauterization of the veins precludes the development of bleeding.
There are 2 types of laser rhinoplasty:
- open, which involves dissecting the tissue before modeling the soft part or cartilage base;
- superficial - no incisions are made in the skin, but evaporation of the superficial layers to correct small changes in the tissues of the nose.
Injectable reconstructive rhinoplasty
Sometimes those who opt for rhinoplasty surgery want to not only predict and develop a model, but also see the end result. The procedure of injecting the nose into the contour can help. The result is faster, more comfortable and cheaper.
You can inject drugs multiple times. In some cases, fibrous tissue forms at the injection site and the nose can take a long time to form.
Hyaluronic acid injections
The effect of hyaluronic acid injections lasts for about six months. The introduction of medications allows you to smooth the surface of the skin and make the nose symmetrical, small irregularities are filled. Hyaluronic acid-based fillers are used in cosmetic surgery. These agents are classified as biodegradable or solvent. Over time, the drug breaks down into safe components - water and carbon dioxide.
Plastic fillers for the nose
There are several groups of fillers. Biodegradable, in addition to the above, include:
- based on animal collagen;
- about collagen of human origin;
- on calcium hydroxyapatite;
- on synthetic lactic acid.
These fillers can have a long lasting effect.
Biodegradable (non-absorbent or permanent) fillers are made on the basis of silicone or other synthetic bases (biopolymers). The effect after their application lasts a long time, but experts do not recommend its use. There are several reasons for rejecting synthetic fillers:
- can cause tissue fibrosis;
- it is impossible to remove them from the body;
- may become an obstacle to operative rhinoplasty in the future.
Hormonal drugs
To correct some imperfections in the nose, glucocorticosteroids are used - synthetic substances similar to hormones produced by the human adrenal cortex. They are able to soften and partially dissolve cartilage tissue, which enables the correction of the shape of the wings and the tip of the nose, smoothing the hump.
The procedure is relatively simple to carry out, but difficult to prepare: it is necessary to calculate very accurately the dose and depth of application of the drug to avoid asymmetry and the creation of unnecessary cavities in the nose. In addition, excess hormones can trigger uncontrolled tissue atrophy.
Most often, such a correction is performed during several procedures.
Lipolytics
Lipolytics are agents used for mesoinjections. It is a biologically active material that promotes the burning of subcutaneous fat. Dermaheal is used to correct the shape of the nose. Helps remove wrinkles and creases, will get rid of "fleshy" nose. It contains active ingredients: phosphatidylcholine, hyaluronic acid, carotene and others.
Rhinoplasty without injection
Much less often, nose correction is done without injections. Experts believe that such procedures are insufficiently effective.
With tongue attached
To align the back of the nose and its tip, use a splint - a device made of plastic or plaster. The design creates constant pressure on cartilage and soft tissues and changes their position over time. With the help of a splint, you can raise the top, narrow the wings, reduce the length (by raising the top), smooth the hump and restore symmetry.
Nowadays, light removable structures in the form of buckles or clasps are spreading. They should be worn every day for several months.
Nor
To eliminate asymmetry, straighten the back, straighten the wings and tip of the nose, filament rhinoplasty is used. The correction technology consists of inserting strong self-absorbing threads under the skin. Unlike fillers, the nose does not visually enlarge after thread insertion. The result lasts 3 years.
Bion threads are made of caprolacs and fix the tissues of the nasal area through a multitude of grooves. The sutures are inserted through small holes, and then the beautician tightens them and gives the desired shape to the nose area. The result becomes visible after 2-3 days. Other advantages of using thread:
- low invasiveness;
- painlessness;
- use of local anesthesia;
- no complications;
- no swelling and bruising.
Disadvantages of this correction method:
- scars may appear at the injection site;
- nor can they be contoured, that is, they will be visible.
The procedure is contraindicated in people with thin fair skin and those who have a tendency to form keloid scars.
Indications for the procedure
When the shape and size of the patient's nose are satisfied, the doctor will most likely prescribe the procedure without performing surgical manipulations. You can correct the details to get rid of:
- from nasal asymmetry;
- from dents, falls, dents and irregularities;
- from the drooping tip of the nose;
- from the coat of arms;
- from the flat upper back;
- of relaxed skin near the nose.
Such a procedure is also used as a temporary measure in case a minor patient with a severe disability (as a result of a fracture or injury) cannot be operated on.
In men
Men prefer a radical approach to filler fillers to get rid of flaws once and for all. Indications for rhinoplasty in men can be:
- frequent sinusitis, chronic nasal congestion;
- injuries that led to deformity of the nose and its septum;
- congenital pathologies and deformities in the bone structure of organs;
- saddle shape, large nostrils, wide bridge of nose, large length or thickness of nose;
- breathing disorders;
- the presence of an ugly hump.
Among women
Any type of intervention can be applied to women. Who will resort to, the surgeon decides. If small changes are to be made, then the aesthetic problem will be solved without the use of a scalpel. The injection method is often used before surgery so that a woman can assess what her nose will look like in the future.
What can be fixed with this procedure
Coat of arms correction
The reduction is achieved by injecting the filler into the curved part. To correct the hump, the gel is injected along the entire nasal dorsum. Absorbent preparations with hyaluronic acid are most often used to correct the nose.
Advice correction
It is performed by injecting filler into problem areas. Such rhinoplasty is especially needed when there are small dimples or depressions on the tip of the nose. The nose of the potato is corrected by introducing the filler into the very top, making it sharper.
The tip can be lifted by injecting the gel into the area of the nasal columella. Visually, this hides a hooked top. In some cases, it is also necessary to inject into the wings of the nose to reduce the nostrils a little.
Repair of a broken nose
If the nose is injured more than once, contouring will not help. In such a situation, only nasal septum surgery is indicated. And most likely a full-fledged reconstructive and aesthetic operation. Reconstruction of the septum and external osteochondral skeleton may be required.
Backrest alignment
It is impossible to straighten a crooked nasal bridge without surgery. Rhinoplasty by injection only allows you to cover up the defect. For example, the correction of a snub nose (with a low bridge and a raised tip) is done by injecting filler over the entire surface of the nasal bridge to the very tip.
Wing reduction
Hyaluronic acid gel is used to correct the asymmetry of the nasal wings. In that case, the specialist must calculate the dose accurately.
The nose becomes thinner and more pronounced after rhinoplasty with hormones.
If it is necessary to remove the asymmetry of the nostrils or reduce them, then the fillers are injected into the lower part of the wings of the nose.
How old is the operation
There must be clear reasons for facial surgery. A conscientious plastic surgeon will not undertake the correction of a minor's nose if a particular whim of a girl or boy serves as its basis.
People over the age of 18 are allowed surgery. In extremely rare situations, this condition can be violated. The minimum age for rhinoplasty for girls is 13-14 years, for boys - 15-16 years.
For medical reasons, a teenager can undergo almost any plastic surgery. However, doctors recommend patience until the onset of old age, when the operated organ forms at least 80-90%.
How is the preparation for non-surgical procedure going
Unlike classical surgery, it is easier to prepare for non-surgical surgery. Your doctor may advise you to consult a dermatologist and tell you what tests are being done to determine contraindications and limitations.
Adherence to the following rules will help reduce the risk of complications:
- 10 days before plastic surgery you must stop drinking alcohol;
- salicylates increase bleeding, which means that a week before the procedure you should stop taking "Aspirin" and other similar drugs;
- refrain from eating at least 10 hours in advance;
- a few days before plastic injection, it is recommended to exclude heavy physical activity;
- hair should be washed the day before, because after the procedure you can not bend and wet your face.
The doctor prescribes an antihistamine. With fever, menstruation, respiratory diseases, the procedure will have to give up until recovery.
Do I need anesthesia
General anesthesia is not required for non-surgical rhinoplasty. Local anesthesia or infiltration anesthesia is used for anesthesia.
Performing technology
Non-surgical plastic surgery is performed on an outpatient basis, there is no need for hospitalization of patients. After the procedure, the plastic surgeon's clients go home.
Preliminary thorough examination and computer modeling of the future shape of the nose is performed. The average duration of manipulations is 35-60 minutes. The operation continues step by step as follows:
- The patient is conscious, only local anesthesia is used. The doctor applies a lidocaine-based cream to the nose and the area around it. The exposure time under the film is 10-15 minutes.
- After opening the medicine ampoule and filling the gel into the microchannel, gradually and carefully inject the filler into the areas of the nose provided. If the client has the desire, he can observe the progress of the process with the help of a mirror that he will keep to himself.
- If necessary, the beautician can refill the filler.
- The final stage is a light hand massage. It is needed for better filler distribution.
The result can be assessed immediately. Fillers are safe and completely absorbed within 1. 5 years.
Consequences and contraindications of non-surgical rhinoplasty
Correction should not be done on women during pregnancy or during menstruation. Non-surgical correction is contraindicated for people suffering from the following diseases:
- acute infectious diseases;
- keloidosis;
- autoimmune pathologies;
- endocrine system pathologies, including diabetes mellitus;
- hemophilia and other blood clotting problems;
- allergies and individual intolerance to the components of the drugs used;
- oncological diseases, tumors of any localization.
What complications can occur
Complications after surgery occur in 10% of cases. They can also occur during surgery (bleeding, cracking of the skin, tearing of the mucous-cartilage lobe, violation of the integrity of the bone pyramid, fracture of the bone site).
If several cosmetic defects are removed during the operation, a number of complications can develop:
- nosebleeds;
- postoperative pigmentation;
- bone callus;
- swelling and soft tissue hematomas;
- odor loss;
- appearance of keloid scars;
- difficulty breathing;
- curvature of the nasal septum.
Rhinoplasty without surgery is not so dangerous, although it is considered a difficult procedure in cosmetic surgery. After that, a special splint is placed on the patient's nose to correct the result and protect it from injury.
Redness and swelling of the skin in the nasal area may appear a few hours after the procedure. These problems completely disappear within 24 hours. After tightening the threads, bruises can form, which completely disappear within a week.
Rare complications include processes that can occur due to the inexperience of the surgeon performing the procedure or the patient's non-compliance with postoperative rules: squeezing the filler and cracking the threads inserted under the skin. The doctor should address the problem urgently.
Nose care after surgery
Laser rhinoplasty, hyaluronic acid injections and fillers reduce the rehabilitation period to a minimum. Immediately after the nose contour procedure, you can go home. The swelling subsides within 1-2 days.
On average, rehabilitation lasts up to several days (depending on the correction performed). There are almost no restrictions after the manipulation. You can still go to work, play sports and live your normal life.
In the postoperative period, it is necessary to follow the facial expressions: you cannot squint, frowning. You should not strain your muscles for a few hours, blow your nose, sneeze and cough. You should not wear glasses for the first 2-3 days of recovery.
Strict restrictions apply to visit any swimming pool (ponds, swimming pool, bathing area, sauna). You also need to give up sunbathing, smoking, substrate.
You cannot massage the injection site or perform physiotherapy for 2 weeks.
How long does edema last after surgery?
The entire period of rehabilitation after the operation can last about a year. In the first days, the patient must wear a bandage, bandage or plaster. The swelling of the face will subside in 1-2 days. After 21 days, the cast is removed and blood clots from the nose and tampons are removed.
Active recovery occurs in the next 3 months, the traces of side effects subside, but minor changes may occur by the end of the year.
What to do if the operation is not successful
The result of the performed operation can be assessed only after 6 months. Practice shows that 20% of all interventions to correct or remove damage to the nose is not the only one.
If after this time the nose does not take the desired shape or the swelling remains, then the operation can be considered unsuccessful. In such situations, repeated operations are assigned.
When to repeat the procedure
The effect of non-surgical nasal surgery lasts on average about a year. You can repeat the process at any time.
After the operation, repeated (secondary) rhinoplasty can be prescribed at the earliest one year later. Technically, this is a more complex procedure. It is prescribed if the patient is not satisfied with the result or the previous operation was unsuccessful (did not give the expected effect).
Advantages of non-surgical rhinoplasty
The procedure of fillers and sutures cannot be considered a full-fledged alternative to surgery, but it has a number of obvious advantages. The main ones are:
- painlessness;
- short period of rehabilitation (sometimes absent);
- rapid achievement of results;
- reversibility (you can always return the previous form if the result is not satisfactory).
The procedure has both advantages and disadvantages. It has an extremely weak effect on the general condition of the body, does not injure facial tissues, after which scars and scars do not form. But if injected improperly, lumps of gel can form under the skin. Moving them will change the shape of the nose.
After a minimally invasive intervention there are no sutures, the skin heals better. But the risk of infection and contagion still remains.
The low price makes the procedure accessible to anyone who wants to improve their appearance. However, possible complications oblige extreme caution when choosing a clinic.Unsuccessful cosmetic interventions most often occur after visits to non-specialized salons and doctors who do not have the appropriate qualifications.The final decision should be made only after studying the previous work of the master and the evaluation of the clinic.