Rhinoplasty Operation | Dr. Yavuz Ozsular

Rhinoplasty

Anesthesia
General
Operation Period
1.5-2.5 Hours
Pain
2/5
Recovery
10 Days
Hospital Stay
1 Night
Dressing Period
5 Days
Corset
5-7 Days/Air splint buffer

Rhinoplasty

Nasal deformities – whether caused by unnoticeable childhood trauma or genetics – can be not only aesthetically and visually unpleasant, but also cause your respiratory problems, and even drastically impair your quality of life. Rhinoplasties can correct all of that.

In rhinoplasty surgeries we treat and reshape the bone and cartilage curvatures in your nose and also plan the best nose for you based on your expectations.

Rhinoplasty is the most common plastic surgery in Turkey. And, like every surgery, it requires experience and neat work. Rhinoplasty surgeries incorporate a range of techniques. Rather than the superiority or comparison of techniques to each other, the correct and ideal technical approach to the patient will be more accurate. Considering the structure of your nose and all other variables, Dr. Ozsular will determine the most accurate surgical technique during the examination according to your needs.

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    Surgeon YAVUZ OZSULAR

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    Closed rhinoplasty: Closed rhinoplasty requires no incision from the outside of nose. Instead, the surgeon makes incisions on the inside of nose to reach intranasal structures, and operates from there. There are no visible external scars afterwards.

    Open rhinoplasty: Open rhinoplasty requires incisions on columella located in the middle part of nostrils and on the inside of nose to reach the intranasal structures. It will leave behind mild scars that will fade over time.

    Preservation rhinoplasty: Preservation rhinoplasty shapes the nose with the interventions made from the inside without dissecting the nasal roof in patients with a beautiful dorsal hump and preserves most of the tissues.

    During your examination, Dr. Ozsular first will listen to your complaints and expectations and examine you based on all of following variables; your age, the thickness of your skin, the current condition of your cartilage, whether you’re having any nasal congestion or difficulty breathing through your nose, whether you have any disease that affects your nasal mucosa (e.g. allergic rhinitis), whether or not you’ve suffered previous trauma, bumps and pits on your nose, nasal cartilage curvatures and deformities, your nasal bone curvatures, nasal tip drooping, the structure of your face, any history of previous nasal surgery. He’ll also examine history of previous different surgeries, check out your overall health, and ask you whether you’re on any medications (including vitamin).

    Afterwards, he’ll do a detailed physical examination on you to assess your cartilage, bone structure, and mucosa, how thick your nasal skin is and what type it is, and the cartilage structure of your nasal septum, and structure of concha.

    Next, after he detects the existing problems, he’ll take photos of your nose from different angles, make calculations, and arrange which nose type might be aesthetically suit your face using photoshop and simulation programs – all to give you a preview of what your results may look like.

    Rhinoplasty requires a meticulous work in a small area. That said, there is nothing better than finding the right surgeon once who can know you exactly what you want first time. Note: If you have more than one surgery done, the results dwindle over each procedure.

    When you know what you want and find just the right nose that suits you and the right surgeon who can get the job done, then you and your new nose will live happily and healthily ever after.

    Dr. Ozsular may tell you to temporarily stop using certain medications – in which case you should do so. (If you take aspirin or any form of anticoagulant, certainly tell Dr. Ozsular and continue only if he tells you to do so.)

    Try to reduce how much salt you consume as well a few days before the surgery. This will reduce your risk of developing edema.

    You are allowed to eat as well as drink water until 00:00 (12 AM) the night before your surgery. Since the surgery will be conducted with general anesthesia, you will need to fast for at least six hours prior to the procedure. (If you forget to do so, your surgery may be postponed or canceled.)

    You should wash thoroughly your face before going to bed the night before the surgery. Don’t wear make-up absolutely.

    Don’t wear nail polish or enamel.

    Don’t wear wigs. Don’t wear any jewelry (including piercings) – your body should be free of metal.

    Also, don’t forget to put together an overnight bag – including loose, casual clothes (preferably with zippers/buttons) before you come in for the surgery – especially avoid anything that may hit your nose. You should also wear comfortable sneakers and, if you’re a woman, hair pins.

    On the morning of the surgery, you will be taken to your room to rest. Your final preparations for the surgery will be conducted. Dr. Ozsular and his assistant will come and visit you.

    The doctor will begin shaping your nose soon as you’re placed under anesthesia. Every technique differs in process, but all of them have common points as well.

    At the end of the surgery, he’ll photograph your new nose, place thin silicone pads, tape, place a protective splint, and then slowly awaken you. Local anesthesia applications allow you to wake up comfortably, without any pain.

    You will not feel any pain upon waking up from the surgery. However, you may feel dizzy due to the effects of anesthesia, this is normal and temporary. You should rest in bed until the wooziness passes and should call your nurse for help if you need to stand up.

    New-generation thin soft silicone nasal packing will be placed inside your nose in place of bandages or cotton balls – meaning that you’ll be able to comfortably breathe.

    There, however, will be various tapes and a protective thermoplastic splint over your nose.

    Analgesics will be given to you for the first few days so that you feel comfortable.

    You – or preferably a relative or companion – should apply cold application to your nose – the doctor will tell you where, and for how long.

    Don’t try to suddenly stand up within the first few hours after the surgery; you may fall.

    You must protect your nose from all forms of impact.

    You will develop swelling/edema a few hours after the surgery – this is normal, and will subside three days after the surgery. Again, put a cold compress to your nose according to doctor’s orders to alleviate the process. You may develop slight ecchymosis depending on your skin structure and how your skin reacts to the trauma.

    You’ll be able to eat again 4 to 6 hours after surgery. (Preferably go for a light soup, as it will get kick-start your (hungry) digestive system again.)

    You’ll need to stay overnight in the hospital. You’ll be discharged the next day – with a prescription list containing antibiotics, analgesics, nasal wash solution, intranasal moisturizer, and anti-sneeze medication.

    You shouldn’t do any prolonged bed rest or do any heavy labor for the first week after the discharge. You however can take short walks. You can also sunbathe so long as you protect your head. Take time for yourself and relax.

    If you have pain in the forthcoming days, you can take mild analgesics.

    You can take short, warm showers (10 to 15 minutes) for the first 5–7 days until your bandages and splint get removed (be sure that neither area gets wet).

    Be sure to hold your head up high so that the swelling goes down faster.

    Your packing will be removed five to ten days after the surgery (depending on the procedure). New generation packing is easy to remove – no more pain awaits you, however you may experience slight bleeding. Don’t blow your nose; rather, gently clean it with cotton swabs (q-tips), sea-water spray, and moisturizers, as directed.

    You can return to your normal routine 7 to 10 days later.

    You can begin wearing contact lenses again 1 week later. However, you shouldn’t wear sunglasses or normal glasses for the first one to two months.

    Don’t do anything to your face for the first 15 days.

    Make sure that you should protect your new nose from any impact for the first six months after the surgery.

    You nose will fully assume its new shape 10 to 12 months after the surgery.

    The surgery takes two to three hours on average depending on the technique and the condition of your nose.

    Yes, you’ll need to stay in the hospital overnight.

    It depends on the procedure. Local anesthesia is preferred for small filling procedures and fat injections.

    General anesthesia is preferred for open and closed rhinoplasties, given that both require neat work. General anesthesia is preferred for comfort of both you and your doctor, or else you would be scared, get anxious and panic during the surgery.

    Fillers are done if you need collapses on your nasal hump filled but if there aren’t any existing problems with general projection of your nose on your face. Filling are meant to fill collapses and cavities on your nose.

    It may also be done to raise your nasal tip, give it more volume, and make it look “cooler,” so to speak. There are no sutures and incisions, just injector!

    People are living, organic beings. Thus, we’re constantly changing. Likewise, the tip of your nose will change with your body, and naturally drop as you age.

    After the surgery, the tip of your nose will experience a small amount of dropping and rotation loss – the amount depends on your cartilage structure. Dr. Ozsular will take your dropping rate into account during the surgery and lift it accordingly – usually by 5 to 6 degrees. He’ll inform you about this issue during your examination.

    We will photograph your nose straight after the surgery whilst you’re still on the operating table. Your nose will be in its final shape, but the edema won’t have developed yet. You will develop swelling/edema a few hours after the surgery – this is normal, and will subside three days after the surgery. Again, apply a cold compress to your nose according to doctor’s orders to help alleviate the process. You may develop slight ecchymosis as well depending on structure of your skin and how your skin reacts to the trauma. Everything will have subsided seven to twelve days later.

    You won’t be in pain during the surgery because you’ll be under general anesthesia.

    The same goes when you wake up from and after the surgery because of the effects of the analgesics we’ll have put you on – you’ll be comfortable. Some patients experience a mild but temporary headache due the general anesthesia drugs.

    People fear mostly of having their packing removed – to the point that many abandon the idea of surgery. It used to be painful 10 years ago! Now it isn’t thanks to advances in packing technology; they’re now smaller, more practical and portable and therefore pain free. Your comfort is everything.

    Since we will be operating on the septum cartilage-bone curvatures and swollen nasal concha (hypertrophic concha) which narrow your airway, your airway will open, and thus you’ll be able to easily breathe.

    You may experience mild nasal congestion in the first 2 weeks, after your packing is removed, due to nasal mucosal edema. Nasal sprays with seawater will help alleviate that.

    You may experience some obstruction for the first six months due to scabs. This, too, is temporary, and can be prevented with moisturizing nasal sprays.

    If you experience any nasal congestion related to allergies before the surgery, your concha may swell again and block your nose. In this case, you may need drug therapy and concha radiofrequency.

    Yes – sometimes your concha may expand and block your air passages (where there already is bone cartilage curvature inside) due to allergies or change in heat, thus making breathing difficult. Dr. Ozsular will only assess and decide so within your knowledge and during the examination. That said, rhinoplasty alone won’t solve your concha problem.

    If you’re coming from outside Istanbul, then you should stay in Istanbul for at least 7 to 10 days. Your final pre-operative examination will be done 1 to 2 days before the surgery. After the surgery, you’ll need 6 more days before your dressings, plaster, and packing get removed. Afterwards, you’ll have a new nose totally 7 to 10 days later.

    • First control – 6 to 7 days after the surgery (at the clinic)

    • 12 days after the surgery (if possible, at the clinic)
    • 1. month
    • 3. months
    • 6. months
    • 12-18. months after the surgery.

    All remaining (except for the first one) control can be done over video call or via video clips and photos.

    Perception of esthetic beauty emerges when your nose, lips, eyes, eyebrows, hairline, chin, and even skin harmoniously match one another.

    Sometimes the organs of your face are not based on standards of generally accepted “esthetic” perception but as a whole, very much match one another. Sometimes you need intervention for any of them to capture that harmony (i.e. and this is how plastic surgery began…)

    If you bring us a photo, don’t forget that it is of someone else’s face – and the harmony of their face features skin thickness and skin quality, not yours. They are even cosmetic procedures done by someone else. Even if we were to re-create something close (e.g. a nose), it won’t match your specific face, and you’ll end up disappointed. This is not the right approach.

    This is because we surgeons share before/after shots on social media and offer you the best results possible. However, you need to know that everyone’s cartilage, skin, and bone structure/thickness are different; therefore, your results will be unique to you only. How you fair after surgery will depend on how will you listen to the doctor’s orders, where you live (climate-wise), your quality of life, whether you injure your nose or not, and whether you smoke or not.

    More importantly, we do this photo sharing to inform you – wherever in the world or Turkey you happen to be. In doing so, you’ll get to learn more about your doctor, his approach to surgery, his experience, which surgeries he does most.

    After Dr. Ozsular examines you, he’ll decide the right surgery for you and tell you more about details. Social media is meant to inform you only.

    Be careful! You should never haphazardly massage your nose after the surgery, especially if you’ve heard that another doctor has had their patient do it.

    Depending on what procedure you’ve had done, sometimes you massage yourself, sometimes doing so is just too risky!

    You should only do so – and gently – if your doctor tells you so. Do not do it for any longer than he tells you to either. Most often, this is three times a day for three minutes (each). If you go beyond that, you could cause your new nose to collapse or bend out of its shape.

    It is not recommended after every rhinoplasty for every patient. Consult with your doctor first and listen to his advice.

    No-one’s nostrils are not 100% equal. There are always differences (at the millimeter-level) that cannot be seen with the naked eye.

    Some people have suffered any trauma to their nose or some others may develop congenital disproportionate nostrils. Others may develop uncomfortably large nostrils.

    The surgery won’t equalize the nostrils. However, no one will be able notice this millimetric difference either.

    Most plastic surgeons no longer use old-type packing. They used to be very painful to remove and would prevent you from breathing properly because of the wrapped bandages.

    Modern packing is very thin, yet large enough. They won’t block your breathing, nor cause you to feel pain until their removal – meaning that you’ll be comfortable right up until they’re gone.

    Yes, but this is temporary. It is a result of the surgery, and moisturizers containing seawater used after the surgery.

    Smoking will slow down your tissue recovery – causing your nose to heal more slowly and your edema to subside later. If you can, try to not smoke for the first month.

    You must be at least age 18 - your nasal bones don’t fully develop until then.

    You mustn’t be suffering from any condition that would prevent you from having surgery or going under anesthesia.

    You should be in good mental condition as well (although no test or document is required)

    You cannot be pregnant or breastfeeding.

    Yes, provided that there is no medical contraindication.

    However, as your cartilage tissue weakens at advanced age, you may not get the results you desire.

    Surgical technique-wise, there is no difference. Esthetic wise, there are big differences. The angle of one’s nose in proportion to their lips, the height, shape, and fracture angles of tip of their nose (including dorsal), the naso-frontal and nasal dorsal passages are important and determinant between women and men.

    People tend to classify noses as natural, thin, assertive, cool, or otherwise. That said, everyone’s face has different proportions, expressions, and skin thicknesses. When deciding what shape your nose should be, it should match your own face, cartilage, bone structure, and skin thickness – not just your expectations. Your doctor will keep all of the above in mind when designing you the best nose.

    Dr. Ozsular will plan your new nose down to the last detail before the surgery and give you a preview through photos and simulation. We want you to end up with best results in a single operation.

    Your nose will settle into its new shape after the surgery. If you don’t like the results, then we can arrange for further “revision” surgeries to correct and replan a new surgery depending on your circumstances.

    We may do revision surgery (or secondary rhinoplasty) for any number of reasons:

    You aren’t satisfied with the results of their first surgery

    You’ve suffered from large deformities due to the surgery

    You need minor touch-up works

    Your nose has bent and collapsed due to impact after the surgery

    Your tissue hasn’t healed properly

    Your plastic procedures were faultily or incorrectly done

    You can’t psychologically adjust to your new nose

    You over-massaged your new nose against doctor’s orders

    We will interview and examine you to figure out the problem, as well as assess your expectations are, and then plan solutions and inform you.

    If you need minor corrections, you should wait 6 to 8 months after the surgery. If you have major deformities, you should wait at least one year.
    If you have insufficient nasal cartilage due to prior surgery, we may need to take cartilage grafts from another part of your body. Your doctor will inform you in advance.
    In cases where it is not possible to replace the septum that collapsed from previous surgeries with the cartilage graft, a small piece of cartilage from your rib is taken by making a 2 cm incision and leaving the scar under your breasts, so that the nasal cartilages are reshaped.

    How thick your nasal skin dictates the final shape of your nose. Two different patients who have undergone the exact same surgery may come out with two different outcomes due to the thickness of their skin.

    If you’ve got thick nasal skin, we can’t thin it down or remove it surgically. In such cases, the thick skin covers the uprightness and characteristic of the nasal tip. We encounter patients like you often, and thus know how to shape your cartilage anatomy accordingly. However, your results won’t be the same as those of someone with thin nasal skin.

    Many people ask us whether a closed rhinoplasty is better than an open one, or vice versa. Neither technique is better than the other. Which one we use depends on the structure of your nose.

    During an open rhinoplasty, we make an incision on the front of your nose, and then shape it by lifting the nasal skin. Last, we suture the incision site. An open and visible nose poses an advantage for surgeons when they’re first starting out their education. The more surgeries they do, the better they get at doing open rhinoplasties. Since the incision is made on the front of the nose, only a minor scar gets left behind. For some, that scar will fade over time; for others, it remains obvious (it depends on how well your wound recovers.)

    During a closed rhinoplasty, we make incision on the inside of nostrils, shape your nose, and then close the incision accordingly. There is no visible scar left. However, this surgery is technically much more difficult to learn and perform – therefore you surgeon needs to be experienced.

    Both techniques are still widely used today. Your doctor will choose the right one for you depending on the structure of your nose, nasal dorsum, and cartilage, and your surgery history.

    In the old days, one could understand a mile off that you underwent rhinoplasty just by your immobile nose tip. The tip of your nose stayed stationary even when you moved your face. You moreover understood that you had something abnormal there when you touched your nose, blew it, or slept.

    New-generation rhinoplasties can preserve your cartilage and bone structure (if possible) and make a nose that moves with you when you laugh, move your face, etc.

    We’ll take photos of you from different angles and making different facial expressions, analyze your cartilage and nasal muscles, and plan your surgery accordingly. The above said, the structure of your nose, how well your new nose will adapt to your face, the surgery’s own success, and your surgeon’s experience will determine everything.

    Some patients want a more assertive nose and others want a more natural one. Some want two in one!

    No. Especially if you have an extremely hooked nose, or large septum defects. 

    Patients who are eligible for rhinoplasty in the first place can have the closed technique done to them. We will ensure that your nasal tip moves in accordance with facial muscles by preserving certain parts of your cartilage tissues.

    We’ll take photos of you from different angles and making different facial expression before surgery, analyze them, and design your nose around how your original one moves. We’ll also design your nose and suture it accordingly. Your new nose will move in sync with your face, whether you’re smiling or crying.

    Photoshop and 3-D simulation give you the opportunity to tell us what you want, and get a better idea of what your results might look like. It also strengthens how you communicate with your doctor – in which he’ll be more clearly able to explain how your procedure will unfold.

    In the old days, we used to shape people’s nose by breaking it with a hammer and rasps into each nostril, and then shape the bones in your nose accordingly. Those days are long gone! Now we perform rhinoplasty in the patients with a straight septum and only a hook by using a micromotor or piezzo devices and high-resolution cameras by seeing clearly all the parts of the nose without breaking.

    The right method will give you the right results. Recovery now also takes much faster now than with surgeries that break your nose; and, you’ll experience far less swelling and ecchymosis.

    Piezzo is a very popular device that offers successful results. This device relies on ultrasonic vibration and allows the surgeon to perform micro-interventions – i.e. meaning high success rates in rhinoplasties as well! They’ve virtually replaced hammers and rasps.

    Piezzo requires minimal incisions, and both enables the surgeon to do more precise and neat work as well as offer them more control during the surgery. One no longer needs hammers or rasps, or to apply force to the nasal bone in order to make minor corrections. This lack of damage to your soft tissue drastically shortens your recovery time after the surgery, and lets you return to your normal life fast.

    Endoscopies give your doctor more control during your surgery and monitor every detail of your surgery with the help of two-dimensional and high-definition cameras.

    As with all forms of plastic surgery, likewise, choosing the right doctor to perform rhinoplasty on you is crucial. Your doctor should be a specialist in relevant branch of surgery; moreover, you should prefer reliable institutions and doctors.

    Every race has its own skin color, eye shape, cheekbone, lip fullness, nose, hair, and body structure, and particular set features. One’ nose and eyes are reveal what their race the most.

    Ethnic rhinoplasty aims to correct one’s nose deformations and design them a new nose that matches their face, whilst preserve their racial characteristics – to make them beautiful without harming their ethnic beauties.

    Thus, needs in ethnic rhinoplasty differ depending on their races and ethnicity. We can talk about numerous ethnic origins and races such as Caucasians, Middle Easterners, Latin Americans, East Asians, Afro-Americans, Australians, Africans, and Native Americans. For example, if you’re Asian, your needs for rhinoplasty, skin structure, skin color, skin thickness, facial structure, and expectations are going to be different than an African patient. The methods used to correct your issues are different as well.

    Caucasians: Caucasians ethnically and genetically hail from the Caucuses (north and south). They tend to have flat faces, broad cheeks, a light skin tone, brown eyes (in general), straight brown hair with a strong structure, and an eagle-like nose. When operating on them, we’d need to treat their intranasal bone and cartilage curvatures, remove excess bones, and design their nose around their existential features.

    Middle Easterners: The Middle East is an intercontinental region that broadly encompasses North Africa and Western Asia, including Arab countries and a part of Turkey. People from this region tend to come in a wide range of skin and eye colors. They are generally dark, have brown hair, and large and beautiful eyes. Their need in rhinoplasty is generally for eagle-like noses with breathing problems. Their nasal bone and cartilage curvatures need to be corrected and excess bones are removed so that their new nose matches their facial contours and symmetry.

    Latin Americans: Latin America refers to South American continent especially Cuba, Brazil, Argentina, Dominican Republic, where Romance languages are spoken, and surrounding countries. Latin women are famous for their hips, full breasts, dark skin, and attractiveness. They tend to have dark skin, full cheekbones, upright noses, and delicate face features. Their noses tend to be thicker skinned and more rounded than other races. When they want surgery, it’s generally to correct the tip of their noses, which tend to be too big in proportion to their faces.

    Asians: Asian people represent anyone hailing from countries such as China, Taiwan, Japan, and Korea. They have very distinct physical features: light skin color, slanted eyes, black straight hair, and flat and small noses. Their rhinoplasty needs are, like themselves, distinct. They may want to correct their small nose structure because it causes them discomfort, or makes their faces look flat and disproportionate. If they suffer from deformities in their noses, they are treated. Generally, surgeons would take cartilage from their ribs or another part of their body to reshape their nasal dorsum and tip – thus giving them a new nose based on their ethnic anatomy and face features.

    Afro-Americans: Afro-Americans carry genetics of their black African ancestors: dark skin color, curly hair, thick and full lips, and flat, wide noses. Their nose skin tends to be thick, which thus affects their scarring potential. Those who have rhinoplasties done may have their nasal dorsum and root lifted, and their nasal tip re-shaped and lifted. They may want their nasal wings narrowed too – which can pose a risk of scarring not to mention poor wound recovery. In these patients, surgery should be planned with the least scars.

    Australian Aborigines: Indigenous Australians make up 37% of Australia’s rich multicultural population. Aborigines, one of the oldest indigenous peoples of Australia, are famous for their dark skin, dark brown hair and eyes, heavy bone structure, thick skin, and wide distinctive noses. In rhinoplasty, a nose in harmony with their face should be designed by preserving their ethnic features of. It is not possible to obtain a thin nose due to the thick skin of their nose.

    Africans: Africans are renowned for their dark skin, hair, and irises, because it containing large amounts of melanin pigment. Their most distinctive features are prominent and strong jaws, thick and sagged lips, small ears, and excessively wide nasal bases and wings. Hereditary characteristics of ethnic origin reveal a general treatment principle in rhinoplasty surgeries. When planning rhinoplasty in black patients, the need for rib cartilage is reviewed, intranasal cartilage structure and nasal tip support are also evaluated. When designing African patients a new nose designed, surgeons should do so in a way that preserves their existential characteristics and respects their genetic background. For example, a black African patient and their white European counterpart are going to have different skin thickness, cartridge and bone structure, and nasal wing with – thus you can’t turn one into another. It would be wiser to give them a nose that is smaller and natural, and that matches their face.

    Native Americans: Native Americans are – as the name suggests – the indigenous peoples of North and South America. They are often the subject of films and legends. They’re known for their reddish-brown skin tone, unique lip structure, wide foreheads, distinctive cheekbones, and thin and sagging noses (especially as they age). When having a rhinoplasty done, the one designing their nose(s) should preserve their genetic features as much as possible, whilst repairing their bones and cartage from the inside– thus, making it more in harmony with the rest of their face.

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