Common problems after rhinoplasty
Rhinoplasty (correction or restoration of the nose) is a kind of art.
Not only does the surgeon need to take into account all relevant aesthetic proportions and unique features of the patient’s face during the operation itself, the physician must also foresee how the patient’s face will change throughout life so that the final result of it (or her) does not disappoint.
On average, the rhinoplasty procedure takes up to 2 hours and ends with a tamponade of the nose using hemostatic sponges and the imposition of a plaster splint. However, the operation is not always successful.
Immediate post-operative problems after rhinoplasty include:
- Airway obstruction : post-extraction aspiration of blood can cause laryngospasm. This may require treatment with muscle relaxants and reintubation or positive pressure ventilation.
- Anaphylaxis : may occur with the use of an intraoperative antibiotic medication.
- Visual impairment : transient and permanent visual impairment sometimes occurs after local anesthesia and vasoconstrictor injection.
- The most obvious and slightly irritating symptom after rhinoplasty is nasal congestion . Occurs due to intranasal edema and persists for the first few postoperative weeks.
- Persistent swelling : The initial swelling of the face and nose and periorbital bruise can last for 10 days. And persistent swelling of the face and numbness in the area of the tip of the nose may occur after external rhinoplasty and last for several months. This is not a problem if the patient has been warned in advance.
Some of the most common “postponed” problems after rhinoplasty include:
- The lump on the nose.
A similar complication appears due to the specific reaction of the periosteum to damage during surgery. At emergence of the cone it is necessary to address the plastic surgeon again.
- Deformation of cartilage or soft tissue of the nose.
Cartilage deformity occurs when too much cartilage remains after surgery. Soft tissue deformity occurs when the surgeon removes too many soft tissues from a patient with thick skin, because of this, the skin subsequently cannot properly contract and stretch. Scars appear in the area of the nose.
- Deformation in the form of an inverted "V".
Occurs due to improper fracture of the nasal bones inside or with inadequate support of the upper lateral cartilage, when the bump of the nasal bridge has been removed. The center of the nose is destroyed, and the nasal bones are visible to the naked eye in the form of an inverted “V”.
- Deformation in the form of "open roof".
After the surgeon has removed the hump of the nose, the free edges of the nasal bones can be palpated (palpated) under the skin. The nose looks asymmetric.
- Overly shortened nose or saddle nose.
This problem after nose correction occurs when the surgeon has removed too much of the support structure for the nose area. This can lead to a number of disorders associated with changing the tip of the nose . If excessive resection occurs in the front of the nasal septum (the structure separating the two nasal cavities), the tip of the nose can "fall" back, resulting in an overly shortened appearance, like a pig's nose. On the other hand, excessive resection can also lead to the opposite problem, in which the tip of the nose hangs, losing an
L-shaped support. This form is called a "saddle" nose. - Kluvovodnuyu deformation.
This term is used for completeness (of varying severity) above the tip of the nose, along with an unnatural ratio of the tip and the area above it. The causes of this condition may be: inadequate support for the tip of the nose, improper removal of the cartilaginous hump, or scarring above the tip of the nose.
- Wide tip and “bulbous” tip.
If during the operation you remove too much supporting cartilage for the tip of the nose, it can collapse and will look too wide or too convex. Excessive scar tissue formation can also lead to these two aesthetic problems after rhinoplasty.
- External valve collapse.
The narrow area in the internal structure of the nose is called the "nasal valve." For normal, unhindered breathing, it is important that the entire valve area remains open. While internal problems of the nasal valve may occur during the removal of the hump on the nose, external collapse of the valve occurs when too much of the tip of the cartilage is removed during the rhinoplasty procedure.
- The disproportion of the wings of the nose and columella.
"Columella" is the name of the structure that separates the two nostrils. Ideally, this area should be only a few millimeters below the edge of the nostrils. In all patients, the wings of the nose are either normal, or lowered, or pulled back, and columella is either normal, or drawn in, or sagging. Many people have an imbalance between the wings and the columella (for example, because of the very long caudal septum), but rhinoplasty can cause it, for example, excessive resection of the caudal septum or resection of the nasal spine.
How to care for your nose after surgery
Bruises and swelling are a normal part of a facial recovery after surgery to correct the nose. Their appearance and severity depends on a number of factors: whether the nasal bones were broken (osteotomy), the degree of soft tissue dissection, whether the operation was performed openly or closed, how old the patient was, how thick his skin was, etc.
Obviously, not many of these factors are under the control of the patient.
However, the scale of the bruises and the severity of the edema can be minimized by following these tips on caring for the nose after surgery:
- Avoid any drugs that thin the blood for at least
2 weeks before the operation, and do not resume taking them until the doctor resolves. These drugs include (but are not limited to): aspirin, ibuprofen, anti-inflammatory drugs, heparin. - Avoid multivitamins, herbal remedies, teas that contain high levels of vitamin E, ginseng, Ginkgo - this can lead to increased bleeding.
- Avoid hot foods, teas and other liquids for 7 days after rhinoplasty.
- If a patient has a tendency to bleed, a family history of a bleeding disorder, or a family member with a bleeding disorder, he should discuss this with your doctor before surgery.
- In the prone position, you need to keep your head so that it is higher than the heart. This will help minimize swelling.
- To avoid smoking for three weeks after the operation, it can negate the efforts to care for the nose after the operation, as indulging this habit impairs healing and provokes edema.
- A visit to a tanning bed or a long stay in the sun for the first few months after rhinoplasty can lead to reddening or "spotting" of the skin of the nose. During the first few months after rhinoplasty, patients should wear sunscreen or a hat to prevent the above problems.
- Some patients who have had severe breathing problems (for example, due to polyps and adenoids) before surgery will notice an improvement immediately after surgery, even in the presence of edema. But sometimes swelling can make it difficult to sleep in the first few nights after surgery. To avoid this, the doctor may prescribe a light sleeping pill.
- In the first weeks after rhinoplasty, it is desirable to use a humidifier, as well as use saline (salt water) to prevent the formation of crusts on the mucous membrane. But it is impossible to show off until the doctor allows it.
- Women who have plastic nose, it is not recommended to become pregnant for a year, until the full recovery of the nose.
Within
After rhinoplasty, the nose will continue to grow; this is a natural process that cannot be prevented. However, the nose grows rather slowly and it is unlikely that a second operation will be necessary.
