It is an operation that makes essential changes in nose aesthetics, external appearance, and personality. It takes many years to master this surgery, which has both aesthetic and vital functional aspects.
As an Otorhinolaryngologist, I will try to share my experiences with you, especially as a physician who deals with this surgery almost in the last five years of my life.
Nose Job surgery is surgery to make the nose image more compatible and aesthetic with the general facial structure of the person.
I suggest general anesthesia in nose job surgery. This surgery is a team surgery in which surgeons, anesthesiologists, surgical nurses, operation room technicians work together.
We also include the patient in the surgery team, because the patient’s behavior, according to the preoperative recommendations, is necessary for a perfect surgery.
During general anesthesia, the patient is placed on the operating table in the supine position. In the meantime, silicones are placed on the protruding points of the body (i.e. below the knees, heels, and nape, etc.) of the body that are in direct contact with the stretcher. After these procedures, the surgical period of the process begins.
The procedures to be performed after the start of general anesthesia show some differences depending on whether the patient is the first surgery or revision surgery and the natural anatomical structure of the patient. Besides, each surgeon can use different methods in his/her technique.
In the Nose Job, surgeons generally prefer one of the open technique or closed technique methods. I like the closed approach with endoscopy support to all of my patients who were the first surgery in my practice.
In this method, we carry out the studies we planned in the relevant bones and cartilage by reaching the nose back, sidewalls, and the tip of the nose with fractions made through the nose.
Also, there are different technologies used by each surgeon during rhinoplasty surgery. For example, in the process of shaping or cutting bones, some surgeons use conventional bone cutters, while others use Piezo or some Micro saw systems, which we call motorized systems.
I use both Bien Air micromotor systems and Piezo devices together in my surgeries. We use it as an alternative to other instruments that are alternative in the stages, but we call the operation method closed or open nose aesthetics.
Here, the different methods preferred by surgeons include protective nose aesthetics (Preservation = Letdown / Pushdown) or classical structural (Structural) rhinoplasty methods.
Protective rhinoplasty is a method that has become very popular, especially in recent years, and this method aims to lower the arch down by removing the cartilage and bone structures in the lower part of the nose without cutting the natural nasal back of the patient.
On the other hand, with the classical method, cartilage grafts are used to restore the cavity formed in this region by cutting the nasal back. In my practice, I usually apply the protective rhinoplasty method to my patients (95%) with the help of endoscopy.
With this method, I think if it can achieve more natural and less likely to revise (3-5%) nasal aesthetics results. However, I would like to state that it is essential that the open-closed or protective-classical nose aesthetic surgery methods mentioned here are the experiences of the surgeon’s chosen method.
I believe that surgeons with sufficient expertise and experience can achieve very successful results in any of the methods mentioned above. I would also like to emphasize that another critical factor affecting the success in the results of the rhinoplasty surgery is the patient’s natural anatomical structure.
Nose Job Surgery is essential for a both aesthetic and healthy life. Because the nose is in the middle of the face, it is a significant body in human facial aesthetics. At the same time, it is also a respiratory organ, since inhaled air is the first entry into the body. In this respect, preserving and further improvement of the nasal physiology, which we call functional together with cosmetic results, should be the ultimate goal of the Nose Job surgery.
The nose warms and moistens the intake air. It also allows the air to be transmitted from the nose to the nasal passage and from there to the lungs. For this, they should not be in the nose and the condition of bone curvature or meat growth (Concha Hypertrophy). In this respect, there is cartilage, which we call septum in the anterior part of the nose, and bone tissue in the back of it. In the nose, it is also vital in respiratory physiology in structures consisting of nasal meats called concha on both sides.
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The nose consists of the nasal cartilage, which we call the septum, and the bone structures that continue at the back, as well as the side visible when viewed from the outside. In nasal aesthetic surgeries, we usually perform an intervention to take the cartilage, which we call a graft, to the cartilage we call septum.
We use these cartilage grafts (sometimes we use structures such as bone, nasal and muscular membrane for graft purposes) to shape and support the outer part of the nose. However, if the patient has cartilage or bone curvature sufficient to cause nasal congestion, we correct them simultaneously during the rhinoplasty surgery process.
If an aesthetic procedure is applied to the outer part of the nose along with the nasal cartilage correction process, which we call breathing-oriented septoplasty, this is called Septorhinoplasty, and if a cosmetic procedure is applied only to the outer part of the nose, we call it Rhinoplasty.
Or if an operation was performed just to breathe, we call it Septoplasty. In addition, during the Nose Job, we also frequently apply the procedure to shrink the nose meats, which we call Concha, with radiofrequency.