RHINOPLASTY - THE COSMETIC NOSE JOB

It warms it up and ensures that the air we breathe is sufficiently humidified so that the downstream airways - the throat, bronchial tubes and lungs - do not dry out. The consequences can be crusting and bruising, as can be observed in patients who have had a tracheotomy and have to breathe through a hole in the throat, a so-called tracheostoma.

Lack of nasal breathing - far-reaching problems

High airway resistance in the nose triggers predominant or exclusive mouth breathing. We know this from sport, when the body needs much more air than can get through the airways at that moment. If nasal breathing is permanently obstructed, this leads to chronic inflammation of the mucous membranes in the mouth, tongue, gums, larynx, trachea and lungs. In children who cannot breathe through the nose because of their large adenoids, discolouration or demineralisation of the incisors can be seen in addition to the raised upper lip, and because the protection provided by saliva is lacking, caries and bad breath are also frequent.

Odour impairment means a reduction in quality of life

Smelling can only take place adequately when the nasal flow profile is undisturbed. Entire professions depend on a good sense of smell (chef, sommelier, cosmetics industry, etc.), but we also associate a whole emotional world with olfactory experiences via our limbic system ("That's what summer smells like"). Smell restriction thus also means restricted emotional sensation and vibrational capacity. Perceiving smells is not only about sniffing out fragrances, perfumes and good food. We are warned of danger by the smell of fire and are glad if we notice dog excrement on the sole of our shoes in time before we carry it all over the flat.

Can someone accompany me?

Depending on the occupancy rate, the hospital also allows the partner to be admitted if this is desired. However, the costs of the hotel service are charged separately for this. However, this only applies if the hospital is not fully occupied by surgical patients. Government orders such as epidemic hygiene measures (e.g. Corona), which entail specific restrictions, can also limit these possibilities.

Can someone visit me in hospital?

Sollte der Eingriff nicht ambulant, sondern stationär durchgeführt werden, freut man sich über Besuch am Krankenbett. Dieser Besuch kann bereits am Abend des Operationstages erfolgen. Er sollte jedoch nicht zu lange dauern, da man nach der Operation in der Regel noch etwas müde ist. Massnahmen der Behörden, wie beispielsweise bei Corona, können allerdings das Besuchsrecht zum Schutz der anderen Patienten deutlich einschränken.

Scars, swelling or discolouration after rhinoplasty surgery

Depending on what the patient has agreed with the surgeon, the rhinoplasty operation takes place as a "closed technique" or as an "open technique". In the closed technique, the incisions are only made in the inner area of the nose, which is not visible to you. This means that no scar is visible during the healing process.
In the open procedure, a small incision is made at the bridge of the nose, which is usually barely visible after some time.
Swelling and discolouration often occur in the immediate post-operative phase. Cooling with ice usually reduces the swelling around the eyes considerably after 1 to 2 days and after a week it is practically no longer present. Discolouration, on the other hand, lasts the longest, although the body usually breaks down the haematoma well. After about 10 days, the skin colour returns to normal. Slight discolourations can also be concealed very well with opaque make-up.

What happens if I have to take blood thinners or other medication?

Taking blood thinners increases the risk of secondary bleeding and haematoma formation due to bleeding into the surrounding tissue. This results in swelling and discolouration. In order to reduce this risk, we recommend either discontinuing the anticoagulant substance for the duration of the operation or replacing it with a suitable preparation after consulting the respective family doctor or attending internist.
Be sure to talk to the surgeon and inform him if you have to take medication regularly because of other chronic diseases, e.g. diabetes, high blood pressure or seizure disorders.

Are tamponades or nasal plaster used during rhinoplasty surgery?

To stabilise the surgical result, it is necessary to fix the cartilaginous-bony structures in the desired position so that undisturbed healing can take place. We distinguish between internal and external stabilisation.
External stabilisation is done with thermoplastic, composite splints made of metal and foam. Alternatively, a plaster of paris is used, as it is known from splinting fractures.
The internal stabilisation is done with silicone or plastic splints, which are positioned on both sides of the nasal septum and are connected to each other by a holding thread and thus fixed. Often a breathing tube is also used, which enables free and unhindered nasal breathing immediately after the operation.

The breathing tube is often removed directly on the first post-operative day. Stabilisation of the nasal septum and external nose should be done for one week. After that, a plaster bandage is used for a few more days to reduce local swelling, for example due to lymphatic congestion.

They are thus protected by the splints from unintentional shape-changing contacts, such as accidentally bumping the nose against objects or when sleeping and turning over in bed, for as long as this is necessary due to the sensitivity of the nose. At the same time, immediate and trouble-free nasal breathing is guaranteed.

When will I see the final result of the nose surgery?

After about a week, the outer splint bandage of the nose is removed. At this point you can already see the basic features of the new nose shape, but the body still needs a few weeks for the swelling of the nose and midface to go down. It takes up to 6 weeks for the bone to regain its original strength. The formation and healing of scars, however, takes up to a year. Therefore, the result can usually only be assessed after a few months. In rare cases, an already good cosmetic result changes even further due to the body's build-up and degradation processes or due to scar traction, so that minor subsequent corrections may sometimes be necessary.