Nose surgery (rhinoplasty)

There is no unique method for rectification of each nose. Nose surgery is one of the most challenging procedures in plastic surgery of the head and neck. Knowing specific problems of each individual and applying different methods is the only way to achieve optimal results: good functionality of the nose, which ensures normal breathing, harmonious overall appearance of the face and the satisfaction of the patient.

Today's approach to rhinoplasty is different than it was before, and the nose is not viewed in isolation, but rather by trying to bring it into an optimal relationship with existing structures of the face, such as the cheeks, lips, chin and forehead. With regard to that, the goal of cosmetic nose surgery in Bagatin Clinic is not getting a "new face", but reshaping the nose so that it fits into normal relations with the rest of the face. There is a wide range of problems that can be solved successfully during surgery of the nose, which are: hump on the dorsum, crooked, too long or too short nose, broad nasal pyramid, irregular nose tip, a too wide or too narrow nose, asymmetric or wide nostrils, etc.

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These photographs show the real condition before and after the procedure. The results of each procedure are subject to individualities and normal variability of surgical results. Consequently, Bagatin Clinic cannot guarantee equal results for each individual client. 

Surgery can shape the bone and cartilage structure of the nose. What you should always keep in mind is that the nose is already partly determined by its initial shape and dimensions. A too radical reduction of the nasal structure is not recommended because it can weaken the backbone of the nose. The strength and thickness of the skin and soft tissue cover, which also limit the extent to which the nose can change have a significant impact on the result of the operation. Although the skin cover does not change, after surgery the skin must cover pre-formed cartilage, because excessive reduction of cartilage and bone can result in inadequate adaptation of the skin. This is especially a problem for people with very thick and oily skin.

These photographs show the real condition before and after the procedure. The results of each procedure are subject to individualities and normal variability of surgical results. Consequently, Bagatin Clinic cannot guarantee equal results for each individual client. 

At the Bagatin Clinic you will find out if you are a good candidate for the nose surgery or not after the consultative examination. The consultation includes analyzing of  the nose structure, motivation for surgery, what are the possibilities of correction and only on the basis of this information are plans for the surgery being made. On examination, in the conversation with the client, we make individual plans for surgery.

You're a good candidate:

• If you want to improve the appearance but not achieve perfection, you're physically healthy, psychologically stable and realistic in anticipation of the results of operations
• If you are unhappy with the size or shape of the nose
• If you have suffered injuries or burns that caused a change in the appearance of your nose
• If you were born with a congenital malformation or nasal deformities (cleft lip and / or palate) and you need a secondary correction
• If you have trouble breathing through the nose
• If you have completed growth and development, turned 18 years old or earlier if you have inherent malformation or nasal deformities like cleft lip and/or palate

Doctor Bagatin will, during the consultation examination, give you all necessary instructions for the operation: which laboratory test and examinations are needed, what to avoid before surgery (such as alcohol, smoking, vitamins, etc.) and how to behave after surgery for a faster recovery. Before nose surgery, one should stop taking the medicine and painkillers from a group of nonsteroidal anti-inflammatory drugs, which contain acetylsalicylic acids like Aspirin, Andol or Acisal. This is also a very important factor in preparing the patient for surgery, because in this way we prevent possible bleeding and hematoma (hematoma) during and after surgery, and significantly improve and speed up recovery and improve the result of the operation.

Once you have completed all the necessary blood and urine tests you will have an appointment for a preoperative examination by Dr. Bagatin and also be examined by our anesthesiologist. You will receive definitive instructions at your last appointment before the surgery, where you will get all the information about preoperative preparation, surgery and post-operative recovery.

Just before the consultation, patients should have a certain idea of how they want their nose to look. During the consultation you should thoroughly discuss your expectations. On this basis, in Bagatin Clinic we will do examination with VECTRA 3D which provides realistic 3D simulations of the face, and gives us the ability to show patients an approximate look after the surgery. 

The operation is performed under general anesthesia, which means that you sleep during surgery. The aesthetic and functional nose surgery takes 2-4 hours. Bagatin Clinic uses an "open method" for correction of the nose because this approach gives the surgeon a direct view and access to cartilaginous and osseous structures of the nose. This approach allows far greater precision, improved performance and satisfaction of our patients. It also gives the opportunity for the best results in any small or large nose corrections.

With open access incision is made through the columella (skin of the nasal septum) Z-shaped and also in nostrils inside where it follows the leading edge of the cartilage. The scar on the columella is in the form of small steps and in the postoperative course is almost invisible. During surgery, the reduction of the bone and cartilage is performed or they are transformed and placed back so that the nose gets the desired shape, appearance and size. For the design of the cartilage of the nose (usually nasal septum), ear cartilage or rib cartilages usually are used if these are insufficient (previously used), or a major reconstruction is required. Dr. Bagatin, depending on the issue, in consultation with the patient selects the best surgical method.

The first 24 hours the nose and face look swollen with bruises (hematomas), and the swelling is increased to 48 hours and is expected to peak after 48-72 hours when a light headache might occur. The nose after surgery does not usually hurt. If there is a slight postoperative pain, which usually occurs in the initial postoperative period one should take analgesics. We recommend that you do not blow your nose during the first 2-4 weeks. It is necessary to avoid sneezing through the nose. Heavy physical activity should be avoided 4-6 weeks after surgery. Be sure to stay away from sun exposure (use a UV factor of 50 and a hat), higher stress and any risk of injury. If you wear glasses, you must take care not to rest on the bridge of the nose, at least a month after the surgery. Straps and other resources will help you wearing glasses without stressing the area where surgery was performed.

Recovery is accelerated by using cold compresses during the first 72 hours and placing your head into an elevated position (two pillows), day and night, the first week after surgery. After the surgery an external fixator is set on the nose as well as silicon plates into nostrils, helping to protect and facilitate healing of the lining. Also, these plates are important in preventing bleeding and supporting new forms on the inside of the nose. It will be removed on average after a week. However, the swelling will still be present, in a few weeks after surgery. Definitive result can be expected 12 months after surgery. After seven to ten days after surgery, the patient is able to return to his/her daily personal and professional activities, noting that adhere to all instructions (to avoid greater physical exertion and contact sports injury because of the nose in early and later postoperative course, can cause new deformity of the nose).

As with other operations, there can be certain complications (infection, bleeding), which Dr. Bagatin will inform you about during consultation. If you follow the instructions received, the risk of the above is much lower. It does not exclude the possibility of minor irregularities and asymmetries in the nose during the postoperative period, which usually disappear within one year of the surgery. If you need a smaller secondary correction, it can be made at least one year after the first surgery.

The package includes: an operation under general anesthetic, short stay in the Bagatin Clinic after the surgery, control and bandaging in the first postoperative days, as well as the necessary controls within 3 months.