What is Rhinoplasty?

Rhinoplasty is one of the treatments that both men and women have the most frequently in cosmetic surgery. In fact, the nose is a vital respiratory organ and is composed of both bones and cartilage. Its primary duties include filtration of incoming air and defense against various external assaults on the human body. However, it has a big impact on how someone’s face looks. The nose is frequently a major source of aesthetic issues when it is too big, droopy, or damaged. With the help of rhinoplasty, you can restore your well-being and get back your precious smile.

With more details, rhinoplasty is a surgical procedure that changes your nose’s shape and size for aesthetic purposes or functionality. It can help improve your appearance, fix breathing problems, and correct the deviated septum. According to the American Society of Plastic Surgeons (ASPS) statistics, nose surgeries are gaining huge popularity and have become the third most popular aesthetic procedure in the USA. The rhinoplasty market size value in 2022, according to Grandview research, is at 5.5 billion USD. Women account for nearly 90% of all plastic surgeries in the US, and male rhinoplasty is also becoming prevalent. The treatment types can be categorized as the following: augmentation, post-traumatic, reduction, reconstructive, revision, filler, and others. Augmentation nose surgery ranks high in Asia, with silicone implants being adopted for reshaping.

A rhinoplasty can be performed alone or in conjunction, as needed, with other facial surgeries that are complementary, most notably a genioplasty (enhancement of the chin, frequently done concurrently with the operation to improve the overall profile).

The objective is to achieve a natural-looking nose that complements the other facial characteristics, fits the patient's psychology and personality, and complies with their wishes.

What are the main types of rhinoplasty?

Reduction Rhinoplasty

The most common technique for facial cosmetic surgery is reduction rhinoplasty. It entails bringing the nose back to its normal size while taking into consideration the rest of the facial features.

We generally distinguish between a decrease in the nose's overall size and a decrease in the size of a specific portion of the nose that changes the nose's overall appearance. Reduction rhinoplasty corrects noses that are too long (wide or flat), noses that are too wide or flat, bumps that deform the nasal bridge, tips that are too thick or droopy, and dilated nostrils.

This rhinoplasty must always be preceded by an endoscopic evaluation of the nasal cavity to detect any pre-existing functional issue that the patient was unaware of.

Augmentation Rhinoplasty

Correcting volume abnormalities of a genetic, traumatic, or ethnic nature requires augmentation rhinoplasty. Using mainly cartilage transplants. Graft augmentation techniques are frequently used in secondary rhinoplasties, but in primary rhinoplasties, where the projection of the dorsum is frequently insufficient, they are typically reserved for ethnic rhinoplasties.

Augmentation rhinoplasty corrects facial deficiencies, whether related to traumatic injury or hereditary, including noses that are excessively short, lack projection, have noticeable saddles, etc. The next step is to do an ear cartilage graft or a cartilage graft derived from the nasal septum. Rib cartilage can be harvested if there isn't enough of cartilage from the ear or septum.

Ethnic Rhinoplasty

The term "ethnic nose surgery" refers to both demands for traditional rhinoplasty adjustments and those connected to a decision to westernize the face.

In this case, it is critical to fully explain the treatment plan to the patient, particularly in cases when thick skin is involved (rib cartilage graft is frequently required). All aspects of the surgical project (lip volume and projection, eyelid alignment, etc.) must be taken into consideration in order to achieve a balanced and aesthetically pleasing change in the face. This is done to prevent the patient from being lost or, conversely, from experiencing a change that they feel is insufficient.

What does rhinoplasty do?

• Correct the shape of the nose that looks bulbous, upturned, hooked, or droopy
• Reduce the width of nostrils, either wide, small, large, or turned upward
• Increase or decrease the size of the nose to create facial balance
• Fix a deviated septum
• Open blocked nasal passages

How is rhinoplasty performed?

Despite the fact that every surgeon has their own unique surgical techniques, there are some principles. In South Korea, surgeons perform both techniques: the open rhinoplasty approach and the closed rhinoplasty approach.

Closed rhinoplasty approach: internal incisions in the nose are used by the surgeon during the surgery. Usually in the nostrils, but less frequently under the upper lip, these incisions are hidden. Externally, there are no apparent scars.

Open rhinoplasty approach: a minor incision at the columella (the area under the nose between the two nostrils) is performed by the surgeon during the surgery. Nowadays more and more people are getting open rhinoplasty.

When talking about the advantages of open rhinoplasty, surgeons often claim that with this approach they can better see what they are doing during the procedure. With the use of this approach, they are also able to work on difficult noses, such as better reshaping the nose tip. Open rhinoplasty will enable more accurate, complicated procedures to be performed on noses that have already had surgery or have been traumatized. However, healing time is the major disadvantage of the closed rhinoplasty approach since more tissue is removed and more procedures are performed. As a result, the recovery period is a little longer. The final outcomes will also be delayed.

The different subunits of the nose to be treated during a rhinoplasty

Four components make up the nose:

• The area colored in yellow: the tip
• The area colored in green: the dorsum
• The area colored in red: the top of the nasal bridge
• The area colored in purple: the nostrils

The pre-operative analysis of each of these subunits must result in the final project.

Rhinoplasty: before surgery

The patient should plan to have one visit or two to the cosmetic surgeon. The pre-operative consultation(s) is crucial for considering the reasons why rhinoplasty is desired, analyzing the morphology of the nose (shape, size, projection), checking the quality and thickness of the skin, and recommending additional tests if necessary. During the consultation with the cosmetic surgeon, the patient should discuss all of his/her concerns in perfect confidentiality. Its purpose is to further describe the process to the patient and clarify the therapeutic possibilities so that the patient can assess the outcomes and how much natural look he/she will have. In general, the best approaches to harmonize the face while retaining the patient’s identity are continually being sought after by the surgeon.

The patient will also be informed by the plastic surgeon of potential risks and consequences associated with the procedure.

What happens during the rhinoplasty procedure?

• The surgeon makes an incision on the inside of the nostrils (closed rhinoplasty). You may also have an incision across the base of your nose (open rhinoplasty)
• Raises the skin covering your nasal bones and cartilage
• Reduces, adds to, or rearranges the underlying bone and cartilage to create a new shape or fix a deviated septum
• Replaces the skin covering your nasal bones and cartilage
• Uses small stitches to secure your skin in place

What happens right after the rhinoplasty procedure?

The patient might have a plastic splint put on his/her nose to minimize swelling and maintain the new nose shape, and a cotton gauze packed inside the nostrils and usually removed within 24 to 48 hours. Swelling and bruising will occur around the eyes and nose, which is completely normal.

Rhinoplasty: healing process

Bruising around the eyes and soreness around the nose could be the first signs of rhinoplasty side effects. This is the body's normal response to surgery. Before the patient is allowed to be discharged, a tiny cast will be applied to the nose. After a week, the cast and any sutures that might be required to finish the treatment will be taken off.

The recovery period can take up to six weeks, depending on the complexity of the treatment and the body's natural immune reaction. However, other parts of the nose, including the tip, can continue to be vulnerable for a longer period of time.

To protect the nose from harm while it heals, specific precautions must be followed. These actions comprise, but are not restricted to:

• Avoid strenuous physical activities such as running and other aerobic workouts
• Avoid eating anything that can make you constipated because this can put pressure on the area that was surgically repaired. And, avoid salty and spicy food, as this can irritate your nasal passages and trigger inflammation. (See more)
• Consider drinking pumpkin juice as it helps accelerate the deswelling process. It contains vitamins A, C, B1, B2, B6, C, E, and beta carotene. (See more)
• Keep your face dry.
• Avoid touching your nose when changing clothes.
• Your face should be upward when you sleep, especially during the first week, to facilitate proper blood flow and prevent further injury.
• Don't laugh too hard or make other facial gestures that make your facial muscles tense up.
• After surgery, avoid wearing glasses that rest on your nose for at least one month.
• Avoid nose-blowing as much as possible, especially during the first period of the recovery process.
• Follow your plastic surgeon’s post-operative instructions.

What kind of scars are left over from rhinoplasty?

Depending on the surgical method, the scars from a rhinoplasty can sometimes be scarcely noticeable if the procedure was not performed by a board-certified and experienced surgeon. The most typical areas where patients might have scars are inside the nose (closed rhinoplasty) or on the columella, the area between the two nostrils (open rhinoplasty).

If the wings of the nose are flattened, one can also find scars in the depression of the wing. Additional scars could appear on the chest, or ear if a cartilage graft was required. However, these scars would be masked behind the ear and under the breast line for the rib cartilage case. The nasal septum is the most popular place where the surgeon takes the grafts because there is no scar and hence no visual harm.

What are the risks involved with rhinoplasty?

• A hole in your nasal septum
• Nosebleeds
• Infections
• Skin discoloration
• Unsatisfactory appearance
• Alteration of your sense of smell
• Additional surgery

FAQ

How to prepare myself before undergoing rhinoplasty in Korea?

Am I a good candidate to get Rhinoplasty?

Can I reduce my dorsal hump without surgery?

How safe is it to use donor cartilage for rhinoplasty?