What is Nose Aesthetic Surgery (Rhinoplasty)?

Surgeries performed to give the nose a more beautiful and aesthetic appearance are called rhinoplasty or rhinoplasty. Aesthetic nose surgery is one of the most common cosmetic surgeries performed today and its positive results are extremely pleasing. 

In surgeries performed to change the external appearance of your nose, which is an aesthetically very prominent structure, very important functions such as breathing and smelling should be protected in the best way. In order for your nose surgery to be successful in terms of functional as well as aesthetic aspects, that is, to be able to breathe and smell comfortably through the nose after surgery, it is very important to solve functional problems such as deviation, nasal flesh growth (inferior turbinate hypertrophy) or sinusitis as much as possible in the same surgery.

Surgical techniques and technologies used in aesthetic and functional surgeries of your nose, which is one of the most striking structures in your facial anatomy, are constantly evolving to provide better visual and functional results as well as a faster and more comfortable recovery period after surgery.

Today, in order to obtain aesthetic and functional results that will be considered successful in rhinoplasty, it is important that your doctor who will perform your surgery is highly experienced in the field of nasal surgery, as well as being able to follow and apply current information, surgical techniques and technologies in this field.

Patient happiness is the most important criterion of success in aesthetic nose surgeries, which can be possible with the desired appearance of the nose and comfortable breathing at the end of the surgery. In order to achieve the visual results you desire in your rhinoplasty surgery, your expectations from the surgery should be fully understood by your doctor before the surgery. Three-dimensional digital animation systems, which have been used in recent years, allow you to fully express your expectations from the surgery by applying the possible results of the surgery on digital images, while helping your doctor to plan interventions that will meet these expectations.

Nose Aesthetic Surgery - How is Rhinoplasty Performed?

During the surgical procedure called rhinoplasty or rhinoplasty, different surgical techniques can be used depending on the content of the aesthetic problem in the nose, the tissue characteristics of the nose, the patient's expectations from the surgery and whether there are conditions such as sinusitis, intranasal obliquities or intranasal flesh growths that are planned to be intervened in the same surgery.

In aesthetic nose surgeries, general anaesthesia is preferred except in special cases and the operation time lasts between 1.5-2.5 hours depending on the content of the intervention and the technique to be used. The duration of the operation may be longer in patients who have previously undergone rhinoplasty and in cases where the sinuses need to be intervened during surgery or cartilage fragments need to be removed from the ear or rib.

The basic principle of rhinoplasty is the separation of the nasal skin and the mucosa lining the inside of the nose from the bone and cartilage structures with the help of instruments applied through incisions made completely through the nose or a small part of it through the skin compartment between the two nostrils, and after the desired shape is given to the bone and cartilage structures of the nose using different techniques and technologies, the skin and mucosa are placed back in place. In aesthetic nose surgeries, no direct intervention is made to the skin covering the nose except in special cases.

Surgical Approaches and Techniques

In rhinoplasty surgeries, the two main approaches applied to intervene in the external and internal problems of the nose are called "Open rhinoplasty" and "Closed rhinoplasty". The difference between the two techniques is that in the open technique approach, the nasal skin is completely lifted with a small incision made at the tip of the nose and a direct view of the entire anatomy can be provided. In the closed technique, on the other hand, the procedures are performed under a slightly more restricted view through incisions made only through the nose without incision in the anterior part of the nose.

After the bone and cartilage problems that are aimed to be corrected during rhinoplasty are revealed using one of these two approaches, different surgical techniques and technologies can be used according to the content of the existing problem and the intervention to be performed.

The main terminology used in aesthetic nose surgeries, which refers to techniques that can be applied with an open or closed approach, is as follows;

• Reduction rhinoplasty
• Preservation rhinoplasty - Preservation Rhinoplasty
  • Push down rhinoplasty
  • Let down rhinoplasty
• Ultrasonic, piezo or diamond rhinoplasty
• Tiprinoplasty

Types of Surgical Approach

Closed Rhinoplasty

In the closed rhinoplasty technique, the areas to be intervened are accessed only through incisions made through the nostrils. This approach allows the operation to be performed in a shorter time in appropriately selected patients, and the recovery takes a shorter time due to less oedema formation since the skin is not completely removed at the tip of the nose.

Closed rhinoplasty technique is more preferred in patients who do not have serious deformity in the tip of the nose called nasal type, who have not had aesthetic nose surgery before, who do not have a significant curvature in the curtain (septum) between the two nasal passages, and whose main complaint is bone and cartilage protrusion on the dorsum of the nose (nasal arch, dorsal hump).

Although it is possible to intervene in the problems at the tip of the nose using the closed technique, this approach does not provide an advantage in terms of postoperative swelling in the nose, since all other interventions are similar to the open technique except for the incision in the midline. In the closed approach, control in terms of symmetry is more difficult because the interventions on the nasal tip cartilages are not performed when the cartilages are in the midline and in their natural position as in the open technique.

Open Rhinoplasty

Open rhinoplasty technique is a preferred method for patients who have significant deformity or asymmetry at the tip of the nose, who have undergone previous surgery, or who need to intervene in serious curvatures of the septum in the nose in the same session with aesthetic surgery.

The open rhinoplasty approach is more preferred because most of the patients who will undergo rhinoplasty also have problems at the tip of the nose and serious curvatures in the nose are frequently observed in our geography.

In the open approach, the surgery is started by making a horizontal incision in the middle part of the skin compartment (columella) between the two nostrils, and after the nasal skin is lifted in this way, all cartilage and bone structures forming the tip of the nose and the dorsum of the nose are exposed and the surgery is performed under direct vision. 

In the surgery performed with this method, it is easier to place cartilage supports in the required areas and fix them with sutures, fix and fix the intranasal curtain and ensure symmetry, and at the same time, the risks such as postoperative deformation of the nose or nasal tip, falling of the nasal tip, slipping of the intranasal curtain (septum) are minimised.

In open technique surgeries, when the incision made at the tip of the nose is closed with the correct technique and using appropriate suture materials, it heals completely in about 1.5-2 months in an unnoticeable way.

Surgical Techniques

Reduction Rhinoplasty

Today, the most frequently used method in rhinoplasty is the "reduction" rhinoplasty technique, which means reduction and minimisation.

Anatomically, the upper part of the dorsum of the nose, called the dorsum, is bone and the lower part is cartilage. Reduction terminology means cutting and removing the protrusions on the dorsum of the nose (nasal arch, hump) using various techniques and technologies. After such a removal procedure on the dorsum of the nose, in order to give the nose a natural and aesthetic appearance, the nasal bones should be reshaped and the weakness in the bone-cartilage transition area on the dorsum of the nose should be repaired with appropriate techniques. Failure to perform this repair sufficiently causes different aesthetic and functional problems during healing.

Preservation Rhinoplasty - Preservation Rhinoplasty

Protective rhinoplasty is the terminology used for the correction of the protrusion (hump, nasal arch) on the dorsum of the nose (dorsum) during rhinoplasty by displacement into the nose by preserving its integrity instead of cutting and removing it as in the reduction technique. In this technique, which can be applied with an open or closed rhinoplasty approach, the bones and cartilages under the protruding part on the nose are removed in the desired amount and the protrusion is pressed inwards to correct the nasal profile.

The protective rhinoplasty technique, which was first applied in the 1940s, was largely abandoned over time due to technical inadequacies in those years. This approach has been re-applied with the changes made according to the new information provided by anatomical studies in recent years.

Protective rhinoplasty technique can be applied in two different ways: "push down" and "let down". The most important advantages of the "push down" technique for mild changes and the "let down" technique for severe changes are the preservation of the natural structure of the nasal ridge and the elimination of the need for repair in this area.

Protective rhinoplasty is not an approach that can be applied in every patient, but it is a technique that can be preferred for patients who do not have significant asymmetry on the dorsum of the nose, who do not have an internal curvature extending to the dorsum of the nose, who have a predominantly cartilaginous arch (hump) and who have not undergone surgery before.

Ultrasonic, Piezo or Diamond Rhinoplasty

These terminologies are not different surgical techniques, they all describe the piezoelectric technology used to shape only the bone structures of the nose during surgery.

While piezoelectric devices, which have become popular in recent years, enable cutting and shaping with micro vibrations on bone tissues, the most important advantages of this technique are that neighbouring soft tissues are not damaged and the bones cut with this method heal faster.

Tiprinoplasty

During tiprinoplasty (tipplasty) surgery, which can be performed with an open or closed rhinoplasty approach, only the deformities of the tip of the nose, which is completely cartilaginous, are corrected without any intervention to the bone structures of the nose.

In these surgeries, open technique is generally preferred except for very limited problems. With tiprinoplasty surgery, it is possible to correct nasal tip drooping and asymmetries, to reduce nostrils, to reduce full nasal tips, to sharpen the tip point in the nasal profile view or to correct cartilage angulations that narrow the nasal entrance. Since the bone structures are not intervened during the operation, swelling and discolouration around the eyes are usually not seen after the operation. Since a one-week bandage application on the nose is sufficient, patients can return to their normal daily lives as quickly as possible after tiprinoplasty surgery.