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 indicated 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 patient's wishes; clinical examinations to assess the patient's suitability for the intervention; a series of nose checks; a careful medical history; etc.
There are various surgical techniques for performing a rhinoseptoplasty.
At the end of the operation, hospitalization is scheduled for a maximum of one day.
The post-operative phase requires some attention from the patient. Complete recovery is quite a long process, generally taking a few months.
What is rhinoseptoplasty?
Rhinoseptoplasty is the rhinoplasty operation associated with the septoplasty operation.
Rhinoplasty is the cosmetic surgery operation practiced 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 reshaping of the nose.
Septoplasty, on the other hand, is the surgical operation, with an exclusively therapeutic purpose, which serves to correct the condition of a deviated nasal septum.
The 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 for rhinoseptoplasty are the same, respectively, as a simple septoplasty and a simple rhinoplasty.
As far as septoplasty is concerned, this is indicated for 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 breathing difficulties mentioned above;
- Repeated episodes of epistaxis;
- Xerostomia (or dry mouth).
As for rhinoplasty, this procedure is usually taken into consideration by people who have:
- An accentuated hump on the nose;
- The tip of the nose pointing downwards (aquiline nose);
- The nostrils very dilated.
Preparation
Preparation for rhinoseptoplasty involves:
- A meeting between the operating surgeon and the patient, in which the first will explain to the second all the characteristics of the intervention (pre-operative measures, stages of the actual procedure, related risks, etc.), while the patient will communicate to the doctor what is the " aspect that he would like the nose to assume, after aesthetic remodeling (sometimes, it is the plastic surgeon who proposes alternatives).
- A "survey on the patient's clinical history. Carried out generally during the doctor-patient meeting mentioned in the previous point, it involves a series of questions concerning: the drugs taken by the patient, his allergies to drugs, anesthetics or other, any present morbid conditions etc.
- A series of clinical tests, which serve to ascertain the patient's suitability for the rhinoseptoplasty operation. The tests in question include: a blood test, a urinalysis, an electrocardiogram and a blood pressure measurement.
- A series of specific examinations and checks of the nose (photographs, physical examinations, etc.). The doctor needs to analyze the nose, to understand the precise connotations of the deviation of the nasal septum and to establish precisely how to proceed with aesthetic remodeling.
REVIEW OF PRE-OPERATIVE MEASURES
Each surgery, including rhinoseptoplasty, involves a series of pre-operative measures, to which it is essential that the patient adheres to, so that the entire operation proceeds smoothly.
In anticipation of a rhinoseptoplasty, doctors recommend that patients:
- Discontinue any intake of 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.
Blood loss is expected from the surgical incisions of a rhinoseptoplasty, which, if antiplatelet 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 surgery, for a period of time of about two weeks. - Do not smoke (clearly if the patient is a smoker) during the entire post-operative recovery phase. In fact, cigarette smoke slows down and makes the healing process of the skin tissues and the inner lining of the nose less efficient.
- Present complete fasting for at least the previous evening, as local or general anesthesia is required, shortly before the operation.
- Be accompanied by a relative and a friend, for support when returning home, at the end of the procedure. This recommendation is explained by the fact that the effects of anesthesia and sedation (dizziness, confusion, etc.) persist for several hours after the operation.
Procedure
Rhinoseptoplasty combines the procedural features of a septoplasty with the procedural features of a rhinoplasty.
Shortly before the procedure begins, a specialist doctor must provide anesthesia to prevent the patient from experiencing pain during the operation. As stated, the anesthesia can be local or general. If it is general, the patient is completely unconscious.
SEPTOPLASTICS IN BRIEF
During a septoplasty, the operating surgeon makes an "incision" inside the nose, at a point where he has free access to the osteo-cartilage component constituting the nasal septum.
If the deviation of the nasal septum is slight, it carries out the straightening in place, that is, without removing the nasal septum from its original position.
If, on the other hand, the deviation is very accentuated, he is forced to divide the nasal septum into several pieces, temporarily remove them one by one and straighten them from the outside. Then, having concluded the external straightening, he re-inserts them in their original position, reconstituting the nasal septum. in full.
Once the surgeon has finished the operation on the nasal septum (whether the deviation is slight or severe), he applies sutures to the incision to close the wound and places plastic tubes inside the nostrils. , to promote sealing and keep the nasal septum straight during the healing period.
Figure: a nose before and after septoplasty
RHINOPLASTY IN BRIEF
The rhinoplasty operation 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 overturned and operated on the underlying cartilage 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.
The hospitalization ends when the effects of the anesthesia disappear. Generally, if the anesthesia was of the local type, the discharge takes place on the same day of the operation; if the anesthesia was of the general type, the discharge takes place. the day following the operation.
During the entire period of hospitalization, the medical staff keeps the patient under observation, subjecting him to periodic checks of vital parameters.
POST-OPERATIVE FEELINGS
After a rhinoseptoplasty, it is quite common for the patient to experience pain in the nose and suffer from bleeding or vomiting with blood.
Generally, for pain, doctors recommend analgesics such as acetaminophen.
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 treating physician. It serves to reduce the risk of bleeding;
- Don't blow your nose for any reason;
- Keep your head up while you sleep;
- Use comfortable clothes with front buttoning. Avoid clothes that slip off the neck.
SURGICAL HEALING (FIRST PHASE OF RECOVERY)
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 not particularly heavy work activity after 7 days.
COMPLETE RECOVERY
Generally, full recovery from rhinoseptoplasty takes 3 to 6 months.
In the most serious cases, however, it could happen after 12 months.
Risks and Complications
An individual who has undergone rhinoseptoplasty is at risk of:
- Hemorrhages;
- Infections;
- Adverse reactions to anesthesia;
- Persistence of the deviated nasal septum;
- Unwanted change in the shape of the nose;
- Septal perforation (opening of a harmful nature, at the level of the nasal septum);
- Reduced sense of smell;
- Nasal septal hematoma;
- Temporary numbness of the gingival and upper dental arch.
Some of the above complications (ex: 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 noted that the best benefits are obtained when the deviation of the nasal septum is mild and the remodeling of the nose is less elaborate."
Any failure of the rhinoseptoplasty requires the re-execution of the same operation.
