How to fix the tip of the nose? Rhinoplasty for those who have a “potato nose. Analysis of the nose and face before rhinoplasty Photos before and after wide nose rhinoplasty

Kira (34 years old, Nakhabino), 04/09/2018

Good afternoon! Tell me, is it normal if I have a low temperature for several days after rhinoplasty? I was not warned about this in the hospital!

Hello! A slight increase in temperature after surgery is normal. Usually, in the first two or three days after the operation, the temperature is kept at 37-37.5 degrees. The temperature should drop on the third day after rhinoplasty. If this does not happen, we advise you to contact the clinic where you were operated on.

Georgy (36 years old, Moscow), 03/21/2018

Hello! Please tell me, is it possible to return the previous shape of the nose after a bone fracture? Thank you!

Hello! Yes, rhinoplasty allows you to return the nose to the desired shape, but plastic surgeons do not work with bones. Rhinoplasty only allows you to visually improve the shape of the nose, reduce it or change the shape of the nostrils. ENT surgery will help change the bone.

Vigen (32 years old, Moscow), 03/18/2018

How long does it take for the nose to heal after plastic surgery?

After surgery, bruising and swelling are observed, which may spread to the eye area or other parts of the face. Puffiness disappears in 7-10 days. At this time, physical activity, exercise is not recommended. Immediately after the operation, bleeding (from the nose) may occur, but these are only the consequences of soft tissue trauma. Bandages, as well as splints, are removed 14 days after the operation, during this period tampons are removed. Some patients feel severe pain when removing tampons, so pain medication is often used. Within a month, mucosal edema can be observed, so breathing will be difficult. After the swelling subsides, breathing will be restored. On average, the result after surgery can be assessed after 6 to 8 months. In rare cases, the result of the operation is evaluated after 12 months.

Alevtina (24 years old, Moscow), 09/15/2016

Hello, Maxim Alexandrovich! I have a very small nose. Is there any way to increase it? Will it affect breathing?? Thanks for your reply Alevtina.

Hello Alevtina! Rhinoplasty can help solve your problem. We can enlarge the nose, keeping its shape or changing it according to your desire. Come to us for a consultation and we will discuss the expected results of the operation. Rhinoplasty will not disturb the respiratory processes, since the structure of the nasopharynx is taken into account during the operation.

Alexey (30 years old, Moscow), 09/13/2016

Hello, Maxim Alexandrovich! Is it possible to correct the asymmetry of the face (due to a severely curved nose to the right) with rhinoplasty? Thanks for your reply, Alexey.

Hello Alexey! In practice, rhinoplasty will help you restore symmetry, but a face-to-face consultation is necessary for an accurate and clear answer to your question. You can make an appointment with us and we will conduct a full examination, discussing the likely outcome of rhinoplasty. It is also important to understand if the nose is crooked from birth or due to injury.

Love (35 years old, Moscow), 09/06/2016

Hello, Maxim Alexandrovich! My daughter has a very big nose, she suffers a lot because of it. Is it possible to have rhinoplasty at 15? How will the operation differ at this age? Thanks in advance, Love.

Hello Love! Unfortunately, rhinoplasty is performed only from the age of 18. The reason for this is the growing up and formation of the child's body. The formation of the skeleton is being completed, and this process must be fully completed before the moment when surgery occurs. Try to work with a psychologist, and then come for a consultation when your daughter reaches 18 years old.

Evgenia (25 years old, Moscow), 09/01/2016

Hello, Maxim Alexandrovich! Is it possible to straighten a displaced septum and remove the hump at the same time? Problems arose after a broken nose. How long will rehabilitation take? Sincerely, Evgenia.

Hello Evgeniya! Yes, it is possible to carry out both operations at the same time. Only in rare cases, two stages are assigned, which are held at intervals of one month. The postoperative period takes about two weeks, during which time bruises and swelling should go away. The hospital stay usually takes no more than three days.

Olga (22 years old, Moscow), 08/30/2016

Hello, Maxim Alexandrovich! I heard that the result of rhinoplasty can be affected by the condition of the skin. It's true? If I have problem skin, then I can not do rhinoplasty? Thanks in advance.

Hello! Yes, the condition of the skin is one of the factors that are taken into account before the operation. The fact is that poor skin condition can give unpredictable complications during the rehabilitation period. You can undergo treatment with a dermatologist, and then make an appointment with us for a consultation, where we will discuss the feasibility of the operation.

Hello Galina! There are two types of rhinoplasty: open and closed. In the first case, a barely noticeable mark may remain on the partition, but with proper care, they disappear after a while. In the second case, all manipulations are carried out without violating the integrity of the skin. What kind of rhinoplasty is appropriate in a particular case - only the plastic surgeon decides after familiarizing himself with the analyzes and examination.

Many of my colleagues believe that working with the tip of the nose is the most delicate and difficult stage of rhinoplasty. I do not think so. In fact, there is nothing particularly complicated here. In order to narrow the nose, it is necessary to remove the posterior pterygoid cartilage:

Thanks to this, we can narrow and slightly lift the tip of the nose well. Like this:

Having sufficient experience, I perform all these manipulations in a closed way. Thanks to this, as well as the special technique of periosteal detachment, it is possible to avoid unwanted internal scars and complications that make rhinoplasty one of the most unpredictable plastic surgeries.

See how much the faces of these young women have changed. It would seem that a small correction, and their features have become noticeably more refined. They both even look younger!

A harmonious nose with a beautiful, well-shaped tip made the features of this young girl softer. And most importantly, only after the operation she finally felt confident. All photos were taken after a short time ( only 4 weeks) after operation. With time ( when the swelling finally subsides) the lines of the nose of the girls will become even more elegant, and the noses themselves will become thinner and more feminine.

The wide nose is characterized by a rounded, dense and fleshy tip without obvious relief. With thin skin, it is distinguished by splitting in the cartilage area.

Sometimes patients think up a problem and follow the momentary fashion trends, having a completely proportional and neat nose shape. Find out if the defect is real in your case: mentally draw strictly parallel vertical lines from the corners of the eyes to the chin (for clarity, you can use a pencil or other oblong object). If the wings of the nose protrude beyond the line, then the tip is really wide.

Rhinoplasty of a wide nose is a frequent request for modern surgeons. With the correct and proportional structure of the back, the operation affects only the tip of the nose. Manipulations extend to cartilaginous and soft tissues.

The structure of the wide nose

A wide nose is a "merit" of genetics. The problem is almost never associated with post-traumatic and other complications. A voluminous and shapeless tip of the nose is quite common among the Slavs. This is due to the ethnic specificity of the structure of the soft tissues of the face.

The main features of the structure of a wide nose:

• Widely spaced domes of the great alar cartilages
• Convexity of the lateral cartilage crura
• Excessive thickness and "dumpiness" of the soft tissues of the nose

In patients with a wide nasal tip, adjacent defects in the form of a hump and other irregularities of the back are rarely observed. Therefore, rhinoplasty is limited to an isolated surgical field.

How is wide nose rhinoplasty performed?

Wide nose rhinoplasty is performed under general anesthesia or in combination with intravenous sedation. In such cases, I operate exclusively in an open way, forming an access from the columella. Closed rhinoplasty provides much less opportunities for jewelry correction of cartilage and soft tissues, so it is almost never used in this situation.

A wide nose rhinoplasty plan is developed during an in-person consultation. To do this, I talk to the patient about their expectations and goals, and then I do 3D modeling. The procedure helps me come to a consensus with a person, get comprehensive information from him on personal preferences and wishes, clearly identify my own capabilities and demonstrate the final result of the operation with an accuracy of 90%. For 3D modeling, I take pictures of the face in different projections with the latest Vectra H1 camera. Then I transfer the images into a computer program, display them on a large monitor and show the patient the actions that can be performed on the nose during the surgical intervention.

Having agreed on the result with the patient, I direct him to direct preparation for rhinoplasty, which includes a number of tests and examinations. Based on their results, I determine the readiness of the body for surgery and make sure that there are no absolute and relative contraindications.

Rhinoplasty of a wide nose is carried out according to the following protocol:

• Premedication
• Introduction of general anesthesia
• Access formation from columella
• Detachment of the skin flap from the cartilage
• Narrowing and artificial delineation of domes
• Approximation of domes in relation to each other
• Partial excision of the lateral crura
• Moving the lateral legs to the desired position
• Removal of excess skin and subcutaneous fat of the tip of the nose
• Resection of the skin in the area of ​​​​the wings of the nose and their mobilization (due to this, a general narrowing of the nostrils occurs)
• Stitching the arches (vaults) of the tip of the nose to stabilize the structure
• The imposition of cosmetic sutures on wounds, the introduction of turundas or splints into the nasal passages, immobilization with plaster or splint

With full rhinoplasty, osteotomy is additionally performed in different variations, depending on the current problems.

The above actions apply to both the shapeless "bulb-shaped" and the forked tip of the nose.

The role of skin thickness in wide nose rhinoplasty

Skin thickness is a fundamental factor in the visual outcome of rhinoplasty.

Paradoxically, it is difficult to operate on a wide tip of the nose with thin skin. Only virtuosos of rhinoplasty can cope with this qualitatively. The surgeon is required to exercise extreme caution and correct preliminary calculation in order for the final esthetics of the nose to satisfy the patient. However, with thin skin, it is easier to achieve elegance and delineation of the nose, as well as a significant reduction in comparison with the original.

A nose with thick skin is easier to operate on, but this feature often makes it difficult to create a chiseled and “sculpted” tip. In addition, thicker skin is more prone to severe scarring, which may require corrective rhinoplasty later.

Non-surgical wide tip rhinoplasty: is it possible?

Non-surgical rhinoplasty (nose contouring) is designed to provide additional volume in places of pits, dips, ruts and other atrophic nose irregularities. To level the hump, the filler is injected at its base and end - so the back of the nose becomes even and straight. A wide nose cannot be corrected in this way. The only exception is an asymmetric expansion of the nose (but in this case, the opposite, filled side will become wider).

Some surgeons mean by non-surgical rhinoplasty injections of hormonal drugs - glucocorticosteroids (Kenalong, Diprospan, etc.). They are able to soften and split (partially) cartilaginous tissue, which allows you to model the nose "manually" and eliminate a number of imperfections in the wings and tip. The injection is followed by the fixation of a special splint, which compresses the necessary parts of the organ. Only a plastic surgeon (not a cosmetologist!) should carry out such actions. They require careful calculation of the dosage and depth of infusion of the drug. Otherwise, the outcome of the procedure may be disastrous.

Rhinoplasty of a wide nose is a complex operation, the flawless execution of which is only possible for a good experienced surgeon. A responsible approach to choosing a doctor will provide you with the pleasure of contemplating the results of the operation and their stable preservation throughout life.

To avoid complications, carefully approach the choice of a plastic surgeon and clinic! Be honest with the doctor at the first consultations and in the preoperative examination - do not hide information about existing chronic diseases or injuries. Do not forget that the success of rhinoplasty largely depends on compliance with the norms of nasal care in the recovery process.

Photos before and after wide nose rhinoplasty

Cost of wide nose rhinoplasty in Moscow

The cost of wide nose rhinoplasty in Moscow varies quite a lot. Many clinics provide their patients with partial prices that do not include certain mandatory costs. All prices that you will find on my website are turnkey and include:

• Consultation (optional - with 3D modeling)*
• Accommodation in a hospital with meals
• The work of an anesthesiologist, assistant surgeon, junior medical staff
• An anesthetic that is easily tolerated
• Operation
• Modern materials used during the operation and in the recovery period
• Dressings and examinations within 1 year after surgery

Edema is an obligatory companion of rhinoplasty, which manifests itself in 100% of patients. It extends not only to the nose, but also to neighboring tissues - eyelids, cheeks and cheekbones.

Postoperative edema is the body's response to artificial trauma. The severity and persistence of edema depends on various factors - from age to individual characteristics. Edema is conditionally classified as superficial and deep. The former are neutralized quickly, the latter within a year. It is for this reason that an objective assessment of the results of rhinoplasty is relevant only after 9-12 months.

Why does swelling appear after rhinoplasty?

The cause of swelling after rhinoplasty lies in the technique of the operation. In the process of correction, the surgeon peels off the skin from the bones and cartilage. This entails damage to blood vessels and capillaries. Body fluids cease to circulate in the tissues in an optimally healthy manner. Nutritional deficiencies are added to this - oxygen and nutrients are delivered more slowly, which reduces the rate of natural regeneration.

Edema is a transient and conditional complication. It always appears, regardless of the level of competence and experience of the surgeon. The severity of edema is partly associated with the number of tasks in rhinoplasty: the more adjustments are made, the more voluminous the swelling will be.

Quite often, patients themselves provoke an increase and “strengthening” of edema, neglecting the surgeon’s recommendations during the rehabilitation period. First of all, it concerns smoking. The effects of nicotine are bad for healing. From tobacco smoke, blood vessels recover worse and longer, and swelling increases. Forbid yourself to smoke for at least a month after rhinoplasty, and you will notice that recovery is easier and faster.

Important: there is a category of patients who believe that by squeezing or moving the plaster after rhinoplasty, they will “squeeze out” the edema. Such actions lead to displacement and deformation of bone and cartilage tissues, reducing the result of rhinoplasty to zero. Of course, the swelling does not go away from this - on the contrary, it grows.

Having noticed any changes in the position of the cast, I disclaim responsibility for the outcome of the operation.

The mechanism of edema development after rhinoplasty

Primary, or intraoperative edema, occurs even during the operation. Competent surgeons are able to level it. During rhinoplasty, the anesthesiologist and I locally inject certain medications to instantly eliminate swelling (which is why the role of the anesthesiologist is very important!!!). This is useful both for me and for you: I simultaneously achieve "cleansing" of the surgical field and effective prevention of pronounced secondary (postoperative) edema.

Finishing rhinoplasty, I, like any surgeon, put an immobilizing bandage on my nose - a plaster cast or splint. It helps control swelling during peak recovery.

After plaster removal postoperative edema can increase sharply, but after 2-2.5 weeks there will be no trace of it. Only swelling of deep tissues will remain, however, it will be practically invisible to prying eyes. It lasts for 3-6 weeks and gives the patient discomfort - a feeling of heaviness in the nose and nasal obstruction.

Feeling nasal congestion, a person is frightened, believing that rhinoplasty has caused functional complications. However, this is not the case: obstructions are associated with transient expansion and thickening of the tissues of the nose. This condition does not require therapy, but for relief, I advise patients to use mild sprays and drops based on sea salt. Vasoconstrictive solutions ("Xilen", "Tizin", "Rinostop", etc.) cannot be used.

Residual edema affects the deepest structures of the nose. It is almost invisible, although it can "walk", moving from the back to the tip or vice versa. It is expressed in the hardness of the nose when palpated. Elimination period - 5-9 months.

What determines the speed of convergence of edema?

I single out two factors that prolong edema, with which the patient is unable to fight:

• Skin thickness. In people with dense, oily and porous skin, the swelling goes down slowly, and the tissues heal for a long time. Rhinoplasty of the nose with thick skin is a separate issue. Few plastic surgeons cope with it qualitatively. People with thick skin need to carefully and conscientiously treat the rules of rehabilitation;
• Age. Aging is not limited to age-related changes in appearance. Over time, metabolic processes and biochemical reactions in the body slow down, which slows down the regeneration processes. Long-term restoration of blood vessels prevents the rapid removal of edema. It takes longer for older patients than for younger ones.

Other factors are indirect and subject to elimination by the patient himself:

• Bad habits (nicotine and alcohol);
• thermal procedures;
• Irrational nutrition;
• Domestic injuries (even mild ones);
• Wearing heavy-framed glasses.

To speed up the removal of edema, follow simple rules:

• Sleep on your back with a low and firm pillow;
• Refrain from pickles, smoked meats and fast food;
• Eliminate smoking and alcohol for 3-4 weeks;
• Avoid exposure to heat;
• Refuse steaming procedures, including a bath and a sauna;
• Take medication only as directed by your doctor (many "harmless" drugs like diuretics can do a lot of harm to you);
• Treat your face as carefully and carefully as possible (when washing, cleansing from cosmetics, etc.);
• Keep your head straight and do not lean down;
• Keep your nose protected from injury (fasten your seat belt in the car, do not rub or scratch your nose, do not try to clear the nasal passages with foreign objects, do not visit crowded places, do not ride public transport during rush hour);
• Limit physical activity;
• Walk more and breathe fresh air (physical inactivity makes the healing process difficult).

Discuss the use of any local and systemic drugs to optimize blood flow and lymphatic drainage with the surgeon (including Troxevasin, Troxerutin, Traumel-S, etc.). Self-medication is always harmful, and especially after surgery.

Professional cosmetology in the fight against edema

Rehabilitation is a voluntary step, and I do not force my patients to do it. Its average cost is about 30,000 rubles. As a rule, it includes a course of hardware procedures and / or drug injections.

In rehabilitation after rhinoplasty, the following methods have proven themselves to be excellent:

• Microcurrent therapy. Exposure of soft tissues to high-frequency electrical impulses contributes to the normalization of tissue metabolism, activation of local blood circulation, stimulation of regenerative and proliferative functions of tissues;
• Phototreatment. Irradiation of injured areas with blue and infrared light has a disinfecting and anti-inflammatory effect, regulates metabolism, promotes intensive regeneration.

Attention: any additional manipulations aimed at accelerating healing or removing edema, even if they are performed by qualified doctors, must be discussed with the operating surgeon!

Extremely any massage is contraindicated middle third of the face, including the nose area!

You can minimally accelerate the decline of edema, but you should not count on a fabulous transformation. Be patient, follow the recommendations of the surgeon, and very soon you will sincerely admire the reflection in the mirror.