Rhinoplasty

Plastic and esthetic surgeon in Tunisia

Rhinoplasty aims to modify the shape of the nasal pyramid (either partially or completely) and can also if necessary correct nasal breathing problems.

A rhinoplasty can be carried out alone or in association with other facial surgery such as a genioplasty (surgery of the chin). This can be done at the same time to modify the facial profile.
The aim is to improve the aspect of the nose. The problems present can be congenital, caused by an accident, or due to aging.
The result should be a nose in harmony with the facial features, and which corresponds to the personality and expectations of the patient.
The technique uses incisions hidden inside the nostrils and remodels the bone and cartilage which give each nose its distinctive shape. The skin covering these elements will be redraped and will adapt to the new nose. This point shows the importance of the quality of the skin for the final result which is obtained with no visible scar.

This procedure carried out both for men and women, can be done from the age of 16, when growth is complete.

a�? BEFORE THE OPERATION

The motivation and expectations of the patient will have been analysed.
Prior to the operation a thorough examination of the nasal pyramid and its harmony with the other features of the face will have been carried with an endo-nasal examination.
A preoperative check up will be carried out as prescribed.
An anesthesiologist will see you in consultation at the latest 48 hours before the operation.
No aspirin-based medication should be taken during the 10 days preceding the operation.
For certain types of anesthesia you must fast (neither eat nor drink) for six hours before the operation.

a�? TYPE OF ANESTHESIA

This operation is usually performed under general anesthesia. However, in certain cases local anesthesia with intravenous sedation (twilight anesthesia) may be used.
The type of anesthesia will be chosen after discussion between yourself, the surgeon and the anesthesiologist.

a�? THE PROCEDURE

Each surgeon has adopted his or her own specific technique which he or she adapts in order to obtain the best results in each case.
We can however give some basic points :

Incisions :

endonasal incision
As a rule they are invisible, hidden inside the nostrils or under the upper lip, there are therefore no visible scars.
It can however be necessary to use an external incision which will be hidden beneath the upper lip.

It can be also ,necessary to use an external incision concealed at the base of the nose wings if reducing the nostrils, or across the columna, between the nostrils in order to perform an a�?opena�� rhinoplasty (giving access to the internal structure of the nose. This can be used when repairing serious deformations or for touch-up surgery.

The osteo-cartilaginous structure of

Reshaping the nose :
The osteo-cartilaginous structure will then be reshaped as planned. This important step can be carried out in a multitude of ways taking into account the individual case and the preferred technique of the surgeon. The nose may be made smaller or straightened, a bump removed, the tip may be redefined, the septum may be straightened or the nasal concha reduced in size. In some cases a cartilage or bone graft will be used to fill a hollow zone, to support part of the nose or redefine the tip.

Sutures:
The incisions are closed with fine sutures, usually dissolving ones.

Dressings and splints:
The nostrils are packed with wadding. An external dressing of tape is applied then a splint of plaster, plastic or metal is molded and fixed to the nose, this can sometimes extend to the forehead.

The operation can take between 45 minutes and 2 hours depending on the specific requirements and complexity of the case.

a�? AFTER THE OPERATION

There is rarely actual pain, it is rather the fact that the wadding makes it impossible to breathe through the nose which is a problem for the first few days.
Swelling can be observed around the eyelids with bruising which is variable in degree and duration for each patient.
During the first few days rest is advised, with no physical strain.
The wadding is removed 2 to 5 days after the procedure. The splint is removed 5 to 8 days after surgery, to be replaced by a smaller splint for a few more days.
The nose will appear bigger because of swelling and it will still be difficult to breathe because of swelling of the lining of the nose and possible scabs in the nostrils.
The visible signs of the operation will disappear gradually and a return to normal social and professional life is possible after 10 to 20 days.
Sport and strenuous exercise should be avoided for 3 months.

a�? THE RESULT

Two to three months are necessary before the final result becomes appreciable, and it will only be after 6 months to one year that the final aspect will become apparent after a slow and subtle healing process.

a�? POSSIBLE COMPLICATIONS

Fortunately, real complications are rare following a rhinoplasty which has been carried out correctly. In fact practically all the operations go well and patients are completely satisfied with the result.
In spite of the fact that complications are so rare you must be
a�?assured that if you are operated on by a qualified Plastic Surgeon, he will have the experience and skill required to avoid these complications, or to treat them successfully if necessary.