When to have surgery?
For congenital deformities, surgery is best done after 20 years of age, when the formation of the bone and cartilaginous base of the nose is completely completed. The ideal age for surgical correction is from 20 to 35 years, when the osteochondral nasal frame is already fully formed and the skin is still elastic enough to accept and maintain the new corrected shape of the nose.
In any case, the operation is performed no earlier than 18 years, when the formation of the bone structure of the nose is completed.
Acquired nasal deformities leave no choice - surgery is performed when the need arises and the patient’s general condition allows.
Operation
Surgical rhinoplasty is performed under local or general anesthesia. The choice of pain relief method depends on the extent of the intervention. The decision is made by the surgeon and anesthesiologist.
Most often, rhinoplasty is performed in a closed manner, since it gives a more aesthetic result (all incisions are hidden).
Closed rhinoplasty
The incision is made in the nasal cavity, on the mucous membrane of the nostril, so no traces of surgical intervention remain on the outside.
Through the incision(s) made, the surgeon peels away the skin from the cartilage and bones of the nose. Then he carries out the planned correction on the osteochondral frame of the nose, removing excess, or changing the shape, increasing the volume with cartilage taken from another place in the patient, or restoring lost tissue with an endoprosthesis. The skin returned to its place takes root, gradually taking on a new shape of the nose.
Open rhinoplasty
Incisions are made in the nasal cavity along the edge of the nostrils (as with a closed approach), as well as in the lower part of the nose along the columella - the skin part of the septum between the nostrils. Then everything happens in the same way as during a closed operation - peeling of the skin and corrective actions by the surgeon.
With open access, any parts of the nose can be corrected, so if more massive interventions are needed, as well as for revision rhinoplasty, this access is used. The suture after the operation is almost invisible. However, recovery time and the risk of postoperative complications are slightly higher with the open approach.
The duration of the operation is usually 1-2 hours, depending on its complexity.
Reviews from my patients
You can not like yourself for a long time, looking in the mirror, listening to soothing tirades about how this is your “highlight” and so on, or you can finally decide to have surgery and change the quality of your life for the better! More precisely, in such a way that even before the operation it was impossible to imagine: what it would be like to look in the mirror and see a perfect nose, a harmonious face and say to yourself “what a beauty”! This is what happened in my case. It was easy for me to decide on the operation, since our nose of impressive size runs in the family, and my mother and aunt had it redone at one time. It was my turn - I just had to choose a surgeon. And whoever says it, this is the most difficult part of a big job called “rhinoplasty”. I was doubly lucky - my friend, Maria Vaganova (you can also read her review on the website), was the first to find and undergo rhinoplasty with Alexander Vitalievich - and, one might say, inspired me by personal example. Having seen “live” how incredibly neat and harmonious Maria’s nose turned out to be, and also having studied Alexander Vitalievich’s gorgeous portfolio, I realized that I had almost found the surgeon, all I had to do was come for the first consultation) While I was studying all of Alexander Vitalievich’s works, I realized that if a person approaches filling out his portfolio so carefully and competently, it means that whatever he does, he does it with quality. He is a fan of his work and tries to bring every job to perfection. Each “nose” is like new material for him to create another (I’m not afraid of this word) Masterpiece. Alexander Vitalievich, as a sculptor, sculpts truly elegant noses, each of which harmonizes with the face of the “mistress” so much that it seems that a person should have been born with such a nose! And yet, what was a plus for me is that a certain handwriting is already visible, which speaks of the high professionalism of the Surgeon. Alexander Vitalievich has “Golden Hands” - and everyone talks and writes about it for a reason! As for the operation itself: everything happened very quickly, at the first consultation we immediately set the date for February (a month in advance). Most of all, I was afraid of anesthesia, since it was the first experience in my life, however, I would especially like to thank the anesthesiologist Lina Vladimirovna - she not only calmed me down before the anesthesia, but also described the whole process in such detail, answered all my questions, that curiosity set in) the operation went well, there was almost no recovery from anesthesia, since after the operation they give maintenance drips, which contribute to a quick “recovery”. The first three days the swelling on the face increased, then everything began to quickly subside. What was very pleasing was that there were no hematomas at all. At the time the plaster was removed (after 7 days), only small swelling remained on the face under the eyes, but in general the face was already more or less normal) After 2.5 weeks, I was walking as if there had been no operation! Another advantage of Alexander Vitalievich is that he treats not only “noses”, but also the patients themselves in such a way that it seems that you are the only one with him (although this is absolutely not the case =)))) But the attention that you receive during the rehabilitation period – it gives strength and a good mood – which is no less important after such serious interventions! Alexander Vitalievich answers absolutely all questions, personally examines, removes plaster, applies bandages - takes photographs and charges with positivity))) To say that I was satisfied is to say nothing! I wish Alexander Vitalievich to reach all the heights that he desires! Because professionalism at this age, coupled with “golden hands”, is a gift. (www.medgel.ru)
… / 04.04.2017
After operation
In the hospital
After the operation, the patient is in the comfortable conditions of the surgical hospital of the Yauza Clinical Hospital. At his service:
- 1-2 bed rooms with all amenities (functional beds, shower, individual TV),
- 24-hour medical supervision,
- nutrition, taking into account the doctor’s recommendations.
- Each patient has an individual vital signs monitor.
The patient is usually discharged from the hospital on the 3rd day after rhinoplasty.
Rehabilitation period
- After rhinoplasty surgery, swelling occurs in the nose and around the eyes, which can last 10-20 days, and sometimes longer.
- There are tampons in the nose (for up to 3 days, as determined by the doctor), so you need to breathe through your mouth for some time.
- Usually the postoperative period is painless.
- If bone grafting was performed, it is necessary to wear a plaster cast for a week. After removing the plaster, you must visit a doctor at the frequency indicated by him for examination. You can usually return to work 2 weeks after the cast is removed.
The healing period largely depends on the individual characteristics of the body and the age of the patient, so the doctor can only give an approximate duration of rehabilitation. Typically, complete recovery takes 6-8 months.
Not possible after rhinoplasty
- After rhinoplasty, it is recommended to limit physical activity for 2-3 months.
- Since in the first weeks the nose is still weak and easily injured, it is recommended to stop wearing glasses for a while.
- In order not to provoke nosebleeds, it is recommended to exclude too hot and too cold foods from your diet.
Result
The results of rhinoplasty should be assessed no earlier than 6 months after the operation, when the swelling has completely gone away, the sutures have healed, and all traces of the operation have disappeared. The final outcome of the plastic surgery can be assessed only 8-12 months after the operation.
Nose surgery. Before and After Photos
The operation was performed by an otolaryngologist surgeon of the highest qualification category, I.A. Usachev.
Reviews about rhinoplasty and doctors
S.A. about the operation with Dr. Usachev I.A.
“I never thought that my zigzag snout would become like this, the operation got rid of a bunch of complexes.”
R.Z. about the operation with Dr. Usachev I.A.
“I would like to express my deep gratitude to Dr. Igor Anatolyevich Usachev for his professionalism and the operation performed! I came in with a problem of a deviated nasal septum. The problem that tormented me was frequent difficulty breathing. A septoplasty and vasotomy operation was performed. The operation took place a month ago and I already feel how easy it is for me to breathe. Igor Anatolyevich, thank you! And also thanks to all the medical staff for the high service and pleasant conditions.”
E. about treatment with Dr. Usachev I.A.
“Wonderful doctor! Highly recommend! Been to several ENT specialists before him. The only doctor who tried to find the cause of the problem, and found it! I am incredibly grateful to him! Master of his craft!!”
ALEXANDER GLUSHKO
You can not like yourself for a long time, looking in the mirror, listening to soothing tirades about how this is your “highlight” and so on, or you can finally decide to have surgery and change the quality of your life for the better! More precisely, in such a way that even before the operation it was impossible to imagine: what it would be like to look in the mirror and see a perfect nose, a harmonious face and say to yourself “what a beauty”! This is what happened in my case. It was easy for me to decide on the operation, since our nose of impressive size runs in the family, and my mother and aunt had it redone at one time. It was my turn - I just had to choose a surgeon. And whoever says it, this is the most difficult part of a big job called “rhinoplasty”. I was doubly lucky - my friend, Maria Vaganova (you can also read her review on the website), was the first to find and undergo rhinoplasty with Alexander Vitalievich - and, one might say, inspired me by personal example. Having seen “live” how incredibly neat and harmonious Maria’s nose turned out to be, and also having studied Alexander Vitalievich’s gorgeous portfolio, I realized that I had almost found the surgeon, all I had to do was come for the first consultation) While I was studying all of Alexander Vitalievich’s works, I realized that if a person approaches filling out his portfolio so carefully and competently, it means that whatever he does, he does it with quality. He is a fan of his work and tries to bring every job to perfection. Each “nose” is like new material for him to create another (I’m not afraid of this word) Masterpiece. Alexander Vitalievich, as a sculptor, sculpts truly elegant noses, each of which harmonizes with the face of the “mistress” so much that it seems that a person should have been born with such a nose! And yet, what was a plus for me is that a certain handwriting is already visible, which speaks of the high professionalism of the Surgeon. Alexander Vitalievich has “Golden Hands” - and everyone talks and writes about it for a reason! As for the operation itself: everything happened very quickly, at the first consultation we immediately set the date for February (a month in advance). Most of all, I was afraid of anesthesia, since it was the first experience in my life, however, I would especially like to thank the anesthesiologist Lina Vladimirovna - she not only calmed me down before the anesthesia, but also described the whole process in such detail, answered all my questions, that curiosity set in) the operation went well, there was almost no recovery from anesthesia, since after the operation they give maintenance drips, which contribute to a quick “recovery”. The first three days the swelling on the face increased, then everything began to quickly subside. What was very pleasing was that there were no hematomas at all. At the time the plaster was removed (after 7 days), only small swelling remained on the face under the eyes, but in general the face was already more or less normal) After 2.5 weeks, I was walking as if there had been no operation! Another advantage of Alexander Vitalievich is that he treats not only “noses”, but also the patients themselves in such a way that it seems that you are the only one with him (although this is absolutely not the case =)))) But the attention that you receive during the rehabilitation period – it gives strength and a good mood – which is no less important after such serious interventions! Alexander Vitalievich answers absolutely all questions, personally examines, removes plaster, applies bandages - takes photographs and charges with positivity))) To say that I was satisfied is to say nothing! I wish Alexander Vitalievich to reach all the heights that he desires! Because professionalism at this age, coupled with “golden hands”, is a gift. (www.medgel.ru)
… / 04.04.2017
Contraindications for rhinoplasty
- Age under 18 years. The exception is injury. Then nose surgery is possible with the written consent of the parents
- Age over 40 years. The reason is a decrease in skin elasticity, regenerative abilities, increased risk of complications
- Decompensated diseases of the heart and blood vessels (ischemic heart disease, heart failure, hypertension), liver and kidneys
- Diabetes
- Oncological pathology
- Acute viral infections
- Mental illness
- Inflammatory skin diseases in the area of the planned operation (acne, etc.)
- Bleeding disorders
