Rhinoplasty

Rhinoplasty is a surgical procedure that aims to solve aesthetic and functional problems of the nose. Nasal problems may be due to genetic, developmental or acquired causes. Rhinoplasty surgery reconstructs the aesthetic balance of the face while correcting the aesthetics of the nose and gives the person self-confidence.

Rhinoplasty surgery Ankara is among the most frequently performed aesthetic surgeries both in our country and in the world. The goal of rhinoplasty surgery is to obtain a natural, balanced, face-compatible and beautiful nose structure. The aesthetic goals of the surgery are affected by factors such as gender, ethnicity, patient expectations, facial anatomy.

Our goal in rhinoplasty (rhinoplasty) surgery is to preserve the natural nasal structure and to eliminate breathing problems. We analyse and preserve the beautiful features of the nose itself. The parts that negatively affect the aesthetic structure of the nose are changed. In this way, a personalised nose that does not move away from the original is obtained.

The goal of rhinoplasty surgery is not to draw attention to the nose. When we look at a person's face during communication, our attention first focuses on the person's eyes, then around the mouth and then on the frame of the face. In normal face perception, no one takes a long look at your nose. In cases where the nose is large, arched nose, curved nose, wide nose, low nose, long nose, attention is concentrated on the nose. The aim is to eliminate nasal problems and to ensure that attention is gathered in your eyes again.

Rhinoplasty (rhinoplasty surgery) is one of the most challenging operations of plastic surgery and aesthetic surgery. It requires a very good understanding of the internal anatomy of the nose, three-dimensional bone-cartilage structure and a very good command of surgical techniques. It is difficult to learn. As the surgeon's experience increases, surgical results and revision rates improve.

In the majority of rhinoplasty candidate patients, there are also functional problems in the nose. The most common among these problems are as follows;

• Curvature of the nasal centre cartilage and bone (septum deviation)
• Structural deficiency in the nasal valves
• Nasal bone entry strictures
• External bone curvatures of the nose
• Growth of nasal flesh (turbinate hypertrophy)
• Intranasal polyps

Nasal curvature surgery is almost always performed simultaneously with rhinoplasty surgery and is essentially a single operation. It is neither possible to breathe well nor to obtain a symmetrical nasal structure without correcting the curvature in the nasal septum.

From an aesthetic point of view, concepts such as the perfect nose and the best nose doctor cannot be mentioned. Every nose is different and every surgeon has good and not good enough results. In nose surgery, the nose should be balanced and natural. In rhinoplasty surgery, goals such as nose reduction, nose narrowing, nasal tip lifting, nasal arch aesthetics, nasal tip cartilage shaping can be achieved. During rhinoplasty surgery, wide nasal wings can be narrowed and large nostrils can be reduced.

Rhinoplasty Examination

The first step of rhinoplasty is the examination. During the examination, you will learn things you do not know about your nose. You will get information about what is aesthetically possible and how to plan a nose. During the examination, you will be able to learn your doctor's surgery plan visually with computerised nose planning. Nose surgery doctors take individual factors into consideration when planning. This is what personalised rhinoplasty means. During the rhinoplasty examination, you can also get information about rhinoplasty prices and other nose surgery prices. Your doctor will give you verbal and written explanations about the risks and side effects of rhinoplasty surgery. During the rhinoplasty examination, you can see the photos before and after rhinoplasty and get an idea about your doctor's technique. During the examination, you can decide which rhinoplasty technique is best for you together with your doctor.

Who is suitable for rhinoplasty surgery?

Ideal candidates for rhinoplasty surgery are healthy individuals with normal body perception, realistic goals, and a good understanding of the limits of the surgery. We expect the development of facial bones to be completed for rhinoplasty. The surgery can be performed after puberty. Turning 18 is required by law, not medically. If there is family permission, rhinoplasty can be performed before the age of 18.

Rhinoplasty Surgery Preparation

We recommend that patients preparing for this surgery pay attention to the following points before the operation in order to have the best possible experience:

    - Since you will not be able to drive to and from the operation, you should get help from a driver who will accompany you.
    - Patients who smoke should quit smoking at least 3 weeks in advance.
    - You should inform your doctor about all medications, especially blood thinners, before the operation.
    - Herbal teas, medicines, vitamins and nutritional supplements can be stopped by your doctor before the operation.
    - You should prepare yourself to stay in the hospital for one night after the surgery.
    - You should get information about rhinoplasty surgery fees and prepare financially.

Ankara Rhinoplasty Surgery Techniques

Rhinoplasty surgeries can be examined in two categories as primary and secondary. Primary rhinoplasty surgeries describe the first time surgery for patients who have not undergone rhinoplasty, nasal curvature surgery or intranasal surgery before. Secondary rhinoplasty, also known as revision rhinoplasty, describes the secondary surgeries to be performed by patients who have previously undergone nasal surgery but are not satisfied with the shape or function of the nose. As a general rule, primary rhinoplasty surgeries are easier than revision rhinoplasty surgeries. Rhinoplasty surgeries can be performed with open technique or closed technique.

Open Rhinoplasty

In open rhinoplasty, a 2-3 millimetre incision is made in the bridge-shaped area separating the two nostrils, which we call columella. When this incision is combined with intranasal incisions, the entire nasal skin is inverted and the entire nasal skeleton can be seen. In this way, both nasal deformities can be seen and nasal surgery techniques can be performed visually. We frequently encounter the question of whether there will be a scar on the nose in open rhinoplasty surgery. There is a scar in open nose surgery, but you cannot easily see this scar even if you look closely after 3-6 months. The open rhinoplasty approach allows piezzo rhinoplasty, ultrasonic rhinoplasty and structural rhinoplasty approaches to be performed. It is the most preferred form of rhinoplasty worldwide.

Closed Rhinoplasty

In the closed rhinoplasty approach, the nasal tip cartilages and nasal bones are reached through incisions made inside the nostrils. The nasal bones and cartilages can also be shaped effectively with this approach. However, since these manoeuvres are performed only by looking from the outside, they are a little more prone to error. However, factors such as appropriate patient selection and the experience of the surgeon have reduced the complication rates between the two techniques to similar levels.

Nasal Tip Rhinoplasty (Tip Rhinoplasty)

In nasal tip rhinoplasty, only the cartilages at the tip of the nose and the wings of the nose are shaped. Bone structure and nasal arch are not intervened. Nasal tip surgery does not correct the nasal arch, but when the tip of the nose is moved to a higher level than the nasal arch, the arched appearance disappears. Sometimes what patients describe as an arched nose is a nose with a long and low nasal tip and the arch height is actually normal. This visual illusion between the tip of the nose and the dorsum of the nose should be taken into consideration during nose surgery planning. Some patients can have a beautiful nose only with nasal tip cartilage surgery.

Ultrasonic Rhinoplasty / Piezzo Rhinoplasty

In this technique, the nasal bones are shaped using a micro-saw that cuts the bone with ultrasonic sound waves. It is not broken with a hammer and chisel like the bones in classical surgeries. These technologies greatly increase the sensitivity of the surgery on the bone. Postoperative bone shifts, unwanted fracture lines, bone irregularities, step deformities, nasal bone roughness are much less common. Bruising after nose surgery is more limited. It is the most advanced form of nasal bone aesthetics. Some manoeuvres that cannot be performed in classical nasal bone surgeries can be performed with this technology. With Piezzo, it is possible to shape the nasal bones, lower the nasal arch, narrow wide noses, and correct the curved nasal bone.

Septorhinoplasty (Curved Nose Aesthetics)

Curvatures inside the nose are always seen together with curvatures outside the nose. Nasal curvature surgery involves correction of the curved septum structure inside the nose. In curved nose surgery, nasal cartilage curvatures and nasal bone curvatures are first corrected, and then nasal tip cartilages are built on this flat structure. Asymmetries in the wings of the nose, differences in the nostrils, nasal tip curvatures can also be improved during curved nose aesthetics. Due to cartilage memory and healing differences, it is not possible to achieve perfect symmetry in curved nose surgeries. Since septum deviation negatively affects the patient's breathing, correction of septum curvature in curved rhinoplasty (septorhinoplasty) surgeries improves the breathing flow of patients. Sports performance and sleep quality are significantly improved. Nasal curvature surgeries are more difficult and take longer than normal surgeries. Nose surgery prices are also typically slightly higher for curved noses. We prefer the structural rhinoplasty approach in curved nose aesthetics. In this approach, the excess cartilages in the nose are not thrown out, they are used in the construction of the nose to support and strengthen the critical areas of the nose. Correction of your nose curvature is difficult but possible. The choice of the best technique for you in curved rhinoplasty will emerge as a result of your interview with your doctor.

Dynamic Rhinoplasty

In this surgical technique, a flexible and mobile nasal tip is obtained by preserving the connective tissue and ligaments supporting the nasal tip. The flexibility of the nasal tip positively affects the comfort of life. Patients should be selected very carefully for dynamic surgeries. After dynamic rhinoplasty surgeries, the nasal tip position may change over time. Nasal tip drooping is more likely after this technique. Individuals with low nasal tip, thick nasal skin, hyperactive lip muscles, nasal tip cartilage weakness are at risk for nasal tip drop when using this technique. It is a safer option to prefer structural rhinoplasty approaches instead of dynamic rhinoplasty to prevent nasal tip drop after surgery.

Structural Rhinoplasty

In the structural rhinoplasty technique, the nasal tip is strengthened as much as possible and the principle of durability is prioritised. Most of the time, the nasal tip cartilages are fixed to the septum cartilage. There are also approaches in which the nasal tip cartilages are partially fixed to the septum and partially strengthened by matching the cartilages with other cartilages coming out of the nose. The advantage of structural rhinoplasty is that the resulting strong structure is resistant to long-term changes and deterioration in the postoperative healing process. In structural rhinoplasties, the nasal tip is more stable and the nasal tip does not easily lose height or angulation. The disadvantage of structural rhinoplasty is that a more rigid nasal tip is obtained.

Letdown Rhinoplasty

Let down/Push down techniques are approaches used in rhinoplasty and aimed at protecting the nasal dorsum. These techniques are preferred in individuals where the nasal arch is relatively low and follows a smooth curve. In let down/push down rhinoplasty techniques, bone is removed from the base of the nasal bones, not from the back of the nose. The roof of the bone pyramid is not opened. The cartilage just below the roof is reduced and the thin and delicate bone on the roof of the nose is shaped by collapsing with external pressure. The indications for the let down technique are limited. The results are unpredictable in patients with high nasal arches, asymmetrical nasal dorsum and irregular nasal dorsum. Long-term results of this technique have not yet been published and its complications have not been sufficiently analysed. Appropriate patient selection is very important in rhinoplasty with Letdown technique.

Revision Rhinoplasty

It is inevitable that undesirable results occur in a group of patients after rhinoplasty surgery. Corrective surgeries performed in these cases are called revision rhinoplasty surgery or secondary rhinoplasty. In revision rhinoplasty surgeries, it may be necessary to add cartilage to the nose from the outside to support the nasal structure.  Revision rhinoplasty surgeries are classically more difficult than the first surgeries, the operation time is longer and requires advanced surgical experience.

Revision rhinoplasty surgery prices are higher compared to the first surgeries for these reasons. Treatment of minor problems after rhinoplasty can be performed under local anaesthesia in clinical conditions. Sometimes minor defects such as nasal wing asymmetries, nasal tip shifts, nasal tip sagging, nasal tip sagging, nasal ridge irregularities can be corrected with simple cartilage addition, suture techniques, rasp, injection treatments. Such procedures are not considered within the scope of revision rhinoplasty (secondary rhinoplasty). Nose surgery revision is a psychologically challenging process. Although revision rhinoplasty surgeries frighten candidate patients due to the disappointment of the first surgery, it is the only permanent way to prevent this disappointment from becoming permanent in experienced hands.

Revision Rhinoplasty with Rib Cartilage Graft (Secondary Rhinoplasty)

In cases of severe cartilage deficiency in the nose after rhinoplasty, nasal dorsal collapse, saddle nose deformity, inverted V deformity, additional cartilage sources are needed. Since the internal cartilage of the nose is insufficient, we take the cartilage material hard enough to provide structural support from the ribs. With a 2-3 cm incision made under the breast, an amount of cartilage that is not vital for the body but can change the world for the nose can be taken. In cases where rhinoplasty is performed with rib cartilage, there may be a pain that lasts 1-2 days where the cartilage is removed. Since the removal and shaping of rib cartilage is a separate step, the operation time is long. Rib cartilages often provide the structural support we need in the long term. It is possible for rib cartilage to fuse, bend and twist at the transplant site. Since rib cartilage is a hard material, the nose obtained after surgery will also have a hard structure. A detailed preoperative examination is required for nasal problems requiring rib cartilage.

Rhinoplasty with Ear Cartilage

Advanced deformations of the nasal tip cartilages and nasal tip cartilage deficiencies may require transplantation of ear cartilage to the nasal tip. Ear cartilage rhinoplasty technique is used in the treatment of nasal tip volume deficiencies, nasal tip cartilage weaknesses, nasal wing asymmetries. Cartilage can be taken from a 2-3 centimetre disc behind the ear. Removal of a cartilage of this size often does not create any visible deficiency and problem in the ear. The use of ear cartilage in rhinoplasty does not cause hearing problems. Since ear cartilage is soft, it is a suitable spare part for nasal tip cartilages. Ear cartilage can sometimes be chopped into a very fine paste and used to correct the collapses on the back and side walls of the nose.

Recovery After Nose Surgery and Return to Social Life

Rhinoplasty surgery is performed under general anaesthesia and takes approximately 1-4 hours. Patients can go home on the same day. Sometimes, in cases where the surgery is prolonged or nausea and vomiting due to anaesthesia may occur, 1 night hospital stay may be required. After rhinoplasty, mild pain, mild swelling and mild bruising are expected. Postoperative painkillers and antibiotics are prescribed. Your doctor will see you in the morning after the operation and the dressing will be changed. If a nasal tampon is used, it will be removed between 3-7 days after surgery. Stitches at the tip of the nose are removed between 5-10 days. A protective splint is used to protect the nose after the operation, this splint is removed between 7-10 days. After the splint is removed and the nose is opened, you will be able to take a bath. When your nose is first opened, it will be swollen and upturned, but in the next 2-3 weeks, it will gradually take shape and the swelling will decrease. Edema and swelling after nose surgery will disappear within a year and a half. During this time, your doctor will call you for controls.

You cannot drive home after the operation. It is recommended not to lie on your side as much as possible for the first 2-3 weeks. You can resume your sports activities in the 6th week after rhinoplasty, but you should avoid getting hit. It is usually possible to return to work or school within 2-3 weeks after rhinoplasty.

Ankara Rhinoplasty Prices 

Rhinoplasty prices vary according to the technique, duration, difficulty, experience of the surgeon, hospital prices, country and city. It is impossible to determine a clear price without an examination. You can contact us by phone to get information about the average prices of rhinoplasty. Ankara is a city where rhinoplasty prices are below the world average. It is possible to reach good surgeons with reasonable prices. For this reason, rhinoplasty patients from many parts of the world visit Ankara. If you are looking for an experienced surgeon in rhinoplasty in Ankara, Assoc. You can contact Dr Ozan Bitik. During the research process, it is futile to make an effort such as Ankara's best rhinoplasty doctor, I will find Ankara's best plastic surgeon, I will choose the best nose surgeon, and it will wear you out.  There is no title as the best plastic surgeon, the best nose surgeon. Every surgeon has good and not good enough results. The important thing is that you can reach a doctor who specialises in his job and with whom you can communicate easily.

For more detailed information about rhinoplasty, you can access www.yeniyuzyenihayat.com, which is one of the most comprehensive Turkish resources on the internet in the field of facial aesthetics created by Assoc. Dr Ozan Bitik by clicking on the BLOG section of our website.