Rhinoplasty

Procedures correcting the shape of the nose are dedicated to patients with post-traumatic or congenital defects causing deformities of nasal cartilages and/or nasal bones. The inner parts of the nose are often deformed (nasal septum, nasal concha) and thereby impair breathing. In such cases the procedure can both improve the air flow and also change the outer shape of the nose.

Depending on the type of deformity we can either make the nose look smaller by reducing particular nose parts or enlarge it by adding cartilage structures. For last 5 years I have been using the open technic for nose surgery. Each treatment is preceded by appropriate planning of skin cuts. Procedures are performed under general anesthesia. The incision (based on the current state of knowledge) is made on the columella and becomes almost invisible in the course of time (no visible scars). In the reduction procedure, we reduce the structures within the cartilage and bone parts of the nose, but at the same time we try to save the resected tissue as much as possible. We cut the bones using a device for bloodless bone cutting, so-called "piezotome". Thanks to this device, the patient has less bruising around the eyes. After the procedure every patient’s nose is dressed in an adhesive bandage and plaster cast. Tampons are being placed inside the nose. After the procedure patient can feel the discomfort while breathing due to the swelling and the placement of tampons. Patient could observe swelling and bruising around the eyelid up to 1-2 weeks after the procedure.

After such procedures patients should avoid: alcohol, manual effort, spicy dishes, hot drinks, bending over and situations effecting in rise of blood pressure. Getting back to work is usually possible after 2 weeks (only if the job does not involve manual effort, does not affect in constant rising of blood pressure and the patient is not exposed to dusting and reeking). Patients should avoid all extreme and contact sports for 6 months after the procedure.

Consequences and possible complications after rhinoplasty done by open technique:

1. Swelling and bruising - this is a consequence, not a complication.
2. Asymmetry, we are not symmetrical, although it seems to the layman that our body is symmetrical. Therefore, it is impossible to achieve perfect symmetry despite all efforts.
3. Hematoma under the skin causing prolonged extreme swelling, thick scarring, and poorer aesthetic effect.
4. Hematoma in the septum causing abscess and, consequently, perforation of the septum and the formation of a hole in it.
5. Bleeding from the nose, sometimes quite profuse. In most cases it stops on its own and sometimes requires another tamponade.
6. Infection, from small to extreme, which can cause damage to cartilage structures and collapse of the cartilage part of the nose, scarring and distortion of the nose.
7. Wound dehiscence with prolonged healing leaving a wide, uneven, hypertrophic or keloid scar.
8. Necrosis of the skin on the tip of the nose which destroys the aesthetic effect of the treatment.