Nasal correction (functional - cosmetic rhinoplasty)
Correction of nasal contour is one of the oldest and most common plastic surgical procedures. Wide noses may be narrowed, humps may be straightened and hanging tips may be elevated. We generally strive for a nose contour that suits the personality and adapts harmoniously to other facial features. Nasal function and aesthetics have a very close relationship, i.e. a very wide or overly long nose results in breathing difficulties. This treatment is known as a functional - cosmetic rhinoplasty.
This operation is almost always performed under a hospital stay of 2 days, which makes sense since this is the period that the nasal packing in the passages is required to remain in place.
A comprehensive consultation is the cornerstone of a successful operation. The patient should know exactly what such an operation entails and not harbour any unrealistic expectations on the outcome.
It is important when choosing the date for the operation, that the immediate consequences and after-care are factored in. In most cases, the wearing of a prominent nose plaster is necessary for two weeks after surgery. Adhesive plasters are then worn for a further five to seven days thereafter in order to accelerate recovery from the swelling. It is necessary to protect the nose from external influences for a further four weeks, which especially limits sporting activities.
As with any surgical operation, it must be ensured that no other pathological conditions increase the risk of surgery, thus it is necessary to perform a blood test and an electrocardiogram (ECG).
Certain medications may impair blood clotting, and these include aspirin and vitamin E while there are others that recreate this effect. Thus it is important to inform us in advance of your medication intake, and we shall respond with our corresponding Code of Conduct. Alcohol and nicotine consumption must in any case be avoided on the day and evening preceding the day of the operation, and you must be sober. You may take your regular medication with a little water after consultation with the surgeon.
The operation itself takes about 2 hours and is performed under full anaesthesia in the presence of a specialist anaesthetist. Today we almost exclusively operate according to the open-method since the overview of the nasal tip cartilages is superior and the precise contouring of the nasal tip is suitable only with the open-method. To this end, a small incision is made on the bridge of the nose, which when healed, is barely visible after a couple of weeks. Further incisions are made behind the nostrils.
It is then possible to see the cartilaginous and bony structure of the nose with these incisions. It is often necessary to adjust the nasal bone to fit the new contour, and this results in swelling and discolouration in the cheek and eye region. The inner incisions are closed with self-dissolving sutures, leaving only the removal of sutures on the bridge of the nose. The nasal skin is modelled with thin strips of adhesive plaster and a prepared prepared plaster is applied in place.
The nasal packing is removed after 2 days and the splint may be removed after 14 days.
Cooling of the eye and cheek region is performed immediately the operation in order to keep swelling to a minimum. Pain is generally limited and may be treated satisfactorily with analgesics. The nasal packing is left in place for 2 days, and unhindered breathing through the nose thereafter is guaranteed. Further treatment then occurs on an out-patient basis.
Nasal irrigation and application of nasal ointment should be performed several times daily in order to maintain the mucous membrane during the initial post-operative weeks. A normal nasal and mucous function is achieved after 3-6 weeks at the earliest. Poor maintenance of the mucous membrane and smoking significantly prolong this restoration. The nasal cast is renewed after 7 days and removed completely after 14 days.
At this point the nose should look completely normal.
However, modifications made to the bone require about four weeks healing, and gentle treatment is especially important during this period. Complete the healing of all wounds and disappearance of swelling really requires more time. It is only after six months that the nose feels natural again and has achieved its final shape.