Consultation before rhinoplasty
What does rhinoplasty consist of?
- Functional rhinoplasty, the aim of which is to straighten the septum, the source of breathing difficulty;
- Aesthetic rhinoplasty, the aim of which is to modify the morphology of the nose, either at the level of its upper bony part, or of its mobile lower part called cartilaginous.
It is thus possible to straighten, shorten or reduce in height and width a nose in its two bone and cartilaginous structures. Functional and corrective surgeries can be combined, this is called septorhinoplasty. Rhinoplasty can be combined with other cosmetic surgery procedures such as genioplasty (modification of the chin). This procedure can be performed on both men and women. However, it is recommended to wait until the end of growth before practicing it, i.e. from around 17 years of age.
Consultation before rhinoplasty
Understanding the patient’s expectations
The essential step is to clearly define the objectives of the rhinoplasty. The patient must perfectly explain the desires for change that he wishes. Work on black and white medical photographs is essential. It allows you to perform simulations (morphing), in particular in profile, and to imagine the expected result. This is also the time for the patient to ask any questions.
The importance and limits of computer simulations
Face simulations are, unfortunately, less accurate. You have to be wary of the results, especially on the computer, which will not necessarily represent the final result. Nevertheless, a simulation is essential to approach the result and thus better personalize the surgical intervention. Indeed, no two faces are alike and “tailor-made” is essential. Finally, several factors can intervene in the surgical technique and in its result: the structure of the bones of the nose, the cartilage, the shape of the face, the fineness of the skin…
The nose essential element of the whole face
The surgeon must guide the patient and warn him that this intervention always leads to a major transformation in the face, which can modify its harmony.
The face is made of interdependent elements. Modifying the nose is also modifying the importance of an upper lip and above all modifying the importance of the chin in relation to the overall structure of a face. Apart from the chin, however, it is rare for the surgeon to propose an associated gesture, during the same operation, especially if the rhinoplasty is complete.
As part of a functional intervention to improve breathing, the surgeon should warn the patient that in case of chronic disease of the nasal mucosa, the result may not be complete.
The quality of the skin is involved in the final result of a rhinoplasty. Thick, oily skin will not achieve the desired refinement, especially at the tip of the nose. Another limitation of rhinoplasty is the existence of very wide nostrils.
A reduction is certainly possible but at the cost of external scars that will therefore have to be accepted. Indeed, in almost all cases, apart from a major deformation (notably of the tip of the nose) and often congenital, all the scars are hidden under the rim or inside the nose. All this must be specified preoperatively.
The course of the intervention
The patient’s requests have been well identified, he must bring the photographs and the simulation retained to the surgeon on the day of the intervention. The surgeon carefully studied the nasal pyramid and conducted an endonasal examination. This makes it possible to plan the surgical gestures during the intervention.
If it is not a restorative intervention, a period of 15 days between the first consultation and the operation must be respected (this is a mandatory reflection period for all acts aimed at aesthetic). Before the operation, a visit to the anesthetist is mandatory.
A detailed estimate and an operating file are given to the patient.
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