Rhinoplasty repairs cosmetic nose imperfections when they are viewed as unacceptable, to the extent of creating a complex, or even, in extreme cases, leading to a real unhappiness.
Nose surgery requests are very diverse :
- Removing a bump.
- Raising or lowering the tip of the nose, and especially narrowing it when it is too wide from the front.
- Reducing the size of a nose which is too long, too wide from the front or correcting a deflected nose.
- Improving the appearance of the edge or the tip of the nose.
- Increasing the definition and projection of the tip of the nose.
Many requests come from people who are sometimes very young, but we have to respond to them cautiously and wait until they are 18 years old and have stopped growing. After age 50, the procedure also has a certain rejuvenating effect.
Before rhinoplasty, the consultation is particularly important for fully understanding the patient's request and redefine unrealistic wishes. Photo editing techniques help to visualise the future transformation, but can in no way be regarded as a result that will be guaranteed.
Nose surgery may be combined with the modification of the shape of the chin by using genioplasty in the face. This is called profiloplasty which, as its name suggests, completely redesigns the profile.
How the procedure works
Rhinoplasty is performed under general anaesthetic with one night of hospitalisation. It lasts between an hour and a half to three hours.
The incisions may be located inside the nose, in each nostril or well outside the nose across the columella if the surgeon needs to fully explore the nasal structure.
There is no single nose surgery technique, but rather different methods, which are combined depending on the defects to be corrected.
When the surgeon wants to remove a lump or decrease the size of the nose, he removes or sections fragments of cartilage or bone.
Cartilage reduction : He sections the cartilage under the skin which is too prominent. Sometimes he performs a simple weakening of the cartilage to reduce its strength and spring-effect.
Cartilaginous sutures : He joins the overly expanded cartilage together with sutures. This technique makes it possible to reshape the tip of the nose very precisely without weakening it.
Bone reduction : He uses the osteotomy technique to fracture the bone and remove the excess part.
When the surgeon wants to improve the symmetry of the nasal bridge, fill in a hollow or enhance the definition and projection of the tip of the nose, he performs a cartilage graft or uses a nasal implant.
Cartilage grafts : He takes the cartilage, preferably from the patient's nasal septum. In the event of a significant need, he can also take cartilage from the ear at the level of the concha or from the ribs.
The cartilage is easy to shape. The practitioner uses it in one or more fragments. He can also cut it into very thin small cubes, which he insets inside a pouch whose dimensions are exactly the same as the area to be increased. This pouch consists of a fascia membrane, a thin and solid tissue taken from the surface of the temporal muscle.
The surgeon can graft cartilage on both the nasal bridge and the nasal tip.
Implants : They are mainly used in people who have thick skin and who have a dorsum of the nose which is too hollow. There are implants in various shapes made from silicone or porous polyethylene (Medpor).
After the procedure
This dressing is removed the day after the rhinoplasty. Thanks to the plaster that protects the nose, the patient experiences little pain, although this pain is relieved by simple painkillers.
The nose still appears slightly swollen when the plaster or splint is removed after 10 days, but it is entirely presentable. The non-absorbable sutures are removed at this time.
There are bruises on the lower eyelids for one to three weeks. The nose quickly decreases in size after one month, but there is still residual oedema which disappears after a few months.
It is not advisable to wear glasses during the first days. Nasal obstruction is common directly after the procedure. This requires frequent washing of the nostrils in order to prevent crusting. Due to the mucosal inflammation inside the nose, the patient may experience some discomfort breathing, as well as a temporary loss of smell and taste for a few weeks.
The patient can plan to return their social and professional activities after about ten days. The patient can play sports after one month, but they must avoid strenuous activities and swimming for three months.
The changes after rhinoplasty appear gradually. Some changes can be seen sooner than others. For example, the disappearance of a lump is obvious as soon as the splint is removed and we can begin to judge the results after two to three months. But in general, we need to be patient and wait for six months to a year to get the final result.
Why so long? The skin that covers the bone and cartilage frame of the nose has to readjust to its new shape and its new size. The time that it takes the skin to retract depends on both the way it heals and its elasticity. So the changes will be faster for thin skins than for thicker skins. Age also plays an important role, since the younger you are, the more the skin is elastic.
The aim is to achieve an appendice nasal which is consistent with the patient's wishes, respects the proportions between the different parts of the nose and fits naturally into the face.
After one year, it is possible make alterations if the patient is dissatisfied.
Click on a photo to enlarge it
|Intervention||Anaesthetic||Stay||Prices including VAT*|
|Nose surgery||General||1 night||€3,900 to €6,200|
|Other fees||Prices including VAT*|
|Consultation with the surgeon||€50|
|Consultation with the anaesthetist||€100|
* 20% VAT