Risk of rhinoplasty

Rhinoplasty is a relatively easy operation to tolerate. The stay in the hospital after the procedure is usually 24 to 48 hours.

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Ears, nose and throat information

RHINOSEPTOPLASTY

General information about the operation

Rhinoseptoplasty is a complex surgical procedure and aims to change the appearance of the nose, its structures and function. It can reduce or enlarge the nose, change the shape or contours of the back of the nose and the tip of the nose, the nostrils and change the angle between the nose and the upper lip.

The operation is performed under general anesthesia. The duration, depending on its complexity, is between 60 and 150 minutes. The operation can be performed with a one-day or two-day hospital stay. A 10-20 day absence from work is usually recommended due to the presence of a fixative external dressing, swelling and bruising around the eyes, nasal tamponade and silicone plaques in the nose.

Approaches to rhinoseptoplasty can be external or internal (endonasal). Simultaneously with the rhinoplasty procedures, septoplasty is performed in case of nasal breathing difficulties due to a crooked nasal septum and in order to reduce the outer nose. Rhinoseptoplastic procedures in full include:

• Septoplasty (correction of the nasal septum);
• Submucosal electrocoagulation (reduction) of the lower nasal concha;
• Resection of the back of the nose (triangular cartilage and bone hump);
• Transverse osteotomy;
• Medial osteotomy;
• Lateral osteotomies;
• Modeling of the alarm and triangular cartilages and shaping of the nasal tip;
• Placement of plates fixing the nasal septum;
• External fixing bandage for a period of 7 to 10 days.

Risk of rhinoplasty

Each surgical procedure has a certain risk of side effects and complications that need to be understood and evaluated. Each surgical procedure has certain limits. The risk of the operation should be carefully weighed against the expected improvements after it. Rhinoplasty is an operation performed on living tissues that could react differently to surgical trauma – inflammation, fibrosis, scarring, which means that not always the real results could be identical to the desired ones.

• Bleeding – Bleeding during surgery is profuse and does not require bleeding. If necessary, in extreme conditions, infusions of blood substitutes are administered, or blood transfusions of the same blood group, previously tested for HIV and other authorized by the Ministry of Health blood banks and laboratories. Postoperatively, removal of the tamponade (if any) from the nasal cavity is usually followed by profuse bleeding, which usually does not require measures to stop it, as it follows its spontaneous cessation. In order to prevent bleeding, it is recommended not to take anticoagulants and aspirin before surgery, and to avoid surgery around the menstrual cycle of women.
• Infection – rarely seen after surgery. Therefore, it is necessary for patients to be clinically healthy before starting the operation. Infections after rhinoplasty are treated with the usual antibiotics, and patients can rarely be hospitalized.
• Scars – no visible scars are expected after endonasal access. On external access, the scar in the columella area is insignificant and usually disappears after a few months.
• Swelling of the soft tissues of the face and eyelids – is usually insignificant, but it is possible after medial and lateral osteotomies to involve most of the eyelids. It does not require special treatment and resolves spontaneously within a few days.
• Post-surgery pain – usually postoperative pain is minor and is copied with common analgesics.
• Altered skin sensitivity – it is transient and is due to trauma to the nerve endings innervating the nose and nasal cavity.
• Asymmetry and irregularities of the outer nose – normally the human face is asymmetric. Different variations of asymmetry on both sides after the operation are possible.
• Perforation of the nasal septum – may occur as a result of weakening or necrosis of cartilage in postoperative infection or rupture of the mucosa in severely curved nasal septum. This can be asymptomatic in most cases or cause complaints of dry secretions (crusts) or the appearance of a whistling sound when breathing.
• Reducing rhinoseptoplasty (reducing the volume of the nose) can lead to narrowing of the nasal cavity with subsequent reduced nasal breathing.
• Conducting osteotomies can damage the orbit due to its proximity.
• Rhinoplasty is a procedure that aims to change the size of the nose, change the tip of the nose, remove the hump of the nose, change the angle between the nose and upper lip in order to improve the aesthetic appearance of the nose.

The final changes do not always coincide with the predicted ones due to the presence of individual features of wound healing, adhesion formation and fibrosis, which could affect the final result of the operation.

Rhinoplasty is a relatively easy operation to tolerate. The stay in the hospital after the procedure is usually 24 to 48 hours. The next day, the operated can serve themselves and perform their daily duties. The recovery period is between 7 and 20 days and depends on the volume of the operation, the trauma, the individual characteristics of the patient: gender, age, bad habits, harmful environmental influences, the addition of acute viral infections, physical activity, etc. Nasal tamponade (if any) is removed 24-48 hours after surgery, and nasal plaque and fixative external dressing after 7-10 days. After the operation, bloody secretion may leak from the nose. In case of more serious bleeding – clear bleeding from the nose, call your doctor. After removal of the tamponade, nasal breathing remains difficult due to swelling and increased secretion. It improves after removing the silicone plates. For better hygiene of the nose and clearing the secretion, it is necessary to rinse the nasal cavities with saline or sterile sea water. In the postoperative period, antibiotics are prescribed to prevent infection as well as painkillers. The final result of rhinoseptoplasty can be expected from six months to a year after surgery.

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