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How is rhinoplasty performed?

2022-04-24 18:54:12

Dr. Fariba Azadikhah
Reviewed by:
Dr. Fariba Azadikhah

Rhinoplasty or nose job is surgery to reshape the nose by modifying the bone or cartilage. The goal of a rhinoplasty candidate may be to change the appearance of the nose, improve breathing, or both.

The upper part of the nasal structure is bony and the lower part is cartilaginous. Rhinoplasty can change bone, cartilage, skin, or all three, depending on the features of your face, the skin on your nose, and what you want to change.

Let’s know how this procedure is performed!













Medications are prescribed for your convenience during surgery. Choices include local or general anesthesia. Your doctor will recommend the best choice for you:

Local anesthesia: If this is a light surgery, you will receive local anesthesia on your nose, which will also numb your face. you may get medication through an IV line that makes you lethargic, but you will still be awake.

General anesthesia: With general anesthesia, you inhale or receive medication through an IV that anesthetizes you. Children are usually given general anesthesia.



During the surgery



When the surgeon is severely anesthetized or anesthetized inside the nose or through a small external incision at the base of the nose, between the nostrils. The surgeon will probably reset the bone and cartilage under your skin.

Your surgeon can change the shape of your nose bone or cartilage in a variety of ways, depending on how much you need to remove or add.

For small changes, the surgeon uses cartilage taken deep inside the nose or ear.

 For larger changes, the surgeon uses rib cartilage, implants, or bones from other parts of the body.

 Finally, after making these changes, the surgeon puts the skin and tissue of the nose back and sutures the incisions in the nose.

If the wall between the two sides of the nose or the septum of the nose is bent, ie the nose deviates, the surgeon can also correct it to improve breathing.

After surgery, you will be taken to a recovery room. Staff at the recovery room will monitor your return to wakefulness. You will usually leave the same day, or if you have other health problems, you may stay overnight.








After the surgery



Internal dressings usually remain in place for one to seven days after surgery. The doctor will also attach a splint to your nose for protection and support, which is usually in place for about a week.

Mild treatments and mucosal treatments are common for up to a few days after surgery or after removing the dressing, so your doctor may place a "drip pad" of a small piece of gauze under your nose.


Let's learn about two types of rhinoplasty, open and closed :






Closed or endonasal rhinoplasty



You may be one of those people who are looking for a way to change your appearance without significant scarring. Closed or endonasal rhinoplasty is a cosmetic procedure in which incisions are made inside the nostrils and nostrils so that not many scars can be seen on the outside.


Closed rhinoplasty is commonly used to deform the tip of the nose, shorten the nose, or get rid of a bulge or hump on the back. The nose of the ideal candidate will be symmetrical. This type of rhinoplasty causes fewer changes than open rhinoplasty.



How much does closed rhinoplasty cost?



The cost of rhinoplasty varies depending on the surgeon and where you live and includes the cost of the surgery itself and other costs related to anesthesia and the operating room.


Cost of closed rhinoplasty in Iran



How does closed rhinoplasty work?



In closed nasal surgery, the surgeon makes all the incisions inside the nostrils. The nose does not open completely and the structure of the nose is not visible.

It will probably be performed under general anesthesia, and the doctor will make all the changes through narrow holes in each nostril, and the surgeon will have limited vision. In addition to the fact that the scar is not visible, closed nose surgery is relatively quick and does not lead to excessive swelling or prolonged healing.



open or external rhinoplasty



In open rhinoplasty or external rhinoplasty, a small incision is made in the columella (the soft tissue that separates the nostrils). While the patient is under general anesthesia, this technique allows easy access to the bone and underlying cartilage structure.







Preparation for external rhinoplasty



Topical and injectable tighteners are used before surgery. These should be inserted at least 10 minutes before incision to allow the arteries to contract sufficiently.

The vasoconstrictor is usually injected into the lower part of the nose and septum. The programmed incision in the columella is marked with a fine marker before injection.



external rhinoplasty steps



1. Using a fine marker, an incision in the columella is identified approximately at the junction between the proximal one-third and the distal two-thirds of the columella.


2. The surgeon makes an incision to expose the lower lateral cartilage.


3. The mucus is then cut.


4. Elevation is carried out between the perichondrium(Connective tissue that covers the cartilage of the nose) and the cartilage. 


5. The surgeon pierces the skin of the columella at the point previously marked "v".


6. The collar flap is lifted with a delicate skin hook.


7. The nasal septum is located between and behind the inner part of the lower lateral cartilage. The internal is revealed by separating the two crura (part of the columella).


8. The collar incision is closed first to ensure accurate alignment.

One or two absorbable sutures may be inserted into the nose to bring the mucosal edges closer together again.


9. A variety of external dressings can be applied. Most surgeons apply adhesive tape to the back of the nose after applying the adhesive to the skin. Usually, a rigid splint of some kind is used on the bar.







How much does open rhinoplasty cost?



The cost of rhinoplasty varies depending on the surgeon and where you live and includes the cost of the surgery itself and other costs related to anesthesia and the operating room.


Cost of open rhinoplasty in Iran

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