Rhinoplasty traces its roots back to ancient Egypt and India circa 3000 B.C. An Indian Ayurvedic physician named Sushruta recorded reconstructive surgery methods in the Sushruta Samhita. It was not until the 19th century that modern rhinoplasty began to take shape. Credit for the first modern closed rhinoplasty is given to an American otolaryngologist, Dr. John Orlando Roe, in 1887. With refined techniques and technologies of the 20th century, more diverse and accurate ways of reshaping noses were enabled.

Cosmetic Rhinoplasty

Primary Rhinoplasty

This surgery is made to modify the nose for aesthetic appearance. It is often done to decrease the size of the nose, change the shape of the nasal tip, lessen the width of the nostrils, or improve the angle between the nose and upper lip.

Revision (Secondary) Rhinoplasty

This is performed to correct or improve the result of a previous rhinoplasty. This operation is generally more difficult due to the existence of scar tissue and other changes from the initial surgery.

Functional Rhinoplasty

Septoplasty

This is done to correct the deviation in the nasal septum, which hampers breathing. The nasal septum is straightened in this operation to improve airflow.

Turbinate Reduction

This procedure works to shrink the size of enlarged turbinates that may block nasal airflow. The expected outcome of this procedure is smooth breathing.

Ethnic Rhinoplasty

This refers to various ethnic rhinoplasty procedures tailored to preserve these unique features of different ethnic groups while achieving the desired aesthetic outcome. These surgeons take into consideration various anatomical differences in relation to cultural traits that provide a more natural look.

Open Rhinoplasty

This is done by making an incision across the columella, which is that thin wall of tissue separating the two nostrils. This gives the surgeon good vision and access to the structures of the nose. It is thus usually indicated when more complicated cases occur where a lot of reshaping has to be done.

Closed Rhinoplasty

In this, all the incisions are given inside the nostrils, and therefore no scars are visible afterward. This is thus done for less major procedures and gives quicker recovery.

The choice between the two techniques depends on the complexity of the procedure and the surgeon's preference.

Cosmetic Reasons

• Harmonize Face: Reshaping size, shape, or proportions of the nose to create a more symmetrical and pleasing face.
• Asymmetry Correction: Congenitally or due to injury, reshaping for a more symmetrical look.
• Refine Nose Tip: A bulbous, droopy, or excessively upturned nose tip is modified to an individual's desired shape.
• Nostril Adjustment: This would include shrinking wide nostrils or correcting the shape of the nostrils.

Functional Reasons

• Improve Breathing: straightening out the structural problem – for example, a deviated septum or nasal valve collapse – that is obstructing the airflow.
• Repair Injury: sorting out nasal fractures or other external nasal deformities caused by injury.
• Resolve Congenital Issues: sorting out congenital abnormalities of the nose that affect its function or appearance.

Consultation

During the first consultation, the surgeon will:

• Discuss Goals: Understand the motive behind rhinoplasty and what exactly one is expecting after the procedure.
• Medical History: Go over previous surgeries, allergies, or any medical problems that may be represented in the anamnesis of the patient.
• Physical Examination: Detailed examination of the internal structures of the nose and of facial harmony in general.
• Photo graphs: for preoperative analysis and postoperative comparison, take photos of the nose from different angles.
• 3D Imaging: in selected cases, 3D imaging can be performed using software to simulate possible results and help the patient visualize the changes.

You are entitled to an initial on-line pre examination with your  Wellcome  Healthy Life Consultant.

Preparation

Preparation for rhinoplasty involves some measures to ensure safety and optimization of outcomes. These involve the following:

• Medical Evaluation: This includes necessary medical clearances and lab tests.
• Medication: Avoid taking medications, including supplements, which may add to the risk of bleeding, such as aspirin and anti-inflammatory drugs.
• Smoking: Do not smoke since this may impede the process of healing.
• Instructions: This encompasses fasting, and also preoperative instructions concerning medications on the day of surgery.

Selecting a qualified and experienced surgeon is crucial for achieving desired results and minimizing risks. Consider the following factors:

• Board Certification: Doctor should be board-certified in plastic surgery or facial plastic surgery.
• Experience: There is lots of experience on the part of the surgeon operating on rhinoplasty.
• Before-and-After Photos: These should be studied to have an idea of the surgeon's work.
• Patient Reviews: Review the feedback and testimonials of previous patients. Comfort Level: Call a surgeon in whom you feel comfortable discussing your goals and concerns.

Anesthesia

Rhinoplasty may be performed with either local anesthesia with sedation or general anesthesia, depending on the complexity of the surgery as well as the preference of the patient.

Surgical Steps

1. Incisions: The surgeon makes the necessary incision based on whether the method is open or closed.
2. Reshaping the Nose: The cartilage and bone are meticulously reshaped. There may be removal, addition, or rearrangement of tissue.
3. Correcting Deviations: In the event of any functional issues, such as a deviated septum, these are corrected to improve breathing.
4. Closing Incisions: Incisions are carefully closed with sutures. In open rhinoplasty, the external incision is stitching with fine sutures in order to reduce scar formation.
5. Stabilizing the Nose: A splint is fitted to support its new shape during the initial phases of healing.

Duration

The duration of the surgery ranges from one to three hours depending on the complexity.

Conclusion

Rhinoplasty may be a life-changing surgery with regard to aesthetics and function. Types of rhinoplasty, the reasons for it, and what to expect in the phases of consultation, surgery, and recovery are important in decision-making. Proper selection of a skilled surgeon and adherence to pre- and postoperative care will give the patient the satisfaction of a result: an improved quality of life.

Rhinoplasty should be done with realistic expectations and understanding of the surgery, be it aesthetic, functional, or both.