¿Who can receive a Rhinoplasty? People that feel that their nose is too long with relation to the face, that have a hump on the nasal spine in the view from the side, that have a very wide nose in the front view, that have the nasal tip fallen or barge, that have the tip very wide or very thin and extended, that have the nostrils wide and very large, that have the devious nose or has very small and very low spine for the face. Also a rhinoplasty can be practiced to those people that had suffered traumas or previous surgeries that have altered his/her nasal esthetic.
What does the consultation consist of? It is very important that the patient has very defined specific points that does not like from him/her nose, because this will allow Doctor Andrés Mejía to understand his/her expectations. Antecedents of rhinitis will be kept in mind, same as nasal obstruction or snoring. Dr. Mejia also will evaluates aspects such as type of skin, if there is a presence of scars or nasal deviations; the relation of the nose with other facial structures, movement of the tip downward when laughing, if there is nasal obstruction by deviation of the partition wall and cornets increased in size. If the solution presented by Doctor Andres Mejia fills the expectations of the patient, a specific surgical plan will be designed, with the possibility to offer a prognostic through digital media. Alternate procedures that improve the results can be stated such as chin augmentation (mentoplasty), double chin liposuction or wrinkles in the eyelids or cheeks removal.
How is the procedure carried out? Generally the rhinoplasty is completed under general anesthesia. In exceptional cases it can be done under local anesthesia with sedation, provided that qualified specialists assist the surgery same as an adequate technical team. Normally it is not necessary a hospitalization and has an average duration of two hours. Each nostril receives a pair of internal incisions, without being visible externally, cartilages that give the nose support are exposed and parts of these are withdrawn to make thinner the nasal tip. Only external scars will be done in case that the nostrils should be narrowed. Then the scar, short length, will be on the base of the nose. By means of chisels and special hammers utilization the form of the nasal spine is modified by drying up the osteo-cartilaginous hump and fracturing, in a controlled way the sides of the nasal pyramid to turn it more tighten.
Once the surgery is finished, two nasal tampon are introduced in each fosse in order to mold the mucous membrane and to control the bled post surgery, the skin of the nose is fixed with paper bandage and an external ferule of gypsum, metal or plastic is placed on top, this one will maintain the bones in their new position and will protect the nose from any traumatism during post surgery. The ferule of the spine is left in position during 10 days and the court-plaster that maintains the skin in its new position is changed on a weekly basis but remains for 2 weeks. There are non frequent cases where the size of the nose must be enlarged in a significant way, therefore tissue graft must be taken from other sites such as are the auricular building, the rib cartilage, hip bone, from the elbow or from the head front parietal region.
¿Which are the nose surgery risks? Some of the complications are bled, hematoma, prolonged inflammation, anesthesia reactions, infection and relapsed deviation, nasal obstruction. Doctor Mejía counts on a multidisciplinary team of professional experts and the appropriate installations making those risks minimum.
How the patient should be prepared for the surgery? Be accompanied to the procedure is a must and days before not to consume cigarette, aspirins or any type of anti-inflammatory.
How is post surgery? The first 24 hours the patient will feel uncomfortable having to breathe for the mouth due to the internal tampons that are placed to avoid bleeding. It is recommended to sleep with elevated head to reduce the inflammation. In some cases a sheet of gypsum or aluminum will be left on the nose for 6 days, minimum period of rest to avoid greater inflammation. It is possible that bruises around the eyes be present. These ones will get better after 4 or 6 days, although there are cases in which they can remain until a maximum of 15 days.
Some bandages skin color will be placed during 20 days, to avoid inflammation and to maintain the nose shape. The patient cannot expose him/her self to the sun by minimum 3 months. Before 6 days any kind of working activity or student one should not be completed, neither strong exercises. Contact sports such as soccer, tennis, volleyball, basketball and other in which the risk of an accidental nose stroke exist, should be avoided at least by six weeks.
Which will be the results? The patient will see the result of his/her surgery at the sixth day when the gypsum is withdrawn, although the true change only will be appreciated after six months. Nevertheless, after the first weeks he/she will be able to enjoy the new appearance, which each day will be more natural. Results are permanent, except by possible changes related to the normal process of facial aging. It is important to have into account that the relationship physician-patient does not finish once the surgery is finished. In great measure, the right post surgery management that be given, will depend the final result of the rhinoplasty.
