Rhinoplasty

Rhinoplasty is a surgical procedure aimed at improving the aesthetics of the nose and/or resolving functional problems associated with it. I perform it for both aesthetic and health reasons: I help patients improve the appearance of their nose and, where necessary, its function, so that daily functioning becomes more comfortable. I rely on an individual approach, a detailed analysis of the patient’s needs and expectations, and modern surgical techniques.

The decision to undergo the procedure often stems from the discomfort patients feel due to the appearance or function of their nose. Most commonly, they present with problems such as:

• a nasal hump that disrupts the aesthetics of the profile,
• asymmetry caused by trauma or congenital deformities,
• a drooping nasal tip,
• the width or length of the nose that does not harmonise with facial features,
• nostrils that are too large or too small,
• breathing difficulties associated with a deviated nasal septum.

Indications

• dissatisfaction with the appearance of the nose, including its disproportionate shape,
• congenital deformities or those resulting from trauma,
• breathing difficulties resulting from a deviated nasal septum or other congenital anatomical defects.

Contraindications

• active infections of the nose or sinuses,
• uncontrolled chronic diseases, such as diabetes or hypertension,
• pregnancy and breastfeeding,
• a tendency towards pathological scarring.

I analyse each case individually and, during the consultation, discuss in detail the indications, possible outcomes, and potential risks associated with the procedure.

Preparation

Before the procedure, I recommend:

• avoiding smoking and alcohol for at least a month,
• discontinuing medications that affect blood clotting, such as aspirin, in accordance with my recommendations,
• undergoing diagnostic tests, including a full blood count, ECG, and CT scan of the sinuses and nasal septum,
• attending a detailed consultation, during which we discuss expectations and plan the course of the surgery.

During the preparation, I answer the patient’s questions and clarify any doubts.

What the procedure involves

I perform the surgery under general anaesthesia. The procedure lasts from two to three hours, depending on the level of complexity. I perform all the main rhinoplasty techniques. They are described along two independent divisions:

• Access: open or closed rhinoplasty. In open rhinoplasty, I make the incision on the skin of the nasal columella, which gives full access to the bony and cartilaginous structures. In closed rhinoplasty, all incisions are made inside the nose, with no scar on the skin.
• Approach to the nasal framework: structural or preservation rhinoplasty. In structural rhinoplasty, I rebuild and reinforce the framework of the nose; in preservation rhinoplasty, I keep its natural structures and limit intervention in the tissues, which speeds up healing.

I select the surgical technique individually, based on the patient’s anatomy and expectations. During the procedure, I correct the structures of the nose by removing or modelling cartilage, bones, and soft tissues. Depending on the needs, this may involve shortening or lengthening the nose, reducing the hump, changing the shape of the nasal tip or the nasal septum.

If necessary, I use piezosurgery to modify the shape of the bones. The piezo method in open rhinoplasty uses ultrasound for precise modelling of the nasal bones, reducing damage to soft tissues and the risk of bleeding, which contributes to more predictable results and a shorter recovery period.

Regardless of the chosen method, I aim for a natural appearance of the nose that harmonises with the facial features. After completing the procedure, I precisely close the incisions and apply dressings to support and protect the nose (stabilising plates, thermoplastic nose plate, cast). After the surgery, the patient remains in the clinic for 1 day.

In the first days after surgery, swelling and bruising may occur, which gradually subside. I remove the dressing stabilising the nose after about 7 days. I provide care at every stage of healing and give detailed recommendations regarding care and daily activities.

General recommendations after rhinoplasty:

• avoid touching the nose for several days after the procedure to prevent infections and reduce the risk of damage,
• use cold compresses for the first days to reduce swelling and redness,
• avoid strenuous physical activity for at least 4 weeks,
• take prescribed painkillers and anti-inflammatory drugs as directed,
• avoid wearing glasses on the nose for at least 4 weeks,
• protect the nose from direct sunlight and use a high-SPF sunscreen for the recommended period.

The full effect of the procedure is assessed after one year, when the nose has completely healed. After recovery, patients usually observe an improvement in both aesthetics and nasal function: a shape more proportional to the whole face, reduction of a hump or other shape defects, and, after correcting structural defects such as a deviated nasal septum, also improved breathing. The result depends on the patient’s individual anatomical features and the complexity of the correction.