Rubina's Transformation on Dois às 10 (TVI) - Rhinoplasty, Blepharoplasty and Facial Harmonisation
WHAT IS RHINOPLASTY?
Rhinoplasty or nose surgery (also known as nose job) is a surgical procedure that aims to improve the appearance, structure and functionality of the nose. Rhinoplasty can increase or decrease the size of the nose, change the shape of the tip, narrow the base of the nostrils or change the angle between the nose and the lip. This surgery can help correcting birth defects and trauma sequelae.
There is no universal way to perform rhinoplasty, as it is planned according to each patient’s wishes and anatomical characteristics. In some cases, to help reshape the nose, cartilage grafts are needed, and this is harvested from the nasal septum, the auricles (ears) or the rib cage.
Nose surgery should always take both aesthetics and functionality into account. Obviously, it is not possible to plan for an aesthetically perfect nose which does not allow for the patient to breathe properly. For a rhinoplasty aimed at improving aesthetics, exonasal or endonasal routes can be used (outside or inside the nose, respectively). If there is a complex functional pathology, the work of the Plastic Surgeon should be complemented with that of an Otorhinolaryngologist, preferably in the same intervention.
For whom is
rhinoplasty indicated?
Rhinoplasty is ideally suited for patients who:
- Are dissatisfied with the appearance of the nose (either by genetic defects or acquired deformities, resulting from trauma);
- Have functional problems in the nose (deviated nasal septum, nasal polyps, turbinate hypertrophy, chronic nasal obstruction, headaches, recurrent episodes of sinusitis, etc.);
- Are overall healthy;
- Are non-smoking;
- Are emotionally stable and have realistic expectations about the results of the surgery;
- Seek to improve the appearance of the nose, not perfection.
What aesthetic characteristics of the nose
can be improved with rhinoplasty?
Rhinoplasty is indicated for patients with one or more of the following complaints:
- Large and wide nose;
- Prominent nasal hump;
- Large and rounded nose tip;
- Droopy nasal tip and/or very close to the upper lip;
- Wide nostrils.
Types of rhinoplasty
Open Rhinoplasty
Open Rhinoplasty consists of making small incisions in the columella – the narrow tissue that separates the nostrils and on the sides of the nostrils. Then, the skin is lifted so that the nasal structure is fully exposed for a better visualization. Nose bone structure is then reshaped, and bone, cartilage or tissue is added or removed to achieve the desired appearance.
Advantages of Open Rhinoplasty:
- It allows a direct visualization of bone structures;
- It allows a very clear assessment of the nose’s deformities, irregularities and asymmetries;
- Enables an accurate diagnosis;
- It allows the plastic surgeon to operate with both hands;
- Enables a greater number of tissue and cartilage graft techniques.
Disadvantages of Open Rhinoplasty:
- It involves an external scar, despite very discreet (in the columella);
- Longer surgery time;
- More prolonged swelling, especially at the tip of the nose;
- Prolonged or unsightly healing.
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Closed Rhinoplasty
In Closed Rhinoplasty, the plastic surgeon makes small incisions inside the nostrils to access the bone and cartilage. The skin is not detached from the bone structures, as in open rhinoplasty, thus preventing direct visualization of the bone structures.
Advantages of Closed Rhinoplasty:
- Absence of external scarring;
- Less postoperative swelling;
- Shorter surgery time;
- Faster recovery;
- Enables an accurate diagnosis;
- It allows the plastic surgeon to operate with both hands;
- Enables a greater number of tissue and cartilage graft techniques.
Disadvantages of Closed Rhinoplasty:
- It does not allow a direct visualization of bone structures;
- The intervention is performed “by touch”;
- It requires a greater degree of experience and specialization;
- Visualization is limited to one person only;
- The success of the surgery is more dependent on the preoperative diagnosis than in the case of an open rhinoplasty.
Nose job surgery procedure
Rhinoplasty medical appointment
Consultation
The first step of your rhinoplasty medical appointment is to share your complaints (aesthetic and / or functional) with the medical team, the expectations you have regarding the surgery and the result you want to achieve.
3D Simulation
The simulation allows you to have an idea of the possible result to be achieved with a nose job.
Detailed explanation
During the rhinoplasty medical appointment, a treatment plan will be outlined and you will be taught about the risks of the surgery, the results you can expect, and pre and postoperative care.
Quote
After the medical diagnosis, you will be presented with an exact price for your rhinoplasty according to the surgical plan that was drawn up and you will then be able to schedule the surgery. The price will depend on the initial characteristics of the nose and surgical techniques to be used.
Post-operative care
The success of rhinoplasty is directly related to postoperative care, so it is extremely important to strictly follow all medical instructions:
- Rest and avoid any type of physical effort for the first 8 days;
- Sleep with your head in an elevated position (at least two pillows) during the first week after surgery;
- Do not lie down all the time – it is important to walk around 3 to 4 times per hour to promote circulation;
- Apply ice on the area around the eyes, but be careful not to let it burn your skin;
- Take the prescribed medication;
- By the end of the second day you should start cleaning your nose and some scabs with cotton swabs soaked in hydrogen peroxide and applying antibiotic cream;
- It is important not to get the splint wet – washing your head at the hairdresser might be preferable;
- It is important not to sneeze, and not to blow or rub the nose in the first fifteen days after the surgery;
- You cannot wear glasses for 4 weeks, so that you don’t exert pressure on the nose;
- You can go back to work after 1 to 2 weeks;
- Do not get direct sun exposure;
- Do not smoke;
- Drink plenty of water and follow a balanced diet;
- Attend all follow-up appointments.
What results can i expect
after performing a rhinoplasty?
The intervention aims to improve the appearance of the nose and optimize its respiratory function, and these objectives are usually met. It is fundamental to have realistic expectations regarding the proposed intervention, as the final result will always be case specific, depending on the initial characteristics of the nose.
It is not possible to apply an identical rhinoplasty protocol to all patients and expect them to have identical results, as each individual has unique characteristics and different techniques should be applied.
The result of rhinoplasty is long-lasting, but the end result is only expected 6 to 12 months after the surgery.
Type of incision - scar
Open Rhinoplasty
In open rhinoplasty, the scar is located in the columella, the tissue located between the two nostrils. Despite being an external scar, in most cases it becomes practically imperceptible over time.
Closed Rhinoplasty
The scars of the closed rhinoplasty are not visible because the incisions are made on the inside of the nose.
Type of Anesthesia
In most cases, rhinoplasty is performed under general anesthesia but this will depend on the characteristics of each patient and the techniques to be used.
Differences between rhinoplasty and rhino modelling
Both rhinoplasty and rhino-modelling aim at significantly improving the appearance of the nose. The “before and after” cases are quite significant in both cases, but they operate differently.
Rhinoplasty
- Rhinoplasty is a surgical intervention;
- It is performed in an operating room under local anesthesia;
- It is indicated for patients who want to improve aesthetics and functionality of the nose;
- It implies structural changes to the nose;
- It will generate scars (in the open approach);
- Recovery time: 1 to 2 weeks;
- The result is definitive
Rhino-modelling
- Rhino-modelling is a non-invasive treatment (no surgery);
- It is performed in a consultation room
- It is performed after the application of an anesthetic cream;
- It is indicated for patients who want to improve minor deformities;
- It does not correct functional problems;
- It does not alter the structure of the nose;
- Leaves no scars;
- No recovery time;
- The result is temporary – 9 to 12 months.
3D simulation of nose job
We were the first clinic in Portugal to provide rhinoplasty simulation in real time to our patients.
Vectra XT 3D is an innovative and revolutionary software that allows patients to have a very accurate idea of what can be achieved with a rhinoplasty.
This technology allows you to see the changes that will be made to your nose in real time and from various angles. You can anticipate results, weigh your choices and better manage expectations.
The use of Vectra XT 3D has become a unique and differentiating experience that facilitates communication between doctor and patient. It minimizes some patients’ hesitation regarding the surgery and enables a better clarification of more persistent doubts.
Rhinoplasty Step-by-step
MARKING THE NOSE
Before administering general anesthesia, markings are made on the nose.
ANESTHESIA
Anesthesia is administered according to the predetermined surgical procedure (usually general anesthesia).
DISINFECTION AND DELIMITATION OF OPERATING FIELDS
Face and nose are completely cleansed and disinfected to reduce the risk of infection. Operative fields are placed to isolate the surgery area from the external environment.
INCISIONS
Incisions are made on the inside or outside of the nose depending on the type of rhinoplasty to be performed (open or closed).
NOSE RECONSTRUCTION
The nose is reshaped according to what was determined in the medical appointment with the plastic surgeon.
CLOSING OF INCISIONS
The incisions are closed with small stitches. The inner stitches are absorbed and the outer stitches are usually removed after 7 days.
POST-ANESTHESIA CARE
The patient is awakened by the anesthesiologist and is then transported to the recovery room where she/he remains under observation before being discharged after a few hours, on the same day.
PREPARATION for Rhinoplasty
Before Surgery
- Carry out all the preoperative tests requested and send them to the medical team one month before the surgery.
- Do not take aspirin or anti-inflammatory drugs two weeks before rhinoplasty.
- Do not take slimming medication one month before surgery.
- Do not smoke one month before surgery or while the healing process is underway. Smoking compromises tissue oxygenation and negatively affects healing.
- If you catch a cold or suffer from a bad mood in the days before surgery, you should inform the medical team.
- Read all the documentation you have been given carefully, as there may be some questions before the day of the intervention.
- Organize your routines in advance so that you can rest and recover calmly.
- Do you have any questions about rhinoplasty surgery, preparation or the post-operative period? Don't wait until the day of your surgery and ask all your questions first.
On Surgery Day
- The day before, eat light meals that don't cause indigestion. Fast absolutely for 8 hours - do not eat or drink liquids, including water.
- Bathe with the prescribed antiseptic gel the day before and the day of the rhinoplasty to avoid infection.
- No jewelry or watches.
- Do not use creams or make-up.
- Do not use nail polish/gel/ice cream as this may interfere with the reading of vital signs.
- Do not wear contact lenses.
- Bring comfortable clothes to wear when you are discharged - preferably with buttons or zippers.
- After discharge, you cannot go home alone or drive. If you don't have someone to drive you home, you must inform us in advance.
Benefits of rhinoplasty
Nose surgery improves respiratory function and improves the aesthetics of the nose. With a Rhinoplasty you can:
- Increase or decrease the size of the nose;
- Narrow the nasal orifices;
- Narrow the nostrils;
- Correct a nasal hump;
- Straighten and align a crooked and deviated nose;
- Change the shape of the tip (bulbous, flat or too sharp);
- Change the angle between the nose and the upper lip;
- Improve respiratory function;
- Improve your confidence and self-esteem.
Specialist Doctors
About
Dr. Luísa Magalhães Ramos / Plastic Surgery
PORTUGUESE MEDICAL ASSOCIATION, Nr. 42810
Graduated by the Faculty of Medicine of the University of Porto, she specialized in plastic, reconstructive and aesthetic surgery, at Hospital de São José, in Lisbon.
Throughout her training, she subspecialized in aesthetic plastic surgery, having worked in world-renowned clinics.
Currently, she is mainly dedicated to face and breast aesthetic plastic surgery and to intimate female surgery.
About
Dra. Catarina Duarte
Portuguese Medical Association – registration number 51027, specialising in Otorhinolaryngology.
With a Master’s degree in Medicine from the Faculty of Medicine in Lisbon, Dr. Catarina went on to specialise in Otorhinolaryngology at the Santa Maria Hospital in Lisbon, having joined the teaching staff of the Otorhinolaryngology chair as a free assistant. Her training in otorhinolaryngology had a strong component in head and neck surgery, but also in rhinology, otology and paediatric laryngology.
FAQ about
Rhinoplasty – Nose Surgery
ARE THE RHINOPLASTY SCARS VISIBLE?
The incisions depend on the chosen approach. In closed rhinoplasty, incisions are made inside the nose and absorbable suture threads are used. In open rhinoplasty, the incision is made in the lower portion of the nose tip, between the nostrils (the columella), and the line used in the suture is removed 4 to 7 days after the surgery. On both approaches scars are almost imperceptible.
HOW HARD IS THE RECOVERY FROM A NOSE JOB?
The postoperative period of rhinoplasty is not usually painful and patients return to their routine 2 to 4 days after the intervention. They might have bruises in the first two weeks. During this period (and ideally, in the 2 months after surgery) direct sun exposure is strictly forbidden as it impairs healing and negatively influences the resolution of the edema. See the pre and postoperative care section to learn more.
WHEN WILL I HAVE A DEFINITIVE RESULT?
Right after the surgery you will have an idea of the final result, despite some edema and swelling. Just 3 weeks after the intervention, the appearance of your nose will be very close to the end result (which will be definitive after 2 months).
HOW TO CHOOSE A DOCTOR TO PERFORM A NOSE SURGERY?
Rhinoplasty is a very delicate surgery, requiring a lot of precision from the doctor. Choose an experienced surgeon and one accredited by the Portuguese Medical Association and the Portuguese Society of Plastic Surgery. Look for an available professional, who will clarify your doubts and explain the available techniques. To avoid disappointment, ask for examples of rhinoplasties performed by this professional.
WHAT CAN BE CHANGED IN MY NOSE?
Rhinoplasty is a personalized surgery that depends on the characteristics, dimensions and imperfections of each nose. The main objective is to correct the nose functionality and aesthetics, in order to improve the patient’s quality of life and self-esteem. However, it is essential to manage expectations and understand that it is not feasible to try to have a perfect nose or “imitate” someone else’s.
DO YOU HAVE TO BREAK THE NOSE IN ORDER TO CORRECT IT?
Depending on the purpose of the rhinoplasty, it might be necessary to act on the nose’s bone and cartilage for a good nasal reconstruction. Often, a cartilage graft from the nasal septum or the pinna may also occur.
ARE THERE ALTERNATIVES TO RHINOPLASTY TO CORRECT THE NOSE?
Rhino-modelling is a good alternative, without surgery, to correct aesthetic (not functional) imperfections of the nose. It is a technique that injects mix of filling substances in the nose tissues enabling its reshaping. This procedure requires continuous assessment every 1 or 2 years.
I DIDN'T LIKE THE LOOK OF MY NOSE AFTER THE RHINOPLASTY. IS IT POSSIBLE TO FIX?
Yes, if you have had a rhinoplasty in the past and you are not happy with the result, you can have a new surgery with us. At LMR we thoroughly evaluate the anatomy and shape of your nose and program the surgery in detail. In all interventions we look for a proportional and harmonious balance between the nose and the rest of the face. With Vectra XT 3D you can even simulate the final result in real time.
