Preoperative Evaluation in Rhinoplasty

Before consulting your doctor, who is going to perform your operation, it is very important for you to determine all your complaints that directs you to this surgery.

In addition to the problems that you will like to be corrected, determination of the presence of problem while breathing through the nose, nasal discharge, discharge to the nasal cavity and headache will help your doctor in determining and solving the other problems that are present in your nose region during this operation. You must discuss the problems that you determine and the changes that you would like to have with your doctor. The compliance of your expectations from the surgery with your present facial aesthetic proportions and your normal functions of the nose and the probability of meeting your expectations should be clearly expressed by your doctor.

In order to prevent the disappointment after the surgery will be possible by discussing these details thoroughly and with a mutual agreement with your doctor on the changes that will be performed during the surgery.

The performance of visual informing on the possible different results of the operation with digital imaging techniques on your pictures make it easy for you to decide the new shape of your nose. Today, rapidly developing medical technologies enable precise preoperative evaluations of existing problems; and at the same time, make it possible to obtain highly realistic 3D images of the possible end results of the intended interventions in the nose  and face.

Figure: Prediction of different results before the surgery facilitates deciding on the desired result and the operation is planned to achieve this result.

Though your evaluations are performed and your pictures are taken in vertical position before the surgery, performance of the operation in horizontal position, it may be difficult to decide on the amount of the tissue that will be removed also as a result of the injections and the skin edema that forms. Therefore, calculations of these measurements and planning the processes to be performed completely before the operation become very important for your operation to result as desired.

Sometimes the defects that the patient see as enormous may be corrected by a simple process, however, sometime a small defect may only be partially corrected with a long and difficult surgical intervention. Due to some factors like long duration of complete recovery, tissue properties of the patients, properties like healing of the wound, a minor corrective intervention may have to be performed following the completion of recovery at the rate of 5-15%.

In patients with fair skin and thin skin structure, if correction of advanced deformities and graft application is performed, the possibility of a second intervention increases; this possibility is quiet low in patients with not so thin skin and not having a conspicuous asymmetry in the nose. The most frequently seen problem in asymmetrical and deviated noses that are seen as “C” or “S” shape in the frontal view. This type of asymmetries may not be corrected completely due to obviously asymmetrical cartilages and bones in two sides of the nose and some amount of the curvature of the asymmetry may remain when the nose gets the final shape after the healing period. If the result is not satisfactory, the most appropriate approach is supporting the collapsed regions with cartilage pieces that are placed under the skin.

After the surgery, the nose that you will see when your cast and bandages are removed will not be the final result, the final result will form within 6-12 months, the fastest during the first 2-3 months according to the decrease in the edema. The duration for the nose to get its final shape is variable depending on the used surgical technique, the structure of nose skin and the type and amount of the grafts used (tissues like bone, cartilage that are added to the nose).