Aesthetic Nose Surgery

Brief Information:
Aesthetic nasal surgery is a procedure, which takes approximately 1.5 hour and is performed under general anesthesia. When there are no breathing problems previous to the procedure, tampons are not inserted.

If there are disorders hindering breathing like nasal septum deviation or chonca hypertrophy, a tampon is inserted postoperatively which will be removed two days later (the patient feels no pain when removing the tampon). One week after the procedure, the plastic splint which will be placed on the nose will be replaced by a small strip. Three days later, the strip also will be removed. There will be lividness and swelling around the eyes and the nose after the procedure. These spots and swellings will disappear in about 5 days. However, the patient will see a much better shaped nose after the splint of plaster has been removed, the new nose requires 2-3 months to swell down. After about 1 year the nose will reach its final shape.

Detailed Information about Nose Surgery
The nose is placed in a prominent position in the middle of the face and is very important for breathing and shaping the face. Every intervention to the nose must be planned and carried out very carefully. The following part is prepared to inform everyone's thinking about an intervention to their nose.

• You have to describe every detail of discomfort regarding to your nose. Discuss your problems of breathing; its relations to seasons, to activities, to sleep disturbances; and if it causes mouth dryness, headache, snoring, nasal discharge.
• Notify about experienced trauma, previous interventions and their dates.
• Define your particular discomfort of shape and your expectations.
• Afterwards, your doctor will perform your nasal analysis, investigation and will talk about the findings.
• Your Doctor will perform a graphic computer work about the planned shape and talk about the possible changes.
• Than, you will undergo some preoperative investigations including laboratory analyses to identify possible contraindications for the operation.
• Than, you will discuss about the operation where you will decide for general anesthesia (the patient is completely unconscious) or local anesthesia with sedation (the patient receives a sedative agent, which brings him/her to sleep during the operation and the nose is numbed by a local anesthetic). Your doctor will explain every detail to help you decide between the two methods.
• The duration of the operation will change according to the selected and pre-explained details, but will vary between 1.5 - 2 hours.
• When you wake up after the operation, you will recognize a plaster covering your nose, and partially your forehead and cheeks. Additionally you will have dressings with catheters in your nose, which will help you to breathe and swallow. You will receive intermittent cold dressings to limit the swellings in and around your eyes. The first hours after the operation are painless, but possibly you will have some nausea and dizziness. You will receive some appropriate medications to reduce these symptoms. 
• Four hours after the operation you will get aqueous foods and are allowed to walk.  
• You will be discharged in the afternoon, when the operation was performed in the morning or the next morning, when the operation was done in the afternoon.
• 48 hours rest after the operation and cold dressings which will be applied every second hour for 15 minutes to your forehead and cheeks which will help you to relief and to reduce swellings and lividness.
• The dressings and catheters in your nose will be removed two days after the operation. From the third day on the swellings and lividness in and around your nose will improve very fast and you will start to go back to daily life.
• One week after the operation, the splint or plaster on your nose will be replaced by a thin strip to prevent possible swellings on your nose. Also this strip will be removed after a week.
• After the operation you will get a list of things to do or not to do.
• After the strip is removed you will have the first basic impression of your nose, but the details will be visible in time. Especially during the first months your nose will swell in the morning and will improve throughout the day.
• Depending on the intensity and the technique used to shape the end of the nose, it will be partially numb and rigor. In some cases it will take months to relief.
• In the early period after the operation you have to prevent any trauma to your nose. For this reason any contact sport activities are inconvenient in the first 8 weeks. Also the uses of sauna and solarium have to be restricted. From the second week on, you can start with exercising, swimming and the other individual sports.
• The first days and weeks after the operation, breathing is not very comfortable because of the swelling and crusts in your nose. Prescribed medications will ease this feeling of discomfort.
• You will have control investigations on the first, third, sixth, and twelfth month after the operation to follow-up your recovery period. Photos of your nose took 6 months before and after the operation, which will be used to compare the results.

Possible Problems After the Operation
Like every other operation, this operation also can be complicated by some unwanted conditions. These can be divided into early and late term problems. Early term complications are often related to anesthesia. Any condition identified in the preparatory phase of your intervention can require advanced investigation or even delay of your operation. Because these interventions are not any case of emergency, all operational preparations are performed very carefully and no risks will be taken. After all, anesthesia has still a small risk to take. However, these risks are minimized due to up-to-date anesthesia opportunities. Nausea is frequently seen in the postoperative period, but is successfully treated and reduced with appropriate medication. In the first hours of the postoperative period we expect some leakage from the nose passages, but this can be controlled by an applied dressing. This bleeding is remarkable in the first hours and can last up to 24-48 hours, but decrease in time significantly. It changes its color from red to yellow in time.

• Patients with dressings in their nose have often the need to sneeze. Patients may think that they took cold, but this is due to the dressing and will resolve after removing the dressings.
• Although very rare, infection is one of the expected complications. A pre-medication with an appropriate antibiotic reduces this risk to a minimum. In case you have dressings in your nose and have signs of fever and/or shivering on the second day of your operation, please inform your doctor who will immediately remove the dressings. Also any sign of pain and/or swelling, and sensitivity on/in your nose or any feelings of weakness on the following days may be symptoms of an upcoming infection. In such case, your doctor will immediately complete your investigation and prescribe an appropriate remedy.
• Although removing the splint or plaster is a very easy intervention, it has to be done by the doctor. The splint or plaster is more an application to protect the new shape of the nose and prevent swelling rather than giving the nose its new shape. Also the applied strip after the splint or plaster has the same aim and prevents the swelling of the nose. Another problem in the early phase after the operation is unwanted traumas. Although mild traumas cause no severe problems, moderate to heavy traumas can lead to deformities of various degrees. In such a situation please contact immediately your doctor. Small and easy interventions are capable to correct these problems.
• Late term problems include respiration and appearance concerns. Respiration concerns are whether related to the operation performed, or are related to preoperative problems which are not recognized in beforehand or failed to correct during the operation and became manifest because of some certain maneuvers of the operation. Also allergic causes of respiration problems are frequent. After the investigation whether medical remedies or secondary interventions will be recommended according to your complaints.
• The most frequent complaint regarding appearance concerns in early phases are related to the new shape of the nose where the swellings and color changes of the skin are altering the real result. It is clear that the patient wants to achieve the expected results as soon as possible because these operations are related to cosmetic concerns. Unfortunately one should remember that the recovery period in these operations are relatively long and there may be various degrees of daily swellings for a long time. After the nose reaches its final shape in time a second investigation will be performed to identify if any additional corrective surgery is needed. These revisions are not more frequent than 5% of the patients. The best way of reducing the rates of revisions is to discuss in details the expectations of the patient and the possibilities of the operation in beforehand. In each case the anatomic and structural specifications of the nose can set some limitations on the outcome, which has to be discussed in details.