Nose reshaping is the most common type of service offered by plastic surgeons. Many people always consider even a small nose defect to be a tragedy. But it can be difficult to decide on an operation - rhinoplasty. Modern aesthetic medicine offers an innovative way to eliminate imperfections. In the presence of small defects, non-surgical rhinoplasty can improve the appearance and make the face symmetrical.
Types of rhinoplasty
In plastic surgery, it is customary to distinguish the various types of rhinoplasty according to the technique and objectives of the surgery.
All types of operations are divided into primary and secondary (repeated), although they can be:
- Reconstructive. This group includes manipulations aimed at restoring anatomical disorders that have arisen due to inadequate intrauterine development or as a result of injuries or traumatic illnesses.
- Aesthetic. It is intended to correct deficiencies.
According to which problem must be solved, there are several types of rhinoplasty:
- Reducing. It provides a reduction in the size of the osteochondral structure of the nose. It can be a shortening of the tip, narrowing of the nasal bridge, width of the nostrils and lateral cartilage.
- Increase. It is intended to correct defects by increasing the size of the nasal skeleton. It is also used for secondary plastics.
- Septorinoplasty. Elimination of the nasal septum curvature to facilitate nasal breathing, including to solve the snoring problem.
- Graft. The necessary shape of the nose is created from the patient's cartilage tissue. For transplantation, the cartilage tissue of the ear, the nasal septum can be removed.
- Reconstructive rhinoplasty. It is intended to correct the results of previous operations.
The purpose of the intervention can also be a separate hypertrophied nasal mucosa, columella (a bridge between the nostrils). Changing the shape of the tip of the nose (eliminating hooked or upturned shapes) is a separate and more difficult type of surgery.
For any correction, the surgeon can choose a type of operational or non-surgical intervention.
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. Before the operation, the patient must sign a written consent form for the surgical intervention, therefore, it is necessary to carefully weigh the pros and cons and strictly follow the rules of preoperative preparation, which includes:
- delivery of blood tests, fluorography, electrocardiogram;
- consultation with doctors of other specialties (dermatologist, therapist, psychiatrist);
- adherence to a diet.
After the operation, the patient stays in the hospital for several days under the supervision of medical personnel. After discharge, you must also strictly follow certain rules and restrictions.
Like any surgery, nose repair surgery has several contraindications and can cause side effects and complications.
Alternatively, plastic without surgery is used. Contour plastic is minimally invasive and does not involve surgical intervention. It allows to correct the asymmetry, reduce the tip a little, remove the protrusion, straighten the nose, but it is not suitable for solving complex problems (restoring respiratory function, eliminating birth defects).
It differs from classic rhinoplasty:
- the absence of a complex operation and a long period of rehabilitation;
- speed of execution;
- short duration of the effect (no more than one year);
- the possibility of redoing when the result is lost.
It can be plastic injection using fillers, hyaluronic acid-based gels, hormonal disintegrating drugs or correction without injection using sutures or splints.
With a cost, contour rhinoplasty is several thousand rubles cheaper than the traditional one.
Operational Rhinoplasty Classifications
Primary complete rhinoplasty does not involve an intervention that corrects the entire nose. This is the most popular type of surgery. Conditionally, 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 defects:
- lumps on the back (humps);
- excessive length;
- thickened nose (potatoes);
- saddle back;
- large nostrils.
Functional plastic. In order to eliminate defects that lead to bad breath, they interfere with the passage of air through the nose:
- an injured septum with a curvature;
- Narrowing of the nostrils (birth defect)
- congenital imperfections of cartilage tissue.
The technique is used in cases where it is not possible to perform the assigned task in a closed manner. The incision is made along the columella (part of the skin of the fold between the nostrils) and on the wings of the nose where they join the lip. Open rhinoplasty allows the soft tissues and cartilage to be lifted upwards, to gain access to the internal sections for manipulation. Necessary for technically complex and large-scale operations:
- severe deformity of the nose, including lateral displacement;
- combination of nose deformity with malformations ("cleft lip" or cleft palate);
- reconstruction in which grafts are used.
The disadvantages of this intervention include damage to the columella arteries, the formation of a postoperative scar and long-lasting postoperative tissue edema.
Re-rhinoplasty is performed only openly. Correcting deficiencies in primary plastics is a difficult task, so an inflexible aesthetic result is not always guaranteed.
The method is less traumatic than the open method. The incision is made from the inside, in the mucous membrane of the nasal vestibule. This access 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 wings of the nose), transeptal, inter and transchondral. An option for closed access is endoscopic rhinoplasty with microinstruments.
It allows to exclude damage to the arteries and tissue malnutrition, the postoperative scars are not visible, as they are located in the nasal cavity, the outer part of the skin remains intact. The method is often used for aesthetic operations.
Operation in which a laser is used instead of a scalpel to cut the tissue. The laser incision is smoother because the parallel cauterization of the vessels excludes the development of bleeding.
There are 2 types of laser rhinoplasty:
- open, which involves dissecting the tissues before shaping the soft part or cartilaginous base;
- superficial - incisions are not made in the skin, but the evaporation of the superficial layers to correct small changes in the tissues of the nose.
Reconstructive injection rhinoplasty
Sometimes, those who decide to undergo rhinoplasty surgery do not only want to predict and develop a model, but also to see the final result. This can be helped by the plastic procedure of the nose by contour injection. The result is achieved more quickly, comfortably and economically.
You can inject drugs repeatedly. In some cases, fibrous tissue forms at the injection site and the nose can take shape for a long time.
Hyaluronic acid injections
The effect of hyaluronic acid injections lasts for about six months. The introduction of medications makes it possible to level the skin surface and make the nose symmetrical, filling in small irregularities. Hyaluronic acid-based fillers are used in cosmetic surgery. These funds are classified as biodegradable, that is, solvents. Over time, the drug breaks down into safe components - water and carbon dioxide.
Plastic nose fillers
There are several groups of fillers. Biodegradables, in addition to those mentioned above, include:
- based on animal collagen;
- collagen of human origin;
- in calcium hydroxyapatite;
- in synthetic lactic acid.
These fillers can have a lasting effect.
Biodegradable fillers (non-absorbable or permanent) are made from silicone or another synthetic base (biopolymers). The effect after its application persists for a long time, but experts do not recommend using them. There are several reasons for refusing synthetic fillers:
- they can cause tissue fibrosis;
- it is impossible to remove them from the body;
- may in the future become an obstacle to rhinoplasty surgery.
To correct some imperfections in the nose, glucocorticosteroids are used - synthetic substances similar to the hormones produced by the human adrenal cortex. They are able to soften and partially dissolve the cartilaginous tissue, which allows to correct the shape of the wings and the tip of the nose, to soften the hump.
The procedure is relatively simple to perform, but difficult to prepare: it is necessary to calculate very precisely the dosage and the depth of administration of the medication to avoid asymmetries and the formation of unnecessary cavities in the nose. In addition, excess hormones can trigger uncontrolled tissue atrophy.
Most of the time, this correction is carried out in several procedures.
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 to remove wrinkles and folds, will get rid of the "fleshy" nose. Contains active ingredients: phosphatidylcholine, hyaluronic acid, carotene and others.
Rhinoplasty without injection
Much less often, nose correction is done without injections. Experts consider these procedures to be insufficiently effective.
With a clipped tongue
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 the cartilage and soft tissues and changes its position over time. With the help of a splint, you can lift the tip, narrow the wings, reduce the length (by lifting the tip), smooth the hump and restore symmetry.
Nowadays, lightweight removable structures in the form of paperclips or paperclips are spreading. They need to be used every day for several months.
To eliminate asymmetry, straighten the back, correct the wings and the 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 the insertion of the wires. The result lasts 3 years.
The bion threads are made of caprolac and fix the tissues of the nasal region through an infinite number of grooves. The threads are inserted through small holes, then the beautician tightens them and gives the desired shape to the nose area. The result becomes evident after 2-3 days. Other benefits of using threads:
- low invasiveness;
- absence of pain;
- the use of local anesthesia;
- hassle free;
- without swelling and bruising.
Disadvantages of this correction method:
- scars can appear at the puncture sites;
- the wires can be contoured, that is, they will be visible.
The procedure is contraindicated for people with clear and thin skin and with 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 likely prescribe a procedure for him without performing surgical manipulations. You can do without a scalpel by correcting the details to get rid of:
- the asymmetry of the nose;
- from dents, depressions and irregularities;
- the drooping tip of the nose;
- from a flat top to the rear;
- loose skin near the nose.
This procedure is also used as a temporary measure in the event that a minor patient with severe disabilities (as a result of a fracture or injury) cannot be operated on.
Men prefer a radical approach to filling modeling in order to get rid of defects once and for all. Indications for rhinoplasty in men can be:
- frequent sinusitis, chronic nasal congestion;
- injuries that led to deformation of the nose and its septum;
- congenital pathologies and deformities in the bone structure of the organ;
- saddle shape, large nostrils, wide nasal bridge, large or thick nose;
- respiratory disorders;
- the presence of an ugly hump.
Any type of intervention can be applied to women. Which to turn to, the surgeon decides. If minor changes are made, the aesthetic problem will be solved without the use of a scalpel. Often, the injection method is used the day before the operation, so that the woman can assess how her nose will look in the future.
What can be corrected using this procedure
The reduction is achieved by the injection of filler in the curved part. To correct the hump, the gel is injected over the entire length of the nasal dorsum. Most of the time, preparations absorbable with hyaluronic acid are used to straighten the nose.
It is carried out by injecting loads into the problem areas. This rhinoplasty is especially requested when there are small cavities or depressions at the tip of the nose. The potato's nose is corrected by introducing a filling at the tip itself, which makes it sharper.
The tip can be raised by injecting the gel into the columella area of the nose. Visually, this hides the hook-shaped tip. In some cases, it is also necessary to inject into the wings of the nose to slightly decrease the nostrils.
Repairing a broken nose
If the nose has been injured more than once, the contour will not help. In this situation, only nasal septum surgery is indicated. It is most likely a complete reconstructive and aesthetic operation. Reconstruction of the septum and external osteochondral skeleton may be necessary.
It is impossible to align the crooked nasal bridge without surgery. Injectable rhinoplasty only allows to mask the defect. For example, an upturned nose correction (with a low bridge and a raised tip) is done by injecting fillers across the surface of the nasal bridge to the tip.
Hyaluronic acid gel is used to correct the asymmetry of the wings of the nose. In that case, the specialist must calculate the dose accurately.
The nose becomes thinner and more expressive after hormone rhinoplasty.
If it is necessary to remove the asymmetry from the nostrils or reduce it, 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 the operation on the face. A conscientious plastic surgeon will not correct a minor's nose if a girl's or boy's whim is the basis.
Persons who have completed 18 years of age are allowed to operate. In extremely rare situations, this condition can be violated. The minimum age for rhinoplasty for girls is 13-14 years old, for boys - 15-16 years old.
For medical reasons, a teenager can undergo almost any plastic surgery. However, doctors recommend patience until early age, when the operated organ is made up of at least 80-90%.
How is the preparation for the non-surgical procedure going
In contrast to classic surgery, it is easier to prepare for a non-surgical procedure. Perhaps your doctor will advise you to see a dermatologist, tell you what tests are done to identify contraindications and restrictions.
Compliance with the following rules will help to reduce the risk of complications:
- 10 days before plastic surgery, it is necessary to stop using alcohol;
- salicylates increase bleeding, which means that a week before the procedure, you must stop taking "Aspirin" and other similar drugs;
- do not eat at least 10 hours in advance;
- a few days before the injection of plastics, it is recommended to exclude high physical activity;
- it is necessary to wash your hair the day before, because you cannot bend and wet your face after the procedure.
The doctor prescribes taking antihistamines. With high temperature, menstruation, respiratory diseases, the procedure will have to be abandoned until recovery.
I need anesthesia
General anesthesia is not necessary for non-surgical rhinoplasty. For anesthesia, local application or infiltration anesthesia is used.
Non-surgical plastic surgery is performed on an outpatient basis, with no need for hospitalization of patients. After the procedure, the plastic surgeon's clients go home.
A thorough examination and computer modeling of the future shape of the nose is carried out preliminarily. The average duration of manipulations is 35-60 minutes. The operation proceeds 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 surrounding area. The exposure time under the film is 10-15 minutes.
- After opening the ampoule with the drug and filling the gel in the microcannula, gradually and carefully inject the filling into the designated areas of the nose. If the customer wishes, he can observe the progress of the process with the help of a mirror, which he will hold on his own.
- If necessary, the beautician can reinfuse the filling.
- The final step is a light manual massage. It is necessary for a better distribution of the filling.
The result can be evaluated immediately. The fillers are safe and absorb completely in 1, 5 years.
Consequences and contraindications of non-surgical rhinoplasty
The correction should not be made in women during pregnancy or during menstruation. Non-surgical correction is contraindicated for people who suffer from the following diseases:
- acute infectious diseases;
- autoimmune pathologies;
- pathologies of the endocrine system, 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 location.
What complications can arise
Complications after surgery occur in 10% of cases. They can also occur during surgery (bleeding, rupture of the skin, rupture of the mucocartilaginous flap, violation of the integrity of the bone pyramid, fracture of the bone site).
If several cosmetic defects are eliminated during the operation, a series of complications can occur:
- postoperative pigmentation;
- bone callus;
- swelling and hematoma of the soft tissues;
- loss of smell;
- the appearance of keloid scars;
- difficulty breathing
- curvature of the nasal septum.
Rhinoplasty without surgery is not so dangerous, although it is also considered a difficult procedure in cosmetic surgery. Then, a special splint is applied to the patient's nose, which fixes the result and protects against injuries.
For several hours after the procedure, there may be redness and swelling of the skin in the nasal area. These problems disappear completely within 24 hours. After squeezing with wires, bruises can form, which disappear completely within a week.
Rare complications include processes that can occur due to the inexperience of the surgeon who performs the procedure or the non-compliance with the patient's post-operative rules: displacement of fillers and rupture of threads inserted under the skin. The doctor must deal with the problem urgently.
Taking care of your nose after surgery
Laser rhinoplasty, hyaluronic acid injections and fillers reduce the rehabilitation period to a minimum. Immediately after the nose contouring procedure, you can go home. The swelling subsides in 1-2 days.
On average, rehabilitation lasts up to several days (depending on the correction method performed). There are almost no restrictions after handling. You can continue to work, play sports and live your normal life.
In the postoperative period, it is necessary to monitor facial expressions: you cannot squint, frown. For several hours, you shouldn't strain your muscles, blow your nose, sneeze and cough. In the first 2-3 days of recovery, you should not wear glasses.
Strict restrictions apply to visits to any swimming sites (lagoons, pool, spa, sauna). You also need to give up sunbathing, smoking, foundation.
You cannot massage the injection site or do physical therapy for 2 weeks.
How long does edema last after surgery?
The entire rehabilitation period after surgery can last for about a year. In the first days, the patient must use a bandage, bandage or plaster. Facial swelling will subside in 1-2 days. After 21 days, the plaster is removed and blood clots from the nose and plugs are removed.
Active recovery occurs in the next 3 months, the vestiges of side effects decrease, but small changes can occur until the end of the year.
What to do if the operation is not successful
The result of the operation performed can be judged only after 6 months. Practice shows that 20% of all interventions to correct or eliminate nasal defects are not the only ones.
If after that time the nose does not take on the desired shape or if the swelling persists, the operation can be considered unsuccessful. In such situations, repeated operations are assigned.
When to repeat the procedure
The effect of non-surgical nose surgery lasts an average of about a year. You can repeat the procedure at any time.
After surgery, repeated (secondary) rhinoplasty cannot be prescribed before one year later. Technically, this is a more complex procedure. It is prescribed if the patient is not satisfied with the result, or if the previous operation was unsuccessful (it did not give the expected effect).
Benefits of non-surgical rhinoplasty
The filling and suturing procedure cannot be considered a complete alternative to surgery, but it does have a number of obvious advantages. The main ones are:
- absence of pain;
- short rehabilitation period (sometimes absent);
- obtaining results quickly;
- reversibility (you can always return the previous form if the result is not satisfactory).
The procedure has pros and cons. It has an extremely low effect on the general condition of the body, it does not harm the tissues of the face, after which scars and scars are not formed. But if injected incorrectly, lumps of gel can form under the skin. Its displacement will lead to a change in the shape of the nose.
After minimally invasive intervention, without stitches, the skin heals better. But the risk of infection and infection still remains.
The low cost makes the procedure available to anyone who wants to improve their appearance. However, the possible complications require the choice of the clinic to be treated with extreme care.Most of the time, unsuccessful cosmetic interventions occur after visiting non-specialized salons and doctors who do not have the appropriate qualifications.The final decision should be made only after studying the master's previous work and the clinic's evaluations.