Generality
Rhinoseptoplasty is the rhinoplasty operation associated with the septoplasty operation.
Rhinoplasty has an aesthetic purpose and is suitable for people who are dissatisfied with the shape and appearance of their nose. Septoplasty, on the other hand, has therapeutic purposes and is suitable for people with a deviation of the nasal septum.
Rhinoseptoplasty requires some preparation; this preparation includes: a doctor-patient meeting, to discuss the characteristics of the intervention and the wishes of the patient; clinical tests to assess the patient's suitability for surgery; a series of nose checks; a careful medical history; etc.
There are various surgical techniques for performing a rhinoseptoplasty.
Once the operation is completed, a maximum of one day hospitalization is provided.
The post-operative phase requires some attention from the patient. Complete healing is a fairly long journey, which generally takes a few months.
What is rhinoseptoplasty?
Rhinoseptoplasty is the rhinoplasty procedure associated with septoplasty surgery .
Rhinoplasty is the operation of cosmetic surgery performed to meet the needs of those who are not happy with the shape and appearance of their nose. In other words, it is the aesthetic remodeling of the nose.
Septoplasty, on the other hand, is the surgical operation, with a purely therapeutic purpose, which serves to correct the deviated nasal septum condition.
Rhinoseptoplasty, therefore, is the surgical intervention, with aesthetic and therapeutic purposes, which serves to correct, at the same time, the imperfections of the nose and the deviations of the nasal septum.
uses
The therapeutic and aesthetic reasons of rhinoseptoplasty are the same, respectively, as a simple septoplasty and a simple rhinoplasty.
As far as septoplasty is concerned, this is indicated to all those subjects who, due to the deviated nasal septum, suffer from:
- Respiratory problems. They are the result of pathological obstructions due to deviations of the nasal septum;
- Sleep disorders. They depend on the aforementioned breathing difficulties;
- Repeated episodes of epistaxis;
- Xerostomia (or dry mouth).
As far as rhinoplasty is concerned, this procedure is usually taken into consideration by people presenting:
- A hump accentuated on the nose;
- The tip of the nose facing down (aquiline nose);
- Very dilated nostrils.
Preparation
Preparation for a rhinoseptoplasty procedure involves:
- A meeting between the operating surgeon and the patient, in which the former will present all the characteristics of the operation (pre-operative measures, stages of the actual procedure, connected risks, etc.), while the patient will inform the doctor which is the aspect that the nose would like to assume, after aesthetic remodeling (sometimes, the plastic surgeon proposes alternatives).
- A survey related to the patient's clinical history. Generally carried out during the doctor-patient meeting mentioned in the previous point, it includes a series of questions regarding: the drugs taken by the patient, his allergies to drugs, anesthetics or other, any morbid conditions present etc.
- A series of clinical tests, which serve to ascertain the suitability of the patient for the operation of rhinoseptoplasty. The tests in question include a blood test, a urine test, an electrocardiogram and a blood pressure measurement.
- A series of specific nose exams and checks (photographs, physical exams, etc.). The doctor needs to analyze the nose, to understand the precise features of the nasal septum deviation and to establish precisely how to proceed in aesthetic remodeling.
REVIEW OF PRE-OPERATIVE MEASURES
Every surgery, including rhinoseptoplasty, includes a series of pre-operative measures, which it is essential for the patient to adhere to, so that the whole operation proceeds for the best.
In anticipation of rhinoseptoplasty, doctors recommend that patients:
- Stop taking any antiplatelet drugs (aspirin) and anticoagulants (warfarin). This pre-operative indication is explained by the fact that the aforementioned drugs "dilute the blood" and therefore represent a factor favoring bleeding.
From the surgical incisions of a rhinoseptoplasty a loss of blood is foreseen, which, if anti-aggregating or anticoagulant drugs are taken, can be conspicuous and dangerous for the patient's health.
It is a good rule to avoid the aforementioned assumptions, both before and after the operation, for a period of time of about two weeks.
- Do not smoke (clearly if the patient is a smoker) throughout the post-operative recovery phase. In fact, cigarette smoking slows down and makes the healing process of skin tissues and the inner lining of the nose less efficient.
- Be present at full fast since at least the previous evening, as local or general anesthesia is provided, just before surgery.
- Be accompanied by a relative and a friend, to have support when you return home, at the end of the procedure. This recommendation is explained by the fact that the effects of anesthesia and sedation (dizziness, confusion, etc.) remain for several hours after surgery.
Procedure
Rhinoseptoplasty combines the procedural characteristics of a septoplasty with the procedural characteristics of a rhinoplasty.
Just before the procedure begins, a specialist doctor must provide anesthesia to prevent the patient from feeling pain during surgery. As stated, anesthesia can be local or general. If it is general, the patient is completely unconscious.
WEEKLY IN BRIEF
During a septoplasty, the operating surgeon makes an incision inside the nose, at a point where it has free access to the osteo-cartilaginous component constituting the nasal septum.
If the deviation of the nasal septum is slight, carry out the straightening in situ, ie without removing the nasal septum from its original position.
If instead the deviation is very accentuated, it is forced to divide the nasal septum into several pieces, temporarily remove them one by one and straighten them from the outside. Then, once the external straightening is finished, he re-inserts them in their original position, reconstituting the entire nasal septum.
Once the surgeon has finished the operation on the nasal septum (whether the deviation is mild or severe), apply stitches on the incision, to close the wound, and place plastic tubes inside the nostrils, to promote welding and keep the nasal septum straight during the healing period.
Figure: a nose before and after the surgery of septoplasty
RENEWAL IN BRIEF
The rhinoplasty procedure can be performed in two different ways: open or closed.
Closed rhinoplasty involves nasal remodeling, through an incision made inside the nose.
Open rhinoplasty, on the other hand, involves nasal remodeling through an external incision, made at the base of the nose, which allows the skin to be turned upside down and to operate on the underlying cartilaginous tissues.
After the rhinoplasty, the plastic surgeon applies a protective chalk on the back of the nose, which is removed 5-6 days after the operation.
Post-operative phase
At the end of the rhinoseptoplasty, hospitalization is expected.
Hospitalization ends when the effects of anesthesia disappear. In general, if the anesthesia has been local, the discharge takes place on the same day as the surgery; if instead the anesthesia was of a general type, the resignation takes place the day after the operation.
During the entire period of hospitalization, the medical staff keeps the patient under observation, subjecting him to periodic checks of vital signs.
POST-OPERATIVE SENSATIONS
After a rhinoseptoplasty, it is quite common for the patient to experience nose pain and a victim of bleeding or vomiting with blood.
Generally, for pain, doctors advise analgesics such as paracetamol.
POST-OPERATIVE INDICATIONS
Some common post-rhinoseptoplasty indications are:
- Using a decongestant eye drops;
- Antibiotic therapy lasting 5 days;
- Rest and abstention from heavy activities until otherwise indicated by the attending physician. It is used to reduce the risk of bleeding;
- Don't blow your nose for any reason;
- Keep your head high during sleep;
- Use comfortable clothes with front buttoning. Avoid clothes that stick from the neck.
SURGICAL HEALING (FIRST PHASE OF RECOVERY)
The healing of surgical wounds takes one or two weeks, depending on how invasive the operation was. Thanks to modern surgical techniques, a patient undergoing rhinoseptoplasty can return to a job that is not particularly heavy even after 7 days.
COMPLETE RECOVERY
Generally, complete recovery from a rhinoseptoplasty procedure takes 3 to 6 months.
In the most serious cases, however, it could happen after a good 12 months.
Risks and Complications
An individual undergoing rhinoseptoplasty is at risk of:
- Bleeding;
- Infections;
- Adverse reactions to anesthesia;
- Persistence of the deviated nasal septum;
- Unwanted change of nose shape;
- Septal perforation (opening of an injurious nature, at the level of the nasal septum);
- Reduced sense of smell;
- Hematoma with nasal septum;
- Temporary numbness of the upper gum and dental arch.
Some of the aforementioned complications (eg persistence of the deviated nasal septum, unwanted change in the shape of the nose) may require a second nose surgery.
Results
Currently, rhinoseptoplasty is a surgical operation that provides excellent results. However, it should be pointed out that the best benefits are when the deviation of the nasal septum is slight and the remodeling of the nose is less elaborate.
A possible failure of the rhinoseptoplasty requires the re-execution of the same operation.
