Rhinoplasty (Aesthetic Nose Surgery) aims to improve the appearance and proportion of your nose while enhancing facial harmony and self-confidence.
The goal of rhinoplasty is a nose that looks natural and blends harmoniously with your other facial features as well as an open and funtional airway. Sometimes certain breathing problems related to the internal nasal structures can be corrected at the same time as nose reshaping is performed. Dr. Hakan Gundogan will help you to determine whether these structures should be modified along with reshaping your nose.
A nose surgery procedure to improve an obstructed airway requires careful evaluation of the nasal structure as it relates to airflow and breathing. Correction of a deviated septum, one of the most common causes of breathing impairment, is achieved by adjusting the nasal structure to produce better alignment. Nose deformity is usually the result of heredity. The appearance may have been altered in an injury or during prior surgery.
Dr. Hakan Gundogan usually recommends that patients wait until they are at least 18, and possibly older for boys, before undergoing rhinoplasty. This is because the nose may not be fully developed at a younger age. If you are a teen, Dr. Hakan Gundogan will want to be certain that you have thought carefully about surgery and that the desire to change your appearance is based on your own feelings rather than those of your parents or friends.
Assuming you are in good health, there is no upper age limit for having your nose reshaped. Rhinoplasty is sometimes performed in conjunction with a facelift or other rejuvenation surgeries to correct aging changes of the nose such as a drooping tip.
* Nose size, in relation to the other facial structures
* Nose width, at the bridge
* Nose profile, with visible humps or depressions on the bridge
* Nasal tip, that is large or bulbous, drooping, or too upturned
* Nostrils that are large, wide or upturned
* Nasal asymmetry and deviation
Some of the indications that you may be a good candidate for rhinoplasty are:
* Your nose appears too large for your face
* There is a bump on the nasal bridge when viewed in profile
* Your nose seems too wide when viewed from the front
* The nasal tip droops or plunges
* The tip is thickened or enlarged
* Your nostrils are excessively flared
* Your nose is off-center or crooked
* Previous injury has made your nose asymmetrical
It is important that you have a clear idea of how you would like your nose to look and, at the same time, realize that there are limitations to the procedure. Patients with sufficient physical and emotional maturity who undergo rhinoplasty because they want to enhance their self-image are usually very satisfied with their decision.
During the initial consultation, you may be asked to look in a mirror and point out exactly what you would like to see improved. This will help Dr. Hakan Gundogan to understand your expectations and determine whether they can realistically be achieved.
You should come to the consultation prepared to discuss your medical history. This will include information about any medical conditions you may have, medical treatments you have received, previous surgeries including repair of nasal injuries, and medications that you currently take. Dr. Hakan Gundogan may also ask whether you have difficulty breathing through your nose, suffer from allergies that may cause nasal stuffiness, or are a chronic user of nasal spray. It is important for you to provide complete information.
In evaluating you for rhinoplasty, Dr. Hakan Gundogan will conduct a routine and painless examination of your internal nasal structures using endoscope. Your skin quality as well as the size and shape of your nose and its relationship to your other facial features will be carefully studied. In some instances, Dr. Hakan Gundogan may recommend surgery of your chin, making it either more or less prominent, to improve facial balance. This procedure can be done at the same time as your rhinoplasty.
If you are a smoker, you will be asked to stop smoking well in advance of surgery. Aspirin and certain anti-inflammatory drugs can cause increased bleeding, so you should avoid taking these medications for a period of time before surgery. Dr. Hakan Gundogan will provide you with additional preoperative instructions.
If your rhinoplasty will be performed on an outpatient basis, be sure to arrange for someone to drive you home after surgery and to stay with you at least the first night following surgery.
Because of individual factors, not everyone will achieve the same results from rhinoplasty. Dr. Hakan Gundogan's goal is to obtain the best possible results for you.
Alterations may be made to increase or decrease the nasal bridge, reduce the size or width of the nose, narrow the nostrils, change the angle between the nose and upper lip, or reshape the tip. Small wedges of skin, as shown, might be removed to narrow the base of the nose or reduce the width of the nostrils.
The surgical techniques employed will depend primarily on the goals established by you and Dr. Hakan Gundogan. In many instances, all of the incisions will be placed inside your nose, where they will not be visible. If the base of the nose is narrowed or the nostrils reduced, small wedges of skin at the base of the nostrils will be removed. Incisions are hidden in the natural crease where the nostril joins the cheek.
Sometimes a very short incision is made across the vertical strip of tissue that separates the nostrils, called the columella. This technique is called an "open rhinoplasty." Whatever incisions are used to reshape your nose, they will ultimately be very inconspicuous.
Incisions are placed inside the nose to provide access to the cartilage and nasal bones that form the nasal framework.
Through the small incisions described previously, work is done on the cartilage and bone that form the framework of your nose.
Sometimes, the position of certain bones may need to be altered slightly in order to make your nose look narrower and straighter. If your nose needs to be built up in some areas, this can be done using nasal cartilage, or perhaps bone or cartilage from another site. The skin and soft tissues then redrape themselves over this new "scaffolding."
Your rhinoplasty operation will be performed in a hospital.
Medications are administered for your comfort during the surgical procedure. Even thought, local anesthesia and intravenous sedation may be used for patients undergoing nose reshaping, Dr. Hakan Gundogan prefers general anesthesia in most instances, since it does provide safer and more comfortable operation process for the patient. For your safety during the operation, various monitors are used to check your heart, blood pressure, pulse and the amount of oxygen circulating in your blood.
Medications are administered for your comfort during rhinoplasty surgery. The choices include intravenous sedation or general anesthesia. Dr. Hakan Gundogan will recommend the best choice for you.
Surgery of the nose is performed either using a closed procedure, where incisions are hidden inside the nose, or an open procedure, where an incision is made across the columella, the narrow strip of tissue that separates the nostrils.
Through these incisions, the soft tissues that cover the nose are gently raised, allowing access to reshape the structure of the nose.
Surgery of the nose can reduce or augment nasal structures with the use of cartilage grafted from other areas of your body. Most commonly, pieces of cartilage from the septum, the partition in the middle of the nose, are used for this purpose. Occasionally a piece of cartilage from the ear and rarely a section of rib cartilage can be used (mostly in previously operated noses).
If the septum is deviated, it is now straightened and the projections inside the nose are reduced to improve breathing.
Once the underlying structure of the nose is sculpted to the desired shape, nasal skin and tissue is redraped and incisions are closed. Additional incisions may be placed in the natural creases of the nostrils to alter their size.
After your procedure is completed, a splint (no packing) will likely be placed inside your nose and a splint or bandages placed on the outside to support and protect the new structures during initial healing.
When surgery is completed, you will be taken into a recovery area where you will continue to be closely monitored. There may be some discomfort, but this can be controlled by medication, which you may continue taking at home. Depending on the surgical technique used, a splint may have been placed on the bridge of your nose for the purpose of holding the tissues in place until they have stabilized. The splint will protect your nose while you sleep and shield it from accidental bumps. Frequently, you may also have a small triangular bandage beneath the tip of your nose. Dr. Hakan Gundogan no longer uses packing. However soft internal splints are sometimes used inside the nostrils, especially if work has been done to improve your breathing.
You probably will be permitted to go home after a few hours, although some patients may stay overnight in the hospital.
It is important to realize that the amount of time it takes for recovery varies greatly among individuals.
The first couple of days after surgery, you should restrict your activities and sleep with your head elevated. This will help to minimize swelling and reduce the possibility of minor bleeding, which is not uncommon. Remember, you must not take aspirin or certain anti-flammatory medications.
Generally, bruising around the eyes and cheeks is most apparent during the first three days following surgery. Most discoloration will disappear within a week. A few days after surgery, you can begin to use makeup as a concealer, if desired. Noticeable swelling may last for several weeks. Minor residual swelling, most frequently affecting the nasal tip, may continue for many months, but generally this should not be apparent to others. If packing was used, it will either dissolve by itself or be removed three to seven days after surgery. Stitches may also be removed at that time. You may need to continue wearing the nasal splint for up to a week, during which time you should avoid getting it wet.
While initial swelling subsides within a few weeks, it may take up to a year for your new nasal contour to fully refine.
During this time you may notice gradual changes in the appearance of your nose as it refines to a more permanent outcome. Swelling may come and go and worsen in the morning during the first year following your nose surgery.
Since the healing process is gradual, you should expect to wait up to one year to see the final results of your rhinoplasty. You are likely, however, to begin enjoying your new look within weeks of your surgery.
Occasionally, a touchup may be desired to further improve the results. If this is the case, the additional procedure is usually less extensive than the original operation.
It may take several months for swelling to fully dissipate and up to a year - and sometimes longer - for the outcome of the surgery to fully refine after rhinoplasty surgery.
Straining, bending and lifting should be avoided during the early postoperative period. In many instances, you may be able to return to work within a week or ten days after surgery. Most normal activities including exercise can usually be resumed within three weeks.
It will be a few months before you can expose your reshaped nose to direct sunlight. Your nose will be sensitive during this time, and you must be conscientious about using a sunblock to protect your skin. If the bones of your nose were altered, it may be a number of weeks before you can wear glasses without special support such as tape.
In most instances, the results of rhinoplasty are permanent, except for possible changes associated with the normal aging process. Although the results of nose surgery are usually permanent, cartilage may continue to reshape and move tissue that may change the outcome over time.
You will return to Dr. Hakan Gundogan's office for follow-up care at prescribed intervals, at which time your progress would be evaluated.
Please remember that the relationship with Dr. Hakan Gundogan does not end when you leave the operating room. If you have questions or concerns during your recovery, or need additional information at a later time, you should Dr. Hakan Gundogan.
