The nose is a basic element of the anatomy of the human body, being an extremely sensitive sensory organ and part of the respiratory system. In addition, since ancient times, the nose has been considered an element that gives the physiognomy of the human face beauty, harmony, sometimes power, or even details about the noble past of certain people.

Even if it was practiced at a rudimentary level, modifying the shape of the nose to reach the standard of the respective times has its origins over 2000 years ago. People still aspire to the standard of beauty of their times, and they can achieve it through modern plastic surgery techniques that will give your nose a much-desired look while improving its respiratory function.

It is perfectly normal to ask yourself how the surgery will go, its implications, and the result, and through this article, we hope to clarify your every question.

Ideal candidates for rhinoplasty

The minimum recommended age for rhinoplasty is 16 years for girls and a little older for boys. There is no standard age for young patients, all depending on the particularities of each case. There is no maximum age.

Cosmetic nose surgery is addressed to both women and men. However, beauty criteria are different depending on gender, so rhinoplasty must adapt to varying characteristics of women and men.

The ideal female nose can be shorter, thinner and more lifted. While a male nose is more solid and straight. In any case, the nose must match the patient's personality beyond the classic and traditional image, and the surgery must respect aesthetic criteria and the patient's desire.

Relevant motivations for resorting to rhinoplasty

Usually, there are three primary causes for which patients resort to such an aesthetic procedure:

I. Nose reshaping for medical reasons - septal deviation

This section includes the deviation of the nasal septum, a condition that implies that the cartilage in the centre of the nose, the nasal septum, is not positioned centrally, causing breathing problems. The septum spans the entire length of the nose and certain septal deviations can cause external nasal deformities also. The more pronounced the deviation, the more complications it can lead to, including sinusitis or obstructive sleep apnoea.

Possible symptoms of a septal deviation:

  1. Nasal congestion and difficulty breathing
  2. Noisy breathing and snoring during the night
  3. Headache
  4. Hypersecretion of mucous
  5. Frequent sinus infections (caused by mucus blockage and lack of drainage)
  6. Recurrent blood noses

II. Remodelling the nose following traumas/accidents - reconstructive rhinoplasty

The nose treated within 21 days of the accident can potentially correct acute post trauma changes and restore a damaged nose back to its normal state. Following acute nasal trauma, the nasal bones can be significantly shifted, thereby changing the external shape of the nose. Nasal bone fractures start to heal immediately after trauma, however, withing the first 3 weeks, the bones may still be mobile and can be manipulated back to their normal position. If this 3 week window is missed, the mal-positioned bones will be fixed in the post-fracture position, and cannot be shifted with simple manipulation. In these situations, it is preferable to wait about 6 months before further intervention. Intervention will then require a formal reconstructive rhinoplasty.

Reconstructive rhinoplasty can have various causes, and the most common are the following:

  1. Traumatic accidents
  2. Drug abuse
  3. Septum perforations
  4. Congenital anomalies
  5. Cancer
  6. Aesthetic interventions with unsatisfactory results

The benefits and functional advantages of rhinoplasty include the amelioration of congenital and respiratory defects.

III. Remodelling the nose for cosmetic reasons

Such reasons may include humps of the nasal bridge, nose size, deviation of the nose, a large or asymmetrical nasal tip, the size and position of the nostrils, a failed previous rhinoplasty and others. Here are the most common purposes of rhinoplasty for aesthetic reasons:

  1. Reducing the overall size of the nose
  2. Removal of the hump
  3. Narrowing of a bulbous or broad nose tip
  4. Removal of any asymmetries of the nasal tip
  5. Straightening a deviation of the nose or tip
  6. Narrowing of the nostrils if they are too wide
  7. Rounding the tip of the nose too sharp
  8. Raising the tip of the nose

Whatever the aesthetic reason for nasal reshaping, the doctor will always do his/her best to get the most natural and aesthetic results possible. The expert rhinoplasty surgeon will take your desires into account, however, there are certain nasal aesthetic ideals that he/she will abide by. This will create the best nose possible from your existing anatomy. An ideal nose complements facial features without distracting from them.

The aesthetic benefits and advantages of rhinoplasty include subtle changes in the shape of the nose, facial symmetry, and psychological edges that will eliminate inferiority complexes and increase the patient's self-esteem.

What happens during the surgery?

Rhinoplasty is generally performed under general anaesthesia.

- The operation lasts on average 2 -3 hours but can be extended depending on the complexity of the changes required.

- The incisions can be made inside the nose -closed technique- or at the level of the columella (the skin bridge that separates the two nostrils) - open technique-

- Remodelling the nose involves either reducing certain structures or augmenting them by adding cartilaginous or bone grafts

- The deviation of the nasal septum is corrected at the same time

It is important to achieve the best result possible in your initial rhinoplasty. Further surgery often compromises the initial results and may make the nose worse.

Postoperative evolution

- At the end of the operation, the incisions will be sutured

- Postoperatively, the bones and cartilage will be supported by a splint applied to the outer face of the nasal pyramid.

- Gentle soft silicone splints will be inserted in the nostrils, which will be maintained for 7days

- Rhinoplasty causes a small or moderate discomfort, which can be controlled with regular pain medication (paracetamol, Tapentodol); an oral antibiotic will also be given five days postoperatively.

- Postoperatively, a prone position is required (the patient lying on their back), with his head raised.

- The splint will be removed 7 days postoperatively

- The early result of rhinoplasty can be seen 2 weeks after surgery. In the next 3-6 months, there is a progressive improvement of the nasal shape and contour and the disappearance of oedema.

- Sun exposure, wearing glasses, and intense physical exertion will be avoided two months after surgery.

-Avoid alcoholic beverages. These hinder healing and contribute to fluid retention in the body. Do not drink alcohol for at least 10 days.

-Try to quit smoking. Smoking decreases vascularity and prevents the operated tissues from healing.

- Avoid blowing your nose for the first week as this will increase nasal bleeding. After 1 week you can blow your nose gently.

- Be patient with yourself and with the recovery period after rhinoplasty. The appearance of your new nose and the final result of the operation can be fully evaluated after the swelling is completely gone, and this can take weeks and even months.

Complications of rhinoplasty

The general complications are those common to any invasive procedure, represented by certain cardio-respiratory complications that can occur due to general anaesthesia.

Local, specific complications:

Minor bleeding (ooze from the nose) is expected for 3-4 days following surgery. You may use a nasal bolster or gently dab with tissues during this time.

  1. Infection Is rare, being prevented by the administration of antibiotics during and after surgery
  2. Sensitivity disorders at the level of the nose usually disappear within a few months
  3. Nasal obstruction, possible in the first months due to swelling of the nasal mucosa
  4. Perforation of the nasal septum, a rare complication that requires subsequent surgical correction
  5. Contour irregularities and minor asymmetries are expected
  6. Minor scars at the base of the nose or nostrils, usually heal very well and are almost invisible by a month.
  7. A less then ideal cosmetic result.

Final words

The preoperative consultation is as important as the operation itself when it comes to a nose job. Your expectations need to be along the same lines as the surgeon’s expectations. The best thing you could do to ensure you get the results you desire is to choose a facial plastic surgeon with plenty of experience and proven results.

You should know that patience is the key factor when it comes to most types of plastic surgery interventions, and the result of your nose job can be observed and evaluated when local postoperative effects (bruising, oedema) subside.

Its of utmost importance that you realise that a successful result depends on having reasonable expectations. You can expect that your nose will be nicer, gentler, and better compliment your other facial feature. You cannot expect perfection.