DEFINITION
Rhinoplasty is one of the most complex aesthetic surgeries to perform, but it is also one of the most beautiful, as it changes a part of the body that possesses essential aesthetic and social elements which are inextricably linked to a person’s respiratory function. It is therefore essential that the professional that performs this surgery controls not only its aesthetic aspects, but also the functional elements. It would be pointless to have a beautiful nose if it does not allow appropriate breathing.
Rhinoplasty consists of two parts:
- Aesthetics: Consist of changing the shape of the nose from an angular shape with less pleasing lines to a shape that better suits the patient’s appearance, with straighter or slightly curved contours, a finer and more defined nasal tip as well as a narrower base and nostrils. In order to achieve the above results, it is necessary to change all the nasal structures, such as the bones, cartilage and soft parts. But it is also essential to preserve the structures that are necessary for breathing, such as the ligaments.
- Functionality: Consists of changing structures, such as the septum, the concha or the nasal valves when they are not working properly and limit the passage of air through the nose.
In the majority of cases, a complete surgery is carried out, during which the aesthetics of the patient’s nose and the breathing are corrected at the same time.
Ultrasonic rhinoplasty is one of the newest techniques in rhinoplasty. It consists of using a piezoelectric surgical knife which breaks the bone in a very precise manner using ultrasonic vibrations without harming the surrounding soft structures. This avoids the use of hammers, scalpels, saws and chisels that are much more aggressive, which produce haematomas and often produce less precise results. As it does not puncture blood vessels, ultrasonic technology produces less bleeding. It also causes less inflammation and less damage to tissue, which results in milder post-operative symptoms without haematomas or pain and a faster return to one’s daily routine.
In addition to improving the post-op phase, it also improves the results obtained, as it enables very precise osteotomies (cutting of the bone) to be carried out , as well as perfect filing to be achieved, which was not possible in the past.
ADVICE
Any person who presents with a nasal shape that causes them personal discomfort or that affects their self-esteem, regardless of whether they have any type of breathing difficulty can have it corrected with surgery.
The patient must be healthy. Those with chronic pathologies that weaken their health are not eligible for aesthetic surgery. Furthermore, smokers must stop smoking a month before their surgery.
PROCEDURE
Rhinoplasty surgery causes little pain and, generally, does not involve a stay in hospital, although this is normally suggested for the patient’s comfort for some hours after surgery. The intervention is carried out under general anaesthetic and, on average, tends to take some 2 – 4 hours, depending on the difficulty of each case. We perform an open, structural and ultrasound rhinoplasty technique, in which a small incision is made in the lower part of the nose (columella) that, over a period of some weeks, will leave no visible mark. We do not use nasal plugs, so the patient will be able to breathe as soon as they wake up. In cases where a modification to the bone is required, a splint will be placed on the bridge of the nose.
PROFESSIONALS
This type of intervention should be carried out by a plastic surgeon with experience of rhinoplasty surgery. Dr Ospina has trained specifically in this type of surgery in Columbia, his country of origin, at the Clínica Planas in Barcelona, and he has completed a fellowship in Istanbul, Turkey with the renowned Dr Goksel.
In addition to his training, Dr Ospina works with a specialist in Otorhinolaryngology, thereby guaranteeing the correction of any respiratory problem the patient may have.
FACILITIES
This type of intervention should be carried out in a hospital that conforms to all health requirements as well as having an intensive care unit. Aesthetic surgery is very well regulated and there are very few complications, but in case these occur, it is essential to have the support of a good hospital. Low-cost surgeries save on this aspect and are carried out in small clinics where these safety conditions are not met.
Dr Ospina is fully aware of this and, because of this he performs all his surgeries in the operating theatres of the San Roque Hospitals, as this provides the additional safety that he wants for his patients.
CARE
After surgery, the patient will need carry out some basic care at home, such as the application of various creams, frequently washing both nasal cavities to prevent them becoming blocked or the formation of scabs. In addition, they should regularly change the plasters as instructed at their consultation. For the first week, they should sleep on their backs with the head of the bed raised.
RECOVERY
It should only take 7 days to return to a normal daily life. However, depending on your case, you should continue to use the plasters for a few more days. Re-adapting to sporting habits will also be required, and these should be reintroduced gradually after the first few weeks.
RESULTS
After 7-10 days, the splint will be removed and you will see a notable change in the shape of the nose. But although it will have been reduced by the ultrasonic technique, the residual inflammation process will prevent you appreciating many of the final details. The definition of the nasal tip tends to take several weeks or months to appear, particularly in patients with very thick skin. A reduction of the base of the nose tends to take a few weeks. To accelerate this process, it is essential to carry out lymphatic drainage massage, using a splint with plasters during the night and avoiding impact sports or substances that increase inflammation.
COMPLICATIONS
Although these are rare, they tend to be related to long-term inflammatory processes or changes to respiratory function that were not previously diagnosed or that were not corrected properly during surgery or that become worse after surgery.
“Rhinoplasty surgery is very demanding, as every millimetre counts and appreciably influences the final result. The surgeon conducting the procedure should have specialist and up-to-date training in this procedure, but should also be passionate about it in order to meet the challenges of each case.”
