Vasily Pinchuk: “Rhinoplasty as an inevitability: when problems with the nose turn life into torment”

Today, rhinoplasty is among the three most popular plastic surgeries in the country. And it’s not just that most women are unhappy with their noses. Often, rhinoplasty is an operation that is necessary for a normal life. After all, sometimes internal problems do not allow a person to breathe freely. And then the question is not about beauty — it’s just about living a normal life without suffering. After all, you must admit, it’s scary when you can’t breathe freely…

That’s why today I want to talk about rhinoplasty for medical reasons: when and why it should be done, as well as how long rehabilitation takes.

REASONS

Breathing disorders can be caused by three reasons.

The first of them is deformation or curvature of the nasal septum. In my practice, this is the most common case. And it can be different. There are cases when a person can live with it all their life, but sometimes the deformation is so severe that one can only dream of surgery. I had a patient who literally cried with happiness after we corrected her nasal septum and she was able to breathe normally.

The second reason is an enlargement of the lower nasal concha (hypertrophy). There are several reasons why this can happen: abuse of vasoconstrictor nasal drops, allergic or chronic vasomotor rhinitis, and paranasal sinus disease. But the result is the same: as a result, the passage through which air flows is closed.

The third reason is a change in the skeleton of the external nose. As a rule, this is an acquired problem — for example, as a result of a fight or an accident. But it can also be congenital.

ALL ABOUT THE SURGERY

All three of these problems are medical indications for performing certain interventions.

However, in the case of the first two, the shape of the nose may not change — the main manipulations take place internally and are aimed at improving the patient’s breathing, not at solving aesthetic problems.

It should also be said that very often internal problems are revealed when a person comes to have surgery to improve the shape of the nose. After all, before any intervention, it is necessary to examine everything inside, do a computed tomography scan, and find out if there are any concomitant problems. Otherwise, rhinoplasty can worsen nasal breathing. For example, if the nose is reduced, the nasal passages are reduced, and the airflow is reduced. And it turns out that after the operation, a person starts breathing worse. I have seen people curse the moment when they decided to slightly correct their shape and acquired a global health problem. And all this happened because of the doctor’s incompetence.

If the examination reveals concomitant problems with the septum, nasal concha, or paranasal sinuses, an ENT surgeon should be involved. It should be a mutually fruitful cooperation. Then the operation is divided into two stages: the ENT surgeon starts, and the plastic surgeon finishes the procedure, working on the appearance of the nose. Actions must be synchronized and coordinated so as not to harm the patient. After all, it happens that after the ENT surgeon’s unsuccessful work, it is very difficult for the plastic surgeon to do anything and fix it. And vice versa.

PROBLEMS AFTER AN ENT SURGEON

By the way, in recent years, many ENT surgeons have been performing plastic surgery of the external nose themselves.

But many times in my life, I have seen a doctor remove the nasal septum too radically. For a long time, ENT surgeons did not perform plastic surgery of the nasal septum, but simply removed the curved part of it (this is called submucosal resection of the nasal septum). If this is overdone, the nose loses the supporting function of the nasal septum and becomes deformed. There is a supra-tip depression, flattening of the tip, shortening of the nose length, nostril dilation and widening of the base of the end section of the nose: the nose simply falls through and moves apart. There is no support!

I always wondered what the doctor was thinking when he did this. Here’s a crooked septum, they say, why straighten it if you can just throw it away. He cuts it out, throws it away, the operation takes 15 minutes, and no one cares that there are huge problems later.

And after such manipulations, the plastic surgeon has to perform an operation to restore the supporting function of the septum: for this purpose, cartilage is taken from the rib and a frame is formed from it to support the end section of the nose. It is more complicated and expensive than conventional rhinoplasty.

REHABILITATION

Rhinoplasty lasts from an hour to up to two or three, depending on the complexity. After rhinoplasty, a splint and bandage are applied to the nose for ten days. Tampons and special stents are inserted inside, which are removed on average on the third to fifth day. But it all depends on how serious the intervention was.

After such an operation, there is usually swelling and bruising. This is normal. They go away in a couple of weeks. For another month or two, you need to limit physical activity, you may need to drip oil solutions into your nose to prevent crusting. But this is individual. And, of course, regular check-ups with a doctor to avoid fusion and adhesions.

In conclusion, I want to say something trite, but the most important thing: take care of yourself and your health. We have only one. And not everything in this life can be fixed by surgeons. Remember that your well-being often depends on your responsibility. Love yourself, appreciate yourself, and everything will be fine!