Rhinoplasty: initial consultation and examination. Tests before rhinoplasty: diagnostic plan What tests are needed for plastic surgery
Basic laboratory examination methods are prescribed before all operations. The patient passes these tests both before aesthetic rhinoplasty and before plastic surgery, which is performed according to functional indications (breathing disorders due to deviated nasal septum). The list of laboratory tests before rhinoplasty includes:
- general clinical blood test;
- general urine analysis;
- analysis of the coagulation system (coagulogram, prothrombin index, blood clotting time);
- blood biochemistry (bilirubin, creatinine, liver enzymes ALT and AST, urea);
- blood glucose;
- blood test for markers of viral infections (HIV, hepatitis B, hepatitis C);
- blood type, Rh factor.
Urinalysis is done to assess the function of the urinary system, but not only for this. The qualitative and quantitative composition of urine changes against the background of various diseases. Like the KLA, urinalysis is used as a screening diagnostic method, which sets the vector for further diagnostic examination when abnormalities are detected.
Analysis of the function of the blood coagulation system is the most important point of the diagnostic program. Slowing down of coagulation is fraught with severe blood loss during plastic surgery. The risk of bleeding in the postoperative period increases. After rhinoplasty, internal hematomas may form, which are a complication of the operation. The acceleration of blood clotting is also dangerous, because it can lead to thrombosis with the most serious consequences.
If changes in the blood coagulation system are detected, rhinoplasty is not performed! The operation is possible only after a complete medical correction of the identified violations.
A biochemical blood test is another analysis for screening diagnostics, in which the work of the hepatobiliary (liver, pancreas) and urinary systems is analyzed in more detail. If abnormalities are detected, the patient may be assigned an ultrasound examination of the liver, gallbladder, pancreas, and kidneys. Changes in blood biochemistry may also indicate the presence of metabolic disorders and endocrinological diseases.
Abnormal blood glucose levels may indicate the development of metabolic syndrome or a decrease in cell sensitivity to insulin. Both conditions are precursors to type 2 diabetes. If such violations are detected, a glucose tolerance test and other additional tests are prescribed.
Tests for immunological markers of viral infections are mandatory laboratory tests before surgical interventions.
Rhinoplasty is one of the most complex and difficult operations in plastic surgery. Many cosmetic surgeons consider rhinoplasty to be the most surgically and artistically complex of all plastic surgeries. This complexity increases among male patients because, in general, male patients have relatively non-specific complaints and tend to be more demanding.
Rhinoplasty is the most common facial reshaping procedure among women and the second most common among men.
The art of cosmetic rhinoplasty begins with an initial examination. The surgeon must be able to visualize and predict the end result.
There is a wide range of ages and nationalities for people seeking rhinoplasty. In addition, they may have an equally wide range of desired outcomes from the procedure. The initial consultation provides the surgeon with an opportunity to assess both the physical and psychological condition of the patient. In doing so, the surgeon can determine whether the patient is a suitable candidate for surgery. After this decision, the surgeon can proceed to prepare the patient for rhinoplasty.
Initial Inspection
Pre-rhinoplasty consultations begin with an attempt to assess the size of the physical deformity of the nose, as well as the degree of change required. The surgeon should try to understand the person's personal motives for undergoing surgical correction.
A realistic understanding of expectations is essential to the success of rhinoplasty. Understanding the patient's goals is facilitated by the use of open-ended questions. Patients are asked to describe what they don't like about their nose and what they would like to achieve with surgery. Along with cosmetic concerns, functional issues such as breathing difficulties should be discussed. During the consultation, the surgeon must determine whether he can achieve the patient's physical expectations through surgery.
If the surgeon considers the intended patient to be a good physical and psychological candidate for surgery, the next step is to discuss the purpose and limitations of the procedure. The doctor must inform the patient what result can be achieved with the help of surgery. The limitations of rhinoplasty should also be discussed.
The patient must understand the anatomical limitations (if any) that will affect the potential outcome of the procedure. The anatomical features of the face must be carefully studied in order to explain to patients what can be corrected and what is part of the individual anatomy.
Analysis of the structure of the face and nose
After the initial interview has been conducted with the patient, a complete, thorough examination is performed, which includes an analysis of the face and nose. Facial analysis is critical in order to diagnose the problem and determine the best course of action. There are established proportions and ratios for the facial structures that make up an aesthetically pleasing face.
The nose is examined from all sides. They note the quality and properties of skin, cartilage and bones. Palpation is performed along the back of the nose, sides and nasal septum. Palpation of the nose and septum provides the surgeon with valuable information regarding the shape of the cartilage/bone and its effect on the appearance of the nose. The surgeon examines the quality of the facial skin, the thickness of the subcutaneous tissues, facial symmetry. After completing the overall assessment, the surgeon will note and highlight the most striking characteristics of the nose. These are usually the characteristics that led the patient to need a rhinoplasty, such as excessive size, deviations, or a hump in the bridge of the nose.
In frontal projection, the surgeon examines the width of the nose, any deviation from the midline, as well as the characteristics of the nasal tip (symmetry and severity). In the projection from below, special attention should be paid to the triangularity, symmetry, width of the columella. The nose base should be configured as an isosceles triangle with the apex rounded at the tip of the nose and thin sidewalls. Asymmetric orientation of the nostril vertices may indicate an anomaly in the region of the lower lateral cartilages. In the lateral projection, the tip, length and profile of the nose are assessed. Evaluation of the contour of the bridge of the nose should reveal any concavity, convexity, or unevenness.
An intranasal examination is performed using a nasal endoscope. If necessary, a decongestant is used to further evaluate the appearance of the nasal mucosa, nasal septum, and bones. The septum is checked for deformities and changes that may affect the appearance of the nose.
computer images
Computer digital imaging has become a popular and useful means of communication between clinician and patient to better understand the purpose of the procedure. The patient, however, must understand that computer images will not accurately show or guarantee surgical results. Computer visualization is only an educational tool.
When used correctly, digital imaging can give the potential patient a better understanding of the surgical goals and aesthetic ideals that the surgeon is planning for them.
At the same time, the surgeon can gain an understanding of the ideal aesthetic outcome that the patient desires.
The study of preoperative photographic images for rhinoplasty allows for a detailed anatomical analysis that complements the psychological examination.
Physical examination
The doctor conducts a complete physical examination, including ordering laboratory tests such as blood tests. The doctor will also ask questions about the medical history, including whether there is a history of nasal congestion, whether there have been surgeries, and what medications the patient is taking. If the patient has a bleeding disorder such as hemophilia, rhinoplasty is prohibited.
Foreign surgeons believe that most patients do not require a preoperative examination, since healthy people turn to plastic surgery services. Physicians obtain most of the clinical information they need from the patient's medical history and physical examination.
The tests that are required for rhinoplasty will vary depending on several factors. If the patients are young and healthy, the surgeon will probably need a complete blood count. If patients are over 50 years old or have heart disease, a preliminary electrocardiogram is needed. A biochemical blood test may be necessary if patients are constantly taking certain medications, especially antihypertensives. If patients have problems with blood clotting or are anemic, it may be appropriate to obtain preoperative blood tests. Most surgeons order a pregnancy test for all women of childbearing age, as pregnancy is a contraindication for surgery.
The vast majority of tests are performed as a precautionary measure to protect doctors and hospitals against unfounded claims.
In Russia, the patient must provide the surgeon with the results of the following tests for rhinoplasty:
- general and biochemical blood tests;
- blood test for prothrombin;
- blood test for RW, HIV;
- blood type, Rh factor;
- general urine analysis;
- electrocardiogram;
- X-ray or computed tomography of the paranasal sinuses.
Plastic surgery is a serious surgical intervention, even if a person just wants to fix his nose, lips or something else. There is always a risk of complications. To minimize them, it is important to conduct proper preparation. Then the result will be expected and pleasant.
Read in this article
Tests to take before any plastic surgery
As a rule, the surgeon appoints the day of the operation approximately one to two weeks after the first consultation. During this time, the patient must undergo a complete medical examination to identify risks, allergic reactions, contraindications. Analyzes show the general health of the client and what problems he has. Before the operation, you must undergo the following studies:
- General clinical blood and urine tests. They are valid for two weeks.
- Coagulogram - examination for coagulability and prothrombin. The analysis is necessary to exclude the possibility of bleeding during the operation. With poor clotting, the doctor may refuse to conduct. In extreme cases, a course of drugs that correct the indications is prescribed. Valid for a month.
- Analysis for blood type and Rh factor. It is needed in case of an emergency for a blood transfusion. Valid for three months.
- Blood chemistry. This study is carried out to detect diabetes mellitus. In this disease, surgical interventions are not recommended due to the high risk of complications. The analysis also shows the level of bilirubin, creatinine, urea, ALT and AST, the amount of potassium, sodium, total protein. Valid for two weeks.
- ECG - electrocardiogram of the heart.
- Fluorographic study. It is valid for a year.
- Blood tests for the presence of HIV, hepatitis C and B, syphilis. Valid for three months.
- Phlebology consultation. The doctor determines the risks and may recommend that you wear compression stockings during the operation.
- Additionally, depending on the type of plastic surgery, consultation with a gynecologist, mammologist and breast ultrasound is required.
Depending on the results of the anamnesis, the doctor may prescribe more studies or develop an individual plan for preparing for the operation. Sometimes you have to undergo a course of treatment, eliminate bad habits. The main task of a qualified surgeon is to bring the patient to the maximum healthy state for surgery, compensation for all chronic diseases.
In addition, you should follow a special diet - do not eat fatty, salty, spicy drinks, do not drink caffeinated drinks and other stimulants. It is useful to include more fruits and vegetables, light protein foods in the menu. It is important to completely abandon alcoholic beverages, as they worsen the effect of anesthesia.
In addition, they increase blood pressure. It is also recommended to establish a calm and measured lifestyle a week before the operation, go to bed on time, do not catch a cold, do not succumb to stress, walk more.
- Before surgery, it is useful to take vitamins E, A and an increased amount of C. When performing plastic surgery on the chest or abdomen, it is useful to add iron to the diet. This will help you recover faster later.
- You can not drink aspirin, coagulants and oral contraceptives, hormonal drugs. They affect the properties of the blood and can provoke bleeding or, conversely, thrombosis.
- Be sure to tell your doctor about all the medicines that have been prescribed in the last two months.
- You can not go to the solarium or the beach the day before. The skin should have a natural tone.
- It is also important to temporarily abandon cosmetic products with a lifting effect.
- The last time you eat before plastic surgery is 12 hours. In this case, the food should be as light as possible. On the morning of the operation, you should not have breakfast, you should not even drink water or tea if general anesthesia is planned.
What to do before the operation on this day
The day of plastic surgery is very responsible. The patient must follow all the instructions of the surgeon. Depending on the type of operation, there are different recommendations regarding behavior.
On the face before contouring and other interventions
Any plastic is performed on an empty stomach, so the last meal can be 12 hours before the procedure. But you can't eat either. Eating should be easy. On the day of the operation, you can not eat breakfast, snack, or even drink anything.
In the morning it is allowed to take a shower, but without aggressive detergents. You can only use those recommended by the doctor. You need to come to the clinic for surgery in the most natural form, you can not use cosmetics. It is also important to remove varnish and any other coating from the nails. If a person wears contact lenses, they should not be worn on this day, or they can be removed right before the intervention.
On the day of the operation, you need to come to the clinic in compression stockings, you can put them on already in the hospital. This measure helps to avoid complications from the venous system.
It is important to take care of how you can get home after the operation. Some interventions involve a very short stay, often they are released a few days later.
For information on how the preparation for plastic surgery on the eyelids and face is going on, see this video:
On the vagina
The operation can be performed under general or local anesthesia. The method of anesthesia is selected by the doctor. Like any other operation, colporrhaphy is performed on an empty stomach. In addition, to facilitate the recovery phase and minimize complications the day before, it is necessary to do an enema to cleanse the intestines.
In the morning you need to take a shower and remove all the hair in the genital area. You should not put any medicines on the eve of the vagina or douching.
Before breast augmentation
In addition to the above general recommendations, there are some nuances in preparing for mammoplasty. In the morning you need to take a shower, shave the armpits carefully so as not to damage the skin. Epilation is not recommended. It is forbidden to use deodorant and perfume on the day of plastic surgery.
Mammography You must come to the appointment without cosmetics and manicure, without jewelry and piercings. You can't eat in the morning. It is also important to bring comfortable clothes with you: slippers or flip-flops, button-down tops so as not to raise your arms.
Before removing the apron on the abdomen
This type of surgical intervention implies all of the above recommendations in preparation. It is important to maintain a stable weight after the procedure. Also for the postoperative period, you need to stock up on compression underwear for the abdomen.
On the day of the operation, you should not eat or drink, you should definitely take a shower, shave off the hair on the body at the site of the operation (if there is, for example, along the white line of the abdomen). Make-up and makeup should not be used, it will have to be removed before the operation.
Preparing for plastic surgery is an important step. The quality of the result depends on the seriousness of the patient's approach. Many prohibitions and recommendations are simple and do not require special training or skills. If you neglect this step, you can cause serious damage to your health and increase the likelihood of complications.
Useful video
To prepare for plastic surgery for skin tightening after losing weight, see this video:
Any, even the most insignificant operation is to some extent traumatic for the body. And although rhinoplasty cannot be considered a serious surgical intervention, the most complete preparation for this procedure will reduce the risks of unwanted reactions from your body and save you from subsequent health problems.
Before carrying out rhinoplasty, it is necessary to undergo a complete examination, pass tests. These measures will help prevent unwanted consequences after surgery, as well as avoid unforeseen situations during the procedure itself. During an in-person consultation, the doctor will tell you about all the stages of preparation for the operation, ask you questions about your lifestyle and bad habits, and also provide you with a list of tests that you will need to pass. During the conversation, the doctor should find out if you are a smoker, if you drink alcohol, what medications you take, if there are any health complaints, etc.
From the tests you will have to pass the following:
- Blood chemistry;
- General clinical blood test:
- Glucose
- Bilirubin
- Creatinine
- Protein
- Blood type and Rh factor;
- Blood coagulation analysis (PTI, INR);
- infectious group:
- HCV (viral hepatitis C)
- HbsA (viral hepatitis B)
- RW (syphilis)
- General urine analysis;
- Fluorogram;
In addition, the patient will also need to make a nomogram of the maxillary sinuses and nasal bones. This is necessary for an objective assessment of the state of bone and cartilage tissues and the identification of possible diseases. To reduce the risk of breathing problems after surgery, the patient is prescribed rhinomanometry. This examination helps to determine the characteristics of nasal breathing. Only after going through all these procedures, you can count on a positive outcome of the operation.
Many are sure that the body and appearance are constantly in need of perfection. If nature has failed, then you can try to correct the defect with the help of plastic surgery.
The most popular operation in recent times is rhinoplasty, which allows you to get rid of the flaws of the nose, correcting it the way you want. This is an effective method of changing the appearance. The face immediately changes, looks different, sometimes breathing problems disappear. Preparation for rhinoplasty is an important step.
You should start preparing for rhinoplasty with special attention. The first preparations take place a month before the scheduled operation, then 2 weeks, a week and immediately before the surgical intervention itself.
A successful outcome depends on how seriously a person takes the preparation and how he behaves during the recovery period.
Which is correct: rhinoplasty or rhinoplasty?
Both concepts mean the same thing. There are several types of operation:
In terms of time, the operation takes from 30 to 60 minutes. Sometimes open rhinoplasty can take up to 1.5 hours.
It is possible to change the tip and wings of the nose with Aptos threads, but it is used very rarely in practice, due to their possible rupture and scarring.
General information about rhinoplasty
Indications for rhinoplasty
When can a surgeon refuse to operate?
- With diabetes.
- If there is a history of heart failure and vascular disease.
- In case of diseases of the liver and kidneys.
- With active tuberculosis.
- During pregnancy and menstruation (the operation is scheduled for the 10th day of the cycle).
- With SARS.
- With cancers.
- With mental disorders.
- Under the age of 18.
Choice of clinic and doctor
This is a very important stage, the success of which will be determined by the process of the operation itself and the duration of the recovery period. When choosing a clinic, be sure to pay attention to the statutory documents, license. It is recommended to read reviews on the Internet about the staff, as well as the process and result of operations. Having chosen a doctor, you need to study his portfolio, customer reviews, and communicate personally.
When the choice is made
First consultation
When a patient comes to the first appointment with the chosen surgeon, he talks about what worries him and what he doesn't like.
It is also necessary to inform the doctor about the result that you want to get after plastic surgery. If the patient has any functional problems besides aesthetics, these should also be voiced.
The surgeon listens attentively, informs about the possible consequences after the operation and limitations, examines the nose with special instruments.
After the approval of all the nuances, the doctor gives a referral for examination.
By the way, at this stage, you can determine the price of the operation.
Survey
Be sure, in addition to the examination of the doctor, on which he must examine the nose, you will need to undergo a diagnosis. It consists in the delivery of tests. This is necessary to identify contraindications, the concept of the possibility of formation of undesirable consequences after surgery, to assess the overall functioning of the body. Perhaps, before rhinoplasty, cosmetic procedures or the necessary course of therapy for certain diseases will be recommended.
In the list of analyzes:
In addition, you must do:
- - ECG;
- - X-ray of the chest or fluorography;
- - a picture of the nose.
Important! Blood results are only valid for 10 days.
If contraindications to rhinoplasty are identified, there can be two ways to solve the problem:
- Correction of violations related to health.
- Refusal of the operation.
Training
You need to carefully consider this point. A positive result depends not only on the operation itself and the manipulations of the surgeon, but also on the patient, who is responsible for his health before and after rhinoplasty.
So, two weeks before the date of the operation:
- The use of drugs that affect blood clotting and reduce the formation of blood clots is excluded. For this reason, heavy bleeding may open during rhinoplasty. Aspirin is strictly contraindicated, as well as hormonal contraceptives, herbal infusions and decoctions.
- You can not sunbathe and visit solariums for this purpose, otherwise severe swelling may develop during the operation.
- It is forbidden to consume alcoholic beverages.
Why not alcohol?
Because:
Spicy, smoked, salty dishes should be excluded from food. It is preferable to consume dairy products, vegetables, fruits, greens, cereals.
7 days before rhinoplasty
Right before rhinoplasty
- 8 hours before surgery, you do not need to drink and eat so that the exit from anesthesia is easy.
- Do not use perfumes and cosmetics.
- Do not wear collared clothing.
- It is necessary to prepare all the necessary medicines.
- It is not recommended to bring jewelry, watches, lenses, earrings and artificial eyelashes to the clinic.
Preparing for the operation, you must not forget about the documentary side of the transaction. It is important to identify the rights and obligations of the parties, to get acquainted with the warranty obligations, if rhinoplasty does not satisfy you. This will help you avoid trouble.
Important! Re-evaluate your decision!
If you are determined and confident in the correctness of the decision - go ahead!
Anesthesia
The choice of method of anesthesia is carried out by the surgeon. Most commonly used:
- local anesthesia, assuming only numbness of the affected area. At the same time, the person is conscious and hears how the operation is going. Pain is felt in rare cases. Mainly used for septum correction;
- local with sedation is a convenient solution for anesthesia.
- general anesthesia, most often used for rhinoplasty of the tip of the nose. A safer way than the second one.
Will it hurt?
Patients are always afraid of pain. As for, nothing is felt during the operation, since anesthesia or an analgesic is used.
Pain may be during the recovery period. And then, they are not so strong. Basically, discomfort appears due to turundas in the nose.
Recovery
Typically, rhinoplasty is accompanied by the following manifestations:
When during the operation it was necessary to break a bone, a plaster is applied to the nose for 10 days. Severe swelling appears around the nose, passing within the first month. The result of the operation can be determined only after six months. So much time is needed for tissue healing.
The first weeks the patient will have to sleep with the head of the bed raised and only on his back, do not drink, do not smoke. Nutrition must be correct. After the plaster is removed, the patient visits the doctor regularly. During the healing of the nose, it is not recommended to wear glasses, eat spicy and hot food, and engage in physical activity.
The healing time is affected by the severity of the operation and complications. Ideally, after 10 days, the patient can return to normal life and even go to work.
The dangers of rhinoplasty
Rhinoplasty is a surgical procedure. And any operation is always a risk. This is the possibility of developing an anaphylactic reaction to an anesthetic, toxic shock, excessive bleeding, skin tears, burns.
In the first hours, there is a possibility of anaphylaxis, respiratory disorders, vision disorders, hidden complications in the form of bleeding and hematomas.
It rarely happens that an infection gets in and you need to drink antibiotics, and sometimes hormones. With sepsis, a blood transfusion is performed.
According to statistics, three out of ten patients are not satisfied with the result of the operation.