NOSE SURGERY - RHINOPLASTY

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RHINOPLASTY SURGERY - "NOSE JOB"
When you look at person, first thing you notice is their face, and then the rest of their body. On the face, the most prominent part, first thing noticed is the nose, either consciously or unconsciously.

Rhinoplasty surgery is very common with persons between 18 and 25 years of age and both men and women are equally operated on. Plastic surgeons usually do not recommend this type of surgery before 18 years of age because before puberty nose growth is not yet finished. If you are in general good health, there is no upper age limit for this type of surgery.

Nose surgery is sometimes done in combination with face lift or other rejuvenation surgeries in order to correct ageing process of the nose, such as lowering of the tip of the nose. If you have problems breathing that are connected to nose septum deviation, that problem can be corrected at the same time as aesthetic nose shaping is done.

NOSE SURGERY CANDIDATES
Some of the indications that point you out as a candidate for rhinoplasty are: that your nose is too big for your face, that kyphosis is present, i.e. that you have humped nose, that you have long nose, that your nose is wide or it is like a saddle, that you have a wide tip of the nose or wide alar base, lowered or raised tip of the nose or your nose is asymmetric and deviated.

It is very important that you have a clear idea of how you would like your nose to look and, at the same time, realize that there are limitations to the procedure. Dr. Milan Jovanovic can give you further information if you are interested in this type of surgery.

PREOPERATIVE ASSESSMENT
Patient preparation for nose surgery usually begins during the first examination. Patient consent is the first step in preparation of the patient for the surgery. It is very important that feeling of trust between the patient and the doctor is created. Surgeon informs the patient what the surgery includes and what needs to perform the surgery. During the initial examination the surgeon will probably ask you to look in the mirror and show exactly what kind of change you would like to be done to your nose.

During the examination you will give anamnestic data on illnesses or surgical treatments you hade previously, nose injuries or medicine allergies, diabetes, hypertension, anemia, chronic infections. It is very important to give complete information. After receiving anamnestic data an examination of inner nasal structures, examination and quality of nose skin, size and shape, as well as relation of the nose with other structures of the face should be performed.

Two weeks before nose surgery do not use medicine such as: aspirin, vitamin E and C, estrogen. Do not plan the surgery for the middle of menstrual cycle. Eight hours before the surgery do not eat or drink.

RHINOPLASTY PROCEDURE
Nose surgery is done in general endotracheal anesthesia (that allows higher comfort to the patient and surgeon) or in local anesthesia (which requires special technique) and intravenous analgosedation. During the surgery, heart function, blood pressure, pulse and oxygen levels in your blood are monitored.

POSTOPERATIVE TREATMENT
After nose surgery a splint is placed on the nose ridge in order to immobilize nose tissue. After the surgery is completed you will be transferred to semi-intensive care unit where you will still be postoperatively monitored for some time. After a few hours you can go home, or if the surgeon or the anesthesiologist decide, you can stay for a night in hospital.

Generally speaking, bruises around cheeks and eyes are most visible during the first five days after surgical treatment. You can use make-up to cover the bruises if needed. Significant swelling can last up to several weeks. Minor residual swelling, most commonly around the tip of the nose can last up to several months, but generally it is not noticeable and other people do not notice it. If the immobilization is used this will disappear within three to seven days after the surgery. Sutures are removed after 7 to 14 days after the surgery. If lateral and medial osteotomy is performed, nasal splint may be left for several weeks postoperatively.

COMPLICATIONS
Significant complications by rhinoplasty are rare. Every year in the world several thousands of people undergo rhinoplasty and generally, if the surgery is done correctly, all of the patients are satisfied by the results. However, anyone who wishes to undergo this type of surgery must be aware that every surgery has its own risks.

Some of the possible complications that may be considered are the appearance of hematoma, infections, reactions to anesthesia, skin numbness that is usually temporary. Aspirin or some of the anti-inflammatory drugs can cause increased bleeding, so all of these drugs should not be used after the surgery. Some plastic surgeons in the world advise not smoking postoperatively.

Tensing, bending, heavy lifting should be avoided during early postoperative course. You can resume normal activities after seven to ten days after surgical treatment. You should avoid exposing your nose to direct sunlight for a few months, because the nose may be sensitive during this time, so protective creams should be used. If changes to your nose bones were performed, wearing of heavy glasses should be avoided for the first three weeks.

Objective of the rhinoplasty surgery is that the nose looks more natural and that it harmoniously fits configuration of your face. Since healing after nose surgery last very long, one should wait up to one year to see the final results of the rhinoplasty. However, first results can be seen already after a few weeks. In most cases results of rhinoplasty are permanent, except changes related to normal ageing process.

After completed surgery, you will regularly come for check-ups. During regular check-ups that will be scheduled, if you have any questions, you will consult with Dr. Milan Jovanovic.