Considered the most artistic, the most difficult and most complex aesthetic plastic surgery, Rhinoplasty or Nose Plastic Surgery has a high degree of complexity. Reshaping the nose, reducing or increasing its size, changing the shape, lowering the nostrils, or changing the angle between the nose and upper lip requires the surgeon to have a great deal of artistic sensitivity and ability to operate with millimeter measurements.
Over the years, several highly sophisticated techniques have been developed to tailor the nose shape to the individual face characteristics of each patient. Currently, Rhinoplasty has as basic principle the construction of a nose that is beautiful, functional, proportional to the face and individual for each patient.
Because it occupies the central region of the face, the nose has a strong relationship with the other structures of the face and any slight aesthetic change can result in major facial changes. In addition to giving the patient a more beautiful appearance, the surgical procedure may also correct nasal defects, sequelae of accidents or previous surgeries.
Mathematical and detailed studies are done by the plastic surgeon taking into account the proportions of the nose in relation to the face of the patient to be operated. The surgical planning of rhinoplasty is done based on the results obtained and according to the aesthetic sense of the doctor. This planning system avoids the “old” model of surgery, where all noses were made from the “same mold and size.”
Today, with all the evolutions of studies and refinements of techniques, we can perform a specific surgery for each “type” of face, so that the nose is proportional and harmonic. One of the functions of modern surgery is to model the nose proportionally to the face.
A good example of a big nose, beautiful and proportional to the face is the model Gisele Bündchen. Considered one of the most beautiful women in the world, she has a large but proportionate and harmonious nose to her face. If we put the same nose on someone else, we would certainly leave many patients dissatisfied. What if Gisele Bündchen herself had a small nose? Most likely your beauty would not be the same.
Rhinoplasty can provide truly rewarding results to the patient as long as expectations regarding surgery are realistic. Before undergoing plastic nose surgery, the patient should thoroughly discuss their expectations with the surgeon, who will explain the details and limitations of the procedure.
Most people looking for rhinoplasty are young and female. The number of men seeking surgery has increased over the years and now accounts for 30% of patients. The interest of the adolescent by the subject is justified because it is in that phase of the life that significant changes of personality occur. The age at which self-esteem needs to be strengthened so as not to create future recantations or shame.
It should be noted that patients under 15 years of age can not undergo surgery. Before that age the bony and cartilaginous structures of the nose and face are not yet fully developed. In addition, the emotional structure to cope with the change of appearance caused by Rhinoplasty usually arrives after this age group.
In nose surgery, the cartilage and bones that form the skeleton of the nose are sculpted according to the characteristics of the nose and face of the patient. It is almost always necessary to use cartilage grafts (removed from the nose or ear) to correct contour changes and strengthen the remaining skeleton. It is up to the surgeon to position the cartilages millimetrically to model the nose. In cases where there is difficulty breathing, it may be necessary to correct deviations of the nasal septum and other structures that form the pathways responsible for the passage of air.
There are two ways to perform nose surgery: open or closed. In closed surgery an internal incision is made and no scar is visible on the outside. In open rhinoplasty, the incision is performed in the columella, but the cut is small and over the months the scar becomes almost imperceptible. It is through these incisions that the surgeon accesses the nasal structure to sculpt, shape and reposition the nose to the desired position and shape.
The postoperative of nose plastic surgery should be taken seriously so that the final result is not compromised. The patient should abide by all medical recommendations and accomplish all the follow-up, since any manipulation of undue force in the nose during the healing period can lead to displacements of the structures (which are millimetrically positioned during surgery to model the nose) and cause depressions and / or irregularities in the nose.
The major enemy of rhinoplasty is fibrosis, which forms after surgery and tends to pull cartilage and / or cause contour deformities. To minimize this risk, it is important that the physician knows how to use the correct techniques to avoid the deleterious effect of fibrosis, but even so, it is important to note that each organism responds in a way, and this is beyond the control of the surgeon.
The happiest patients performed with surgery are those who understand and understand that the body assumes its function as soon as the surgery ends and that, regardless of the technique used by the surgeon, sometimes some changes occur due to the normal healing of the body.
With 19 years of medical training, with 17 of them dedicated to Rhinoplasty and Face, Dr. Rodrigo Mangaravite has in his curriculum more than 500 noses operated in practical classes that he teaches as a Post-Graduation Rhinoplasty Professor of the Santa Casa de Rio de Janeiro.
Specialist in plastic surgery by the Brazilian Society of Plastic Surgery (SBCP) and by the Brazilian Medical Association (AMB), Dr. Rodrigo Mangaravite integrates the main plastic surgery societies of Brazil and the world. In addition to being a full member of SBCP and the Ibero-American Federation of Plastic Surgery, he is a member of the American Society of Plastic Surgeons and an active member of the International Society of Aesthetic Plastic Surgery and the International Plastic Reconstructive Aesthetic Surgery. He is also the author of the book O Que A Cirurgia Plástica Pode Fazer Por Você.
Dr. Rodrigo Mangaravite operates only in hospitals that offer all the securities that Rhinoplasty (or any surgical procedure) requires.
It is good to know that no medical agreement offers coverage for cases of purely cosmetic nose surgery. If there are functional problems (which must be documented through appropriate examinations), some covenants bear the costs of this part of the surgery, which usually corresponds to 50% of hospital costs. There are also covenants that offer certain reimbursements to patients for the functional part of the surgery.
Some exams must be performed prior to Rhinoplasty: chest x-ray, electrocardiogram, blood tests (blood count, coagulation, electrolytes, renal function etc.) and, if there are respiratory symptoms, a CT scan of the nasal bones and sinuses .
Drawings or photos can be brought and shown to Dr. Rodrigo Mangaravite. For ethical reasons, the patient is informed that these tools are only a sample and do not constitute a promise regarding the result. Medicine is not an exact science and every organism reacts in a way, but if doctor and patient agree, the picture can be taken to the operating room to serve as a reference. Dr. Rodrigo will perform the surgery with all the attention to reach the best possible result. While this does not happen, the surgery will not be terminated.
Feeling good about one’s image is what the whole human being wants. Being able to look at the mirror and enjoy the reflected appearance is undoubtedly a great stimulus to raise the self-esteem of anyone.
Well-done nose surgery improves facial harmony significantly. The beauty of the face “hidden” by the nose before Rhinoplasty is seen more clearly after the surgical procedure. Almost everyone who undergoes Rhinoplasty reports feeling more beautiful and confident in professional and social relationships with the “new” nose.
Patients seeking plastic nose surgery with complaints related to respiratory problems also report a remarkable improvement in quality of life when surgery can restore the integrity of the airways.
Rhinoplasty or plastic nose surgery is considered one of the most challenging procedures within plastic surgery. It requires the surgeon a high degree of surgical ability and artistic sensitivity to plan and sculpt the nose in harmony with the face and thus preserve the naturalness. There is no ideal nose model. Plastic Surgeon Rodrigo Mangaravite explains that each case of plastic nose surgery is studied in detail and that expectations and limitations are discussed with the patient. Surgeon and patient should always agree on the possible outcome to be obtained.
Rhinoplasty can decrease or increase the size of the nose as well as the shape of the tip or the bulging on its back. If there are changes in breathing due to an internal problem (septum, sinuses and turbinates), the problem can be corrected at the same time.
Rhinoplasty takes one to three hours, depending on the complexity of the case. It is worth mentioning that Dr. Rodrigo performs all his surgeries with all possible attention and calmness. Following an individualized surgical plan minutely for each patient, using all their technical capacity and resources to arrive at the best possible result, and only then, the surgery can be finished. Dr. Rodrigo only leaves the surgical center when he is sure that he has reached the maximum, the desired result.
It is usually from 12h to 24h. In the simplest cases of nose plastic surgery, the patient gets in the morning, is operated on and can return home the same day. In other cases, you will be hospitalized for one day. You have to keep your nose stuffed, breathing through your mouth, like a cold and stuffy nose, from one day to the next. The next day, the cap is removed and the patient breathes normally through the nose.
Rhinoplasty needs a very special Post-operative and some care is of utmost importance for the final result. The patient should abide by all medical recommendations and follow all the follow-up, since any manipulation of undue force in the nose made during the healing period can lead to displacements of the structures, which are millimetrically positioned to shape the nose and cause depressions / e or irregularities On the nose.
There is an initial discomfort due to edema (swelling) in the region. Usually, the area becomes swollen more intensely in the first three days after rhinoplasty, especially in the region around the eyes. Do not worry.
After the third day, this edema diminishes. It is common that in the morning the swelling is greater, tending to regress during the day. The edema also occurs in the inner part of the nose, and with that the breathing can be difficult in the first week. The nose is a little congested, with symptoms similar to a cold, sometimes presenting a slight coryza and obstructed nose.
It is normal and tends to regress over time. To facilitate breathing by clearing the nose, it is recommended to drip physiological saline at will or apply nasal drops to the nostrils.
Small bleeding can occur within the first three days after rhinoplasty. If present, rest with your head elevated and insert a small piece of cotton wool soaked in hydrogen peroxide into the bleeding nostril. If bleeding persists or increases, call your doctor.
In the first postoperative week, you will have a plaster bandage covering your nose. It can not be wet. Take a shower normally, but be careful not to wet the plaster. In the second week, a lighter, more discreet micropore (skin color tape) dressing is placed, which remains until the 14th day. The nose should be carefully cleaned with cotton swab soaked in hydrogen peroxide to prevent buildup of crusts that may make it difficult to breathe. The hygiene of the face can be made with moist tissues. For oily skin patients, oils are recommended.
Avoid talking and smiling in excess to avoid swelling. The lips may become dry due to mouth breathing. For your comfort, use cocoa butter or another lip moisturizer. Avoid foods that are difficult to chew. Try to make a nutritious and non-greasy food. Do not drink alcohol in the week after plastic surgery of the nose since alcohol can increase edema.
It is recommended to sleep belly up. Sleeping on one side can leave one side more swollen than the other. If this occurs, do not worry, as the result of the surgery will not be harmed. Do not take sun for one month after the rhinoplasty or while there are purple spots. The glasses can be used after medical release.
Sexual intercourse should be avoided during the first week because of the risk of bleeding and trauma. Do not make any significant physical effort in the first week after plastic nose surgery. Physical exercises will only be released after 20 days or depending on your recovery, at medical discretion. Avoid driving the first week.
Plastic Surgeon Rodrigo Mangaravite explains that nose surgery usually does not hurt. There is discreet discomfort when moving the head and opening the mouth. There may also be numbness in the upper teeth. If you feel pain, it is recommended to use an analgesic. It is essential that the motivation for rhinoplasty is for the person himself and not for external imposition.