The alternation of the nose’s form by operation is specified as nasal-plastic surgery. It is required when the individual feels it disturbs the harmony of the face. It may be too long, too big, hooked, wide, inclined or at any part it may be ill proportioned. This problem is mostly hereditary and appears only at about the age of l6-18 years. Rarely it is acquired because of an accident or by other causes. The operation may take place generally at the age of 18 or anytime later, there is not upper limitation.
It is very important in respect of the success of the operation to have a thorough discussion between the patient and the surgeon. The person who does the operation has to know the patient’s wishes and perceptions and so the patient has to learn what kind of changes are available. That is to say how alterations would affect the harmony of the face. It is a pity, but as with all wishes, every kind of form cannot be achieved. It mostly depends on the original anatomical forms. Otherwise on every kind of nose there can be made modifications in different measures. Some are advantageous some aren’t so. Computer modelling is used to identify the ideal outcome. /This service is free in our clinic. /We make photos by digital camera and by computer we create the possible nose-shapes. From these is the patient is able, together with us, to decide which one would be the most ideal.
The essence of nose surgery is the transformation of the bony, cartilaginous skeleton of the nose. For a complete nose plastic surgery it means engraving, sawing, cracking the nasal bone, which is actually the directed and planned breaking of the nasal bone. The lessening of cartilages is made and changing form and their arch and correcting the relationship between them. We shorten the soft part of nose-wings is carried out if it is needed. In the case of partial nose plastic, which isn’t typical, we make from the above-mentioned intervention only certain operations, not all. The skin of nose follows these changes a little bit later, and is lays itself tightly onto the new shell. Generally the cutting can be done on the inner side of the nose, so the operation doesn’t leave a scar on the skin. If the nose-wings have to be reduced, only a hardly noticeable very thin scar remains at base of nose.
Nasal plastic surgery is commonly made under general anaesthesia, because the engraving and sawing of the nasal bone even at local anaesthesia could be painful. The important, blood and urine tests, EKG can be done in our clinic prior to the operation. The duration of this operation is 1-2 hours.
At the end of the operation impregnated tampons are put into the openings of the nose. On the topside a cast cover is put, which will be stabilized by adhesive tapes. The patient remains in the clinic for the night after the operation, the next morning-after the tampons are removed- it is possible to go home. There is not any pain the only problem is breathing through only the mouth as the tampons have closed the nose.
The cast covering remains, depending on the measure of reforming of the nasal bone- for 5-12 days. It is advisable to rest at home mainly because the patient’s appearance is very disadvantageous as there are bloodshot eyes and a swollen area as well. The bruising is absorbed in about two weeks, but this time can be shortened by icing. If ice jelly is not available the following simple method can be used. A one-liter plastic milk bag can be utilised. The bag should be filled with water and then partially frozen in a freeze. Before it is completely solid it should be removed and crumbled into an ice mush. After the outer sides of the bag have dried, it must be covered by some textile towel and then put onto the eyes daily 4-6 times for 20-25 minutes long. In the first days the patient has to rest preferably in a sitting position and the following activities are forbidden: nose-blowing, bending, lifting heavy objects. It isn’t advised to eat hot or spicy food and alcoholic drinks. To restore the breathing through the nose we supply a nose-cream. Nose-drops are also usable. Taking off the cast is carried out during the first visit after the operation. It doesn’t cause inconvenience. Removal of stitches isn’t needed because they are absorbed by themselves. It should be understood that, the new form of nose cannot be seen just after removal of the cast. A distinct improvement can be experienced but the final form needs another 4-5 month time. This is because the tissues are slightly swollen due to the operational trauma and the withdrawing of skin also needs some time. It is forbidden after the operation to sunbathe or to use solarium for six weeks. No nose can be saved from any energetic impulses. Wearing eyeglasses needs individual consideration the next check up happens after 6-8 weeks.
It happens although not very often that even after a well-made and successful operation in the first or second month disadvantageous changes starts to become apparent. This could be a slight slantwise deformation of the nasal-axe or under it a touchable small hump or perhaps the position of the tip may move. As a matter of fact, these aren’t complications but the body’s reactions. This might occur in 5-6%, of cases during the generating of cicatrices and the processes of new structurizing of bone. Later on, this can be corrected by a smaller intervention.
Bleeding or inflammation may occur after any operation, at this case it is possible is in 1-2% of cases, but these can be kept by under control using more tightened tampon, and by giving antibiotics. It is similarly rare that for some weeks whey-like mucus may flow from the opening of nose.
In one in a thousand cases there might occur the restriction of one opening of nose. This makes the breathing through the nose harder, just as the necrosis of the cartilage which can deform the shape when an other operation is unavoidable.