Rhinoplasty is the surgical intervention that follows the modification of size and shape of the nose in harmony with the rest of face. Rhinoplasty can involve the whole nose or only a part of it, for instance, elimination of the nose hunch, decrease of the nose tip and nose enlargement for the improvement of in profile appearance by means of implants or grafts. By means of rhinoplasty they can be corrected the malformations or the posttraumatic defects.

On the first consultation, the surgeon establishes the extent in which the nose contour can be improved. It is very important to establish a possible associated pathology: personal or family history of long-lasting bleeding, especially of nasal bleedings, history of allergies, medicines abuse, chronic use of aspirin.

Rhinoplasty is one of the most difficult operation of plastic surgery, being a surgery carried out by blind approach in closed rhinoplasty. The final result is evident after months or even years, period in which the nose will endure permanent transformations. Pre-operative it must be carried out a detailed examination, including the anterior and posterior rhinoscopy in order to detect possible septum anomalies and nasal obstruction.

Rhinoplasty can be carried out as an inpatient or in outpatient procedure.

The operation can be performed under local or general anesthesia. In the operations under local anesthesia, only the nasal area will be anesthesized and the patient will be able to communicate all the time with the surgeon.

The operation consists in detachment of soft tissues on the osseocartilaginous skeleton, the modeling of the osseocartilaginous skeleton in order to obtain the desired shape. The rhinoplasty can be closed, the intervention being performed through incisions inside the nose (they heal with invisible scars) or open that supposes the presence of a minor scar at the base of the nose, the method being preferred to other complex operations.

Postoperatively, the patient can feel a nose pain or a deaf headache that can be controlled with medicines. The local cold applications and immobilization in bed with the head held in raised position control the oedema and implicitly the pains. It can be produced an oedema (swelling) that will reach the maximum the third day after surgery and a more or less degree of ecchymosis. Postoperatively, it is maintained a splint at the level of the nose and an endonasal plugging.

The patients subjected to a rhinoplasty surgery can return to their activities after a week. The doctor will also recommend for 1-2 months the respecting of some indications for avoidance of certain activities and exposure to certain environmental factors.

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