Nasal columella plasty. Nose columella. The shape and structure of Columella's nose after open rhinoplasty hanging

Rhinoplasty is a concept that includes many different techniques to change the shape of the nose. Some patients need to work with the bone part of the back, others - with the cartilage part, and the third - with the soft tissues of the tip of the nose. Often there is a need for correction of columella. And what it is, how this part of the nose is corrected and what effect can be achieved with the help of surgical intervention, you can find out by comprehensively considering this issue.

Columella - what is it?

The nasal columella is the part of the skin located between the nostrils. Anatomically, the columella includes the medial crura of the alar cartilages, but they are not visible visually. Sometimes it is called a column or column of the nose.

This small fragment of the nose performs a number of important functional tasks in the normalization of the breathing process. Supporting the tip of the nose and maintaining the optimal lumen of the nostrils, it allows you to freely inhale and exhale air. So, to provide the body with oxygen, which is involved in all biochemical processes.

What should a columella look like?

A small area of ​​skin called the columella of the nose plays a huge role in the perception of the nose as a harmonious part of the human face. A beautiful columella should have the following qualities:

• its width should not exceed 5-7 mm;
• the angle between the nose and lip should be about 100 degrees for women, 95 degrees for men;
• the column should not sag;
• when looking at the face from the front, the columella should be located lower than the wings of the nose;
• nostrils should be symmetrical.

If these rules are ignored, any rhinoplasty will not be successful. The nose will look disharmonious, and the person may go for a second plastic surgery. While in other cases, a simple correction operation can give a more pronounced result.

Problems with columella

What problems can be with columella to require nose plastic surgery - rhinoplasty?

Based on how the ideal size and shape of a columella should look like, we can identify the problems that potential patients of a plastic surgeon most often face:

• the nasal column sags;
• columella is too high;
• the angle between the nose and the lip is too large, or vice versa, small.

A person may regard his nose as too wide, with a curved tip, snub-nosed. But in order to correct the appearance, it is not necessary to do complex and traumatic operations to change the shape of the back or its tip. It is enough just to change the column of the nose.

Non-surgical correction

In the event that the column of the nose is small, that is, the angle between the nose and the lip is increased, and there the nose looks snub-nosed, or the leg of the columella and the wings of the nose are located on the same level, you can use

Its meaning lies in the introduction of a special preparation under the skin - a filler, which increases the volume of tissues. As a result of this, the columella of the nose becomes larger, and the nose itself looks harmonious. During the procedure, the doctor injects the filler into the columella in the required volume through the needle. The intervention causes a minimum of pain, but if desired, you can use an anesthetic injection.

The advantages of the method are:

• minimum rehabilitation period;
• short duration of the procedure;
• no need to do tests and functional studies before the procedure.

The main disadvantage of the method is its fragility. The duration of the effect depends on the drug that was injected into the soft tissues of the columella: a more viscous gel will be retained in the tissues longer. But it is necessary to take into account the individual characteristics of a person.

The safety of the method is great, but relative: the introduction of any substance into the body can become a catalyst for pathological processes, for example, exacerbation of chronic diseases, the development of autoimmune diseases. In order to avoid such consequences, you need to undergo a medical examination and consult with your doctor.

Surgical correction of columella

If the columella is large or sagging, the only method of correction is surgery.

But the methods used by the surgeon when performing the operation may be different. Correction of the columella of the nose should be discussed by the doctor and the patient before the operation, so that the operated person is as satisfied as possible with the result.

The easiest way to reduce the columella is to excise the soft tissue and, if necessary, the adjacent cartilage. Understanding how the nasal septum is connected with the columella, we can conclude that in some cases it will be necessary to reduce the length of the septum itself, and only then tighten the columella.

During the preparation period, the doctor decides which operation technique will be more justified in a particular case: raising the nasal column, or deepening it to create a harmonious angle between the nose and the upper lip.

For patients who are not satisfied with the temporary solution of the problem in the form of a biogel injection in the cosmetologist's office, there is a way to permanently maintain the result with the help of surgical intervention. In this case, we are talking about lowering the columella or filling the columnar labial angle.

For this, cartilage implants can be used, which are installed in the columella region in order to lengthen the nasal septum. The implant is fixed with suture material.

Change of columella during rhinoplasty

The goal of a plastic surgeon is not only to correct a specific defect, but also to maintain the overall harmony of the nose and face, and also to make it as simple as possible. Sometimes the columella of the nose has an irregular shape, but working with it will not make the face beautiful, but, on the contrary, will make other features more obvious.

Therefore, sometimes, in order to correct the nasal column, the doctor can make a volumetric correction, based on the structure of the nose of a person who has come to the plastic surgery clinic. The doctor can change the tip of it higher, thereby pulling up the columella. Sometimes rhinoplasty is effective, when the surgeon moves them higher, so the column, remaining in the same place, becomes visually lower.

Therefore, preparation for surgery is a productive collaboration between the patient, who must explain what result of the surgical intervention he wants to see, and the doctor, who knows the structure of the nose and the person and understands what results and what methods can be achieved.

Is anesthesia necessary?

The need for anesthesia during surgery is determined by the amount of work that will be carried out by the surgeon. If the doctor plans to simply excise excess tissue, thereby raising the nasal column to the required height, local anesthesia can be used. For large-scale surgery, it is better to use general anesthesia.

The advantages of anesthesia in rhinoplasty can be identified by at least two arguments:

• the patient, being in a medical sleep, does not experience excitement, is not able to make involuntary movements, in other words, to prevent the surgeon from performing “jewelry” work on his face;
• with general anesthesia, the need for the use of local anesthetics is reduced, so the doctor gets the opportunity to work with “living” tissues, and not with various drugs that have been injected.

To find out if anesthesia is needed in a particular case, it is better to consult a doctor. Assessing the scale and duration of the proposed work, as well as the degree of pain of manipulation, he should recommend to the patient the most suitable option for a particular operation.

Preparing for the operation

Rhinoplasty in Moscow, St. Petersburg and other cities of Russia requires a mandatory medical examination of the state of health before the intervention. For this, there is a list of laboratory tests and functional studies.

In addition, opinions from the attending physician and, in the presence of chronic diseases, a specialist physician may be required.

Rehabilitation

How long it will last depends on many factors: the experience of the doctor, the extent of interventions, the state of health of the patient, the thoroughness of fulfilling all the surgeon's instructions.

On average, the tissue healing time for nose surgery is two weeks. But if the doctor corrected only columella, a person can return to normal life after 2 days.

It is quite possible to reduce the risk of unsuccessful intervention if you remember a brief reminder for a plastic surgeon's patient.

1. Choosing a doctor is half the battle. It is important to choose a specialist who will have experience in correcting noses with such aesthetic defects. Of course, finding such a doctor for rhinoplasty in Moscow or another big city is much easier.
2. Before the operation, colds, emotional and physical stress should not be allowed.
3. After the operation, you need to give the body time to heal the tissues, carefully following all the recommendations of the surgeon.

Rhinoplasty is the most common plastic surgery in the world, which is performed by people of any age and gender. And there is a reason for this: it is the nose that is called the part of the face, which to a greater extent affects the beauty of a person. Therefore, even slightly changing the structure of the human nose, you can achieve a beautiful result.

Rhinoplasty is by far the most popular plastic surgery, despite the complexity of its implementation. Correction of the shape and size of the nose (rhinoplasty) requires an integrated approach to improve the proportions of the face and the function of nasal breathing.

Who needs rhinoplasty?
As a rule, the main indication for the correction of the shape of the nose is the desire of the patient. However, there are absolute indications for nose plastic surgery, namely congenital (cleft lip, cleft palate) and acquired deformities and defects (as a result of injuries and accidents).

Before deciding on rhinoplasty, you should carefully consider, since the operation is quite complicated and has a lot of contraindications. These include diabetes mellitus, mental illness of any form, bronchial asthma, allergies to medicines, diseases of internal organs, blood clotting disorders, and cancer.

The most suitable age period for rhinoplasty is between 18 and 40 years of age. Surgeons can perform rhinoplasty on patients up to the age of eighteen, but in this case, the patient must be physically fully formed so that the operation does not provoke any major changes. After 40 years, it is undesirable to do nose plastic surgery, because at this age metabolic processes are often disturbed, the skin withers and loses its elasticity. The operation will contribute to the appearance of new wrinkles. In addition, the skin after rhinoplasty will look unnatural, and the rehabilitation period will be much more difficult. In addition, a highly qualified surgeon, a master of his craft, will never agree to perform nose plastic surgery on a patient over 40 years old.

Preparation for the operation.
Any plastic surgery is preceded by a consultation at which the patient is informed about the features of the operation and the postoperative period. The surgeon examines the respiratory function of the nose and its internal structures, reveals the level of health of the patient, the presence of allergies, a tendency to keloid scars. Computed tomography or X-ray examination helps to study in more detail the anatomical structure and functional features. Based on the results of the analyzes, the presence of possible risks associated with rhinoplasty is revealed, and the necessary procedures after the plastic surgery are discussed.

A week before the upcoming plastic surgery, the patient should stop drinking alcohol, smoking, taking anticoagulants (for example, aspirin). Rhinoplasty is not performed during exacerbation of chronic diseases, during menstruation in women, in the presence of acute respiratory infections, as well as inflammatory processes at the site of the operation.

As a rule, before the operation, patients should wash their hair, since it is desirable not to wet the postoperative bandage. On the day of the operation, the patient should not eat or drink anything. After filling in the necessary documents, the patient is taken to the ward and prepared for the operation, taking pictures of the nose.

Columella plastic.
The columella is a septum of skin between the nostrils. It is its size and position that affect the shape of the nose. The view when the columella is located below the wings of the nose is considered beautiful. A columella plasty is aimed at correcting a curvature that is too small or too large. The increase in columella is carried out by transplantation, and its reduction - through partial excision of the tissues that make up its structure. As a rule, these are the inner legs of the large cartilages of the wings of the nose. Correction of the shape of the columella is carried out using various methods, the most common of which is to change the entire shape of the tip of the nose.

Columella plasty lasts for 30-40 minutes and is performed under general anesthesia.

Nostril plastic.
Today, an anomaly of the wings of the human nostrils is not uncommon. Long wings of the nose or too wide nostrils require surgical intervention. Surgery to reduce the nostril alae aims to remove part of the wing on the outside when the wing is too long, and at the level of the nostril passage when that passage is too wide. Often a combination of the two is needed. When the wings of the nose are retracted, after an injury or excessive removal of the alar cartilages, it is necessary to restore the support of the wings of the nose, which is carried out by cartilage transplantation from the nasal septum or from the patient's auricle. Correction of the wings of the nose is also possible during the main operation.

Open rhinoplasty.
Open rhinoplasty is performed using incisions along the skin bridge between the nostrils from the outside. This method of plastic surgery is used for very complex deformities of the nose, allows the surgeon to see the changes taking place during the operation, provides better access. All manipulations in open rhinoplasty are carried out directly on the bone and cartilage section of the nose. The scar after this method of rhinoplasty is in the form of a small thin line, which will disappear over time.

Closed rhinoplasty.
This method of plastic surgery is the most aesthetic and often used than the open one, it does not leave scars on the columella at all. The operation is performed by incision in the nasal cavity, while all manipulations are done by touch, blindly. Closed rhinoplasty is considered less traumatic for the tissues, in addition, they heal faster than with open rhinoplasty.

Rhinoplasty with fillers.
If the patient needs to correct minor flaws, for example, correct the tip of the nose, correct symmetry, smooth out sharp corners, while there is no need to change the shape of the nose, rhinoplasty with fillers will help. The recovery period after this method of rhinoplasty is easier and much faster, moreover, the cost of the operation is lower.

A commonly used filler is hyaluronic acid, which is injected intradermally after applying an anesthetic cream. Another substance used is the patient's own fat, which is taken from the abdomen, inner thighs or knees under general anesthesia. Fat must be cleaned and centrifuged, and only after that an injection is made. Since fat is absorbed quickly enough, every second procedure requires repetition.

Secondary rhinoplasty.
Secondary rhinoplasty is necessary when the result of the first rhinoplasty did not give the expected result. The duration of the operation is about two hours. It is most often performed under general anesthesia. You should know that between rhinoplasty operations, at least six months, and preferably a year, should pass. Predicting the healing process after rhinoplasty is very difficult, no one will immediately tell you whether another operation is required or one is enough. If the first rhinoplasty was performed by an inexperienced or incompetent surgeon and performed poorly, then the second rhinoplasty can be much more difficult, so this issue should be approached more seriously, as well as the choice of a surgeon. In case of poor-quality first rhinoplasty, its reconstruction is often required, and, consequently, tissue transplantation. Most often, this tissue is taken from the inside of the nasal septum or cartilage from the ear, and for reconstruction of the bridge of the nose, the tissue is taken from the scalp, and the cartilage from the rib.

The doctor decides on the method of performing the operation, taking into account the needs and wishes of the patient. The cost of nose plastic surgery depends on the complexity, the degree of involvement of the cartilaginous and bone parts of the nose (for example, to remove the hump).

Recovery period.
After conducting a postoperative examination of the patient, the surgeon determines how long he will stay in the blade. The recovery period after rhinoplasty is accompanied by a lot of unpleasant sensations that are associated with inconveniences and limitations: sleeping only on the back, breathing through the mouth (since the nose is filled with tampons that maintain the shape and absorb postoperative secretions), do not smoke, do not wet the bandage, etc. .

After the operation to change the shape or size of the nose, the patient should be in absolute rest for two weeks. At this time, fever and weakness may appear, which, as a rule, disappear after 3-4 days. It is very important in the first week to limit yourself from any physical activity, try not to be nervous, which will avoid nosebleeds. If the plastic surgery is successful, you will feel great quickly enough, but bruises under the eyes, which occur by themselves and are a natural reaction of the body, will be present on the face for at least another two weeks. For the first ten days after rhinoplasty, it is recommended to sleep on a high pillow for faster elimination of edema.

It should be noted that after the removal of nasal tampons, it will take some time to fully restore nasal breathing, since internal swelling often occurs after surgery, which can persist for several months. In addition, during the first week, the patient must wear a special butterfly cast on the nose, designed to protect against impact and secure the new shape. This plaster bandage is periodically removed to care for the skin of the nose. As a rule, after 7-10 days postoperative swelling subsides. After 5-14 days, the bandage is removed, and the rehabilitation period ends.

Edema of the soft tissues of the nose disappears in about two months after rhinoplasty, after the same time, the final result of the plastic surgery can be assessed. In rare cases, this period can be extended up to a year.

To speed up the healing process after rhinoplasty, special rehabilitation courses are recommended in every plastic surgery clinic. These activities include magnetic nuclear resonance, rubbing medicinal substances from the outside and from the inside. All this contributes to a faster removal of edema and fixing the shape of the nose.

Complications of plastic surgery of the nose.
Early complications after rhinoplasty can be:

• lacrimation;
• excessive swelling;
• bleeding;
• inflammation;
• hematoma;
• blockage of the sebaceous glands.

During the Middle Ages, the method developed and even a number of treatises were created on giving the nose the necessary shape. However, rhinoplasty became most widespread in the twentieth century.

This method is used if it is necessary to work with cartilage or bones. The operation is performed only under general anesthesia. The duration of the operation is up to 2 hours.

During this operation, a skin incision is made along the bridge of the nose at the level of the nostrils. With this method of incision, the skin is removed over a large area and the doctor performs all manipulations under visual control.

Sometimes the skin is incised at the columella ( nostril separator). In some cases, this method can achieve good results. As for the scar, it is so thin that it is difficult to notice. Recovery after this type of surgery takes longer, and the swelling goes down more slowly.

In this method, tissues are cut inside the nasal cavity. Therefore, all manipulations are carried out by touch.

In any case, nose correction surgery is a rather complicated intervention.

Indications, contraindications and at what age is it better to do it?

The most optimal age for rhinoplasty is from 18 to 40 years. Sometimes operations are performed on young patients, if, according to the doctor, his appearance is already sufficiently formed, and no changes should be expected.

As for the upper threshold, after 40 years the skin becomes more flabby, the metabolism in the tissues slows down, the patient's rehabilitation is delayed and is more difficult. And the result may not be what you expected. Therefore, in most cases, a competent doctor will advise against having an operation to change the shape of the nose for a patient over 40 years old, although cases are different.

Examination before surgery

At the first examination, the doctor explains to the patient what the risks of the operation may be, complications and what the final result is likely to be.

If there are no contraindications to the operation, the preoperative period begins: the time between the examination and the operation. At this time, the client passes all the necessary tests, draws up an agreement with the clinic, and the terms of the operation are set.

Preparing for the operation

Rhinoplasty of the nostrils

After removing excess tissue, the doctor tightens the wounds with a special suture material of increased fineness. The suture material is removed five days after the operation. But in order to completely pass the traces of the seams, you need at least 6 weeks. During this period, you should protect the body from stress, and the nose from ultraviolet radiation.

Alignment of the septum (septorhinoplasty)

Physiological curvature occurs because the nasal septum includes different tissues, which sometimes develop at different rates. And then the shape of the septum can be broken, growths can form on it, or it moves to the side. This disorder usually occurs during adolescence.

In some cases, the curvature interferes with normal breathing, and sometimes it does not interfere. It can be detected only when examining the patient with special devices.

• Snoring in sleep
• Difficulty breathing through the nose
• Dryness of the nasal mucosa,
• allergic manifestations,
• Inflammatory processes of the paranasal sinuses in a chronic form,
• Obvious deformity of the nose.

Removal of the nasal mucosa (conchotomy)

• Violation of nasal breathing with hypertrophy of the nasal mucosa.

Often this procedure is carried out simultaneously with the operation to change the shape or size of the nose.

The procedure is performed only under general anesthesia and is carried out by various methods: cutting nasal loop, electrocoagulation and laser destruction.

columella correction

In order to increase the columella, a section of cartilage tissue is engrafted. And in order to reduce the lower parts of the wings of the nose are excised. Sometimes a columella correction is done in conjunction with a nose tip correction.

The intervention is performed under general anesthesia, its duration is from 30 to 40 minutes. After the operation, the patient will have to stay in the hospital for 5 days. For 4-8 weeks, swelling of the tissues can be observed, which is not so noticeable two weeks after the operation.

After the intervention, the patient should refrain from physical overexertion, hot food and drink, and hot baths. Sleeping on your side is also not recommended.

Correction of the shape of the nose

In the event that the nose is flattened, in addition to reducing the width of the nostrils, augmentation rhinoplasty is also performed - raising the bridge of the nose. A similar operation is performed to enlarge a too small and short nose. It's called "grafting". As a frame for the nose, cartilage and bones taken from other parts of the patient's body are used. Most often, bones are taken from the rib, skull or elbow, and cartilage from the ear.

In rare cases, synthetic materials are used, but they can take root worse. Such operations are considered to be almost the most difficult of all plastic ones, so you should trust your face only to surgeons of a high category.

Rhinoplasty

In the event that only the tip of the nose changes during the operation, it is not difficult and the recovery after it is quite fast.

Non-surgical rhinoplasty

The non-surgical technique is most indicated for those who, in general, have an acceptable shape and length of the nose, but there are minor flaws: for example, asymmetry or a too sharp tip of the nose, depressions on the wings of the nose.

This is a very convenient method to correct some inaccuracies after surgery. But in some cases, after the operation, it is forbidden to use the injection method.

• Fill in the holes
• Slightly change the shape of the tip of the nose,
• Eliminate the hump on the bridge of the nose and smooth out sharp corners,
• Make the nose symmetrical.

• The effect lasts from 6 months to 3 years depending on the drug used,
• There is a possibility of "migration" of the gel. This happens if the procedure was performed by a not too professional doctor.

Injection rhinoplasty (using fillers)

Hyaluronic acid is primarily a temporary substance. It is infused intradermally. Before the injection, the skin is treated with an anesthetic. Such an injection will help to change the shape of the nose for quite a long time.

Contour plastic

Today, this technique is not used very often, since it is much easier to use the biogel injections described above.

Laser rhinoplasty

The course of operations using a laser is usually the same as in classical surgery. The operation can also be closed or open. Incisions are usually made along the bridge of the nose and at the bottom of the nostrils.

Reconstructive rhinoplasty

Reconstructive surgery is necessary to restore normal appearance in case of cleft palate or lip. Sometimes a number of surgeries are needed.

Reconstructive surgeries are also performed after injuries that have led to damage to the bone or cartilage. In severe cases, patients who have completely lost their noses end up on the table of surgeons.

One of the most common nose deformities that a reconstructive surgeon has to deal with is the saddle or boxer nose. Both a severe bruise along the bridge of the nose and an infectious disease of the nasal cavity can lead to such a lesion. With this type of deformation, the cartilage that forms the septum can be completely destroyed, and the doctor completely restores the cartilaginous septum and the framework of the nose.

After the operation, to fix the new shape of the nose, tampons are inserted into the nostrils, which are kept for three to six days. The plaster bandage is removed after five to twelve days, depending on the complexity of the operation. But a day after the intervention, the patient is allowed to go home. And in a week he will come to remove the stitches.

Patients are not recommended to wear glasses for 8 weeks, and exercise for 2 weeks. After three weeks, the shape of the nose approaches the final version and further changes are visually almost invisible. However, the traces of the operation completely heal only after six to twelve months.

The patient should be observed by a doctor for a sufficiently long period.

Rehabilitation in the postoperative period

• In the first few days after the operation, refrain from tilting your head down,
• Don't sleep on your stomach
• Eat soft food, not hot
• For the fastest elimination of bruises and edema, lotions should be made with an aqueous solution of furacilin,
• Rinse the nasal cavity with any special solutions ( sold in a pharmacy), injecting into each nostril 2 injections seven times a day, then gently blow out the nose,
• Antibiotic to prevent wound infection Zinnat 250 mg twice a day for five days,
• To prevent the development of a fungal infection Fluconazole 150 mg take one capsule orally on the 3rd day of treatment Zinnat,
• Entrances to the nostrils should be cleaned daily with a cotton swab and hydrogen peroxide 3%,
• Two days after the intervention, you are allowed to take a shower,
• When swimming, keep the nose area from getting wet,
• It is allowed to apply cosmetics 14 days after the intervention.

• 7 days after the intervention, exercise, carry children in your arms and lift other heavy objects,
• 14 days after the intervention visit the pool and sauna,
• Wear glasses and sunbathe for 30 days after the intervention.

Recovery is happening at about the following pace:

• Edema is reduced by about two-thirds after 4 weeks,
• After 12 months, swelling subsides completely,
• In some patients, edema subsides asymmetrically,
• After 14 days, bruises completely disappear,
• 7 days after the intervention, nasal breathing may worsen, as caked crusts of blood appear in the nose.

Edema, callus and other complications

However, in most cases, both types of complications are observed.

Aesthetic: drooping of the tip of the nose, too raised tip of the nose, drooping of the bridge of the nose, beak-shaped nose, curvature of the bridge of the nose. Very often there is asymmetry of the nose after operations. If the asymmetry is caused by the fact that the doctor “did not get” a little tissue, then it is not at all difficult to solve such a problem. But if, on the contrary, more than necessary was withdrawn, you will have to do a tissue transplant. Some time after the operation, you may find that the skin on the nose is too thin or its color is different from the color of the skin of the face.

Ideally, after surgery, respiratory function should remain at the same level or even improve. If breathing worsens, the doctor must find the cause and eliminate it.

Too much exposure to the nasal mucosa can provoke the development of atrophic rhinitis.

Too much narrowing of the bony structure of the nose can lead to poor nasal valve function and nasal obstruction.

Too much trimming of the lateral legs sometimes impairs the operation of the nasal valve.

1. individual response of the body. This is one of the main reasons. In some people, the body has a high degree of self-healing.

2. Physician experience. This is a big part of the operation's success. A doctor with extensive experience has enough secrets and practices to prevent the growth of calluses. If the operation was performed by a doctor with experience in plastic surgery, swelling and bruising are common complications and nothing more.

Scars after rhinoplasty

With open surgery, thin scars, upon closer examination, can be detected for several years. Then they disappear completely. But here everything again depends on the skill of the surgeon.

Revision rhinoplasty

Sometimes the first operation was done correctly, but the results did not satisfy the patient. In this case, the repeated operation is easier to do, its duration is shorter.

Issue price

A day in the hospital will cost approximately roubles. Moreover, in some clinics, the cost of dressings is not included in the total cost of the service.

For each dressing you will have to pay a couple of hundred rubles.

You should be especially careful if a good clinic offers services cheaper than its colleagues. Most often, a lot of necessary and rather expensive services will be added to the initial price, for example, they can charge a separate fee for anesthesia during surgery.

Free rhinoplasty

Not everyone knows that some clinics hold promotions: free plastic surgery. Moreover, they are not made by students - trainees, but by experienced and eminent surgeons.

Such promotions are announced in advance on the websites of clinics or on thematic websites. All interested send their data. Usually a photo and a few lines about yourself are required. On some sites, contestants receive points for the number of contestants involved in the process. And on other sites, a blog contest is held between the participants. The winner gets a free rhinoplasty.

As incentive prizes, another two or three participants may be offered an operation for half the cost.

Very often, such promotions are held in the summer, as the influx of clients to aesthetic surgery clinics subsides at this time.

Reviews

There are a number of complaints about the poor performance of anesthesiologists. Therefore, the choice of this specialist also needs to be approached carefully. After an improperly selected anesthesia, it will be difficult and long to come to your senses. But a day of sleep after the intervention is normal.

Read more:

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Nose plastic surgery (rhinoplasty)

As a rule, the main indication for the correction of the shape of the nose is the desire of the patient. However, there are absolute indications for nose plastic surgery, namely congenital (cleft lip, cleft palate) and acquired deformities and defects (as a result of injuries and accidents).

Any plastic surgery is preceded by a consultation at which the patient is informed about the features of the operation and the postoperative period. The surgeon examines the respiratory function of the nose and its internal structures, reveals the level of health of the patient, the presence of allergies, a tendency to keloid scars. Computed tomography or X-ray examination helps to study in more detail the anatomical structure and functional features. Based on the results of the analyzes, the presence of possible risks associated with rhinoplasty is revealed, and the necessary procedures after the plastic surgery are discussed.

The columella is a septum of skin between the nostrils. It is its size and position that affect the shape of the nose. The view when the columella is located below the wings of the nose is considered beautiful. A columella plasty is aimed at correcting a curvature that is too small or too large. The increase in columella is carried out by transplantation, and its reduction - through partial excision of the tissues that make up its structure. As a rule, these are the inner legs of the large cartilages of the wings of the nose. Correction of the shape of the columella is carried out using various methods, the most common of which is to change the entire shape of the tip of the nose.

Today, an anomaly of the wings of the human nostrils is not uncommon. Long wings of the nose or too wide nostrils require surgical intervention. Surgery to reduce the nostril alae aims to remove part of the wing on the outside when the wing is too long, and at the level of the nostril passage when that passage is too wide. Often a combination of the two is needed. When the wings of the nose are retracted, after an injury or excessive removal of the alar cartilages, it is necessary to restore the support of the wings of the nose, which is carried out by cartilage transplantation from the nasal septum or from the patient's auricle. Correction of the wings of the nose is also possible during the main operation.

Open rhinoplasty is performed using incisions along the skin bridge between the nostrils from the outside. This method of plastic surgery is used for very complex deformities of the nose, allows the surgeon to see the changes taking place during the operation, provides better access. All manipulations in open rhinoplasty are carried out directly on the bone and cartilage section of the nose. The scar after this method of rhinoplasty is in the form of a small thin line, which will disappear over time.

This method of plastic surgery is the most aesthetic and often used than the open one, it does not leave scars on the columella at all. The operation is performed by incision in the nasal cavity, while all manipulations are done by touch, blindly. Closed rhinoplasty is considered less traumatic for the tissues, in addition, they heal faster than with open rhinoplasty.

If the patient needs to correct minor flaws, for example, correct the tip of the nose, correct symmetry, smooth out sharp corners, while there is no need to change the shape of the nose, rhinoplasty with fillers will help. The recovery period after this method of rhinoplasty is easier and much faster, moreover, the cost of the operation is lower.

Secondary rhinoplasty is necessary when the result of the first rhinoplasty did not give the expected result. The duration of the operation is about two hours. It is most often performed under general anesthesia. You should know that between rhinoplasty operations, at least six months, and preferably a year, should pass. Predicting the healing process after rhinoplasty is very difficult, no one will immediately tell you whether another operation is required or one is enough. If the first rhinoplasty was performed by an inexperienced or incompetent surgeon and performed poorly, then the second rhinoplasty can be much more difficult, so this issue should be approached more seriously, as well as the choice of a surgeon. In case of poor-quality first rhinoplasty, its reconstruction is often required, and, consequently, tissue transplantation. Most often, this tissue is taken from the inside of the nasal septum or cartilage from the ear, and for reconstruction of the bridge of the nose, the tissue is taken from the scalp, and the cartilage from the rib.

After conducting a postoperative examination of the patient, the surgeon determines how long he will stay in the blade. The recovery period after rhinoplasty is accompanied by a lot of unpleasant sensations that are associated with inconveniences and limitations: sleeping only on the back, breathing through the mouth (since the nose is filled with tampons that maintain the shape and absorb postoperative secretions), do not smoke, do not wet the bandage, etc. .

Early complications after rhinoplasty can be:

• lacrimation;
• excessive swelling;
• bleeding;
• inflammation;
• hematoma;
• blockage of the sebaceous glands.

Complications can also be unexpected, due to unpredictable tissue scarring or cartilage deformation.

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Columella plastic surgery

Columella (column, column of the nose) is called a jumper, the skin part of the septum between the nostrils. It should be below the level of the nasal wings and have proportional dimensions. However, nature does not always endow us with an ideal appearance. With too large or small, as well as a curved columella, the perception of the nose, and hence the entire face as a whole, is greatly deteriorated. Aesthetic imperfections in this area can be corrected with the help of a plastic surgery performed by a qualified surgeon.

What defects are corrected by columella plastic surgery?

The columella has not only an aesthetic, but also a mechanical function: it supports parts of the nose, contributing to normal nasal breathing. That is why plastic surgery of this area is resorted to not only to achieve an aesthetic ideal of appearance, but also for physiological reasons.

In general, rhinoplasty is performed in the following cases:

• excessively high location of the jumper or its omission;
• too large or small nasolabial angle;
• "Hanging" columella against the background of an incorrect position of the wings or an excessively long nasal septum.

What is the essence of the operation?

Correction of the skin part of the nasal septum is achieved depending on the defect by increasing or decreasing it. The increase is performed with the help of transplantation, and the reduction is performed by partial excision of the columella tissues. One way to correct its shape is to change the shape of the tip of the nose. The technique and scope of the operation required for correction, the surgeon together with the patient, is chosen individually in each case.

The procedure is performed under general anesthesia and takes about a minute. In this case, a long recovery after surgery, as a rule, is not required.

Columella plastic surgery in Moscow is performed at the clinic of Dr. Pavlyuchenko. Professor L.L. Pavlyuchenko, over more than 30 years of successful practice, has developed his own methods for the surgical correction of nasal defects, which allow him to translate into reality almost any wishes of patients.

Example 1. In addition to an enlarged and humpbacked nose, a patient also has a sagging skin part of the nasal septum (columella).

After the operation, the nose is of correct proportions with a normal shape and position of the columella.

Example 2. The patient has a columella sagging in the middle and retracted at the base.

In the photograph after the operation, the correct position of the columella is observed.

Example 3. In the first photo, attention is drawn to the curve, strongly shifted to the right of the nasal septum and columella (before the operation) and their corrected median position after the operation.

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©Clinic "Beauty Surgery" of Professor Pavlyuchenko, Moscow

Columella plastic surgery

Columella plasty is an aesthetic rhinoplasty aimed at correcting the size and shape of the skin septum separating the nostrils. Columella, or the nose column, plays an important role in the aesthetic perception of the face as a whole. The standard is the columella, located below the level of the wings of the nose. A columella plasty may be required in case of its curvature, too large or small size, smoothness or sharpness of the nasolabial angle, and in other cases. Reduction of the columella is achieved by partial resection of the skin septum and pedicles of the alar cartilages. In order to increase the size of the columella, cartilage grafts, lipofilling and contouring are used. With a smoothed nasolabial angle, a quadrangular cartilage resection is performed, with a pointed one, suture plasty or implantation of expanding prostheses is performed.

In Moscow, columella plastic surgery costs 0 rubles. (average). The procedure can be completed at 3 addresses.

Columella plastic - prices in Moscow

Moscow, Shmitovsky pr-d, 16, building 2

Making an appointment at the clinic

Moscow, Volokolamsk highway, 30, bldg. 2

Moscow, Vernadsky Ave., 92

Plastic surgery

Rhinoplasty

Related diseases

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What is rhinoplasty

The term plastic characterizes a certain surgical intervention with the aim of changing the anatomical shape of an organ or part of the body for cosmetic or functional (medical) purposes.

The term rhinoplasty is translated from Latin as a correction of the shape of the nose, respectively, in modern plastic medicine it is defined as a surgical intervention to correct the shape of the nose.

Indications

Conventionally, indications for surgery are divided into 2 groups - cosmetic and functional.

Cosmetic indications include:

• excessive length of the nose;
• convexity of the back - nose with a hump;
• saddle bridge of the nose;
• thickened - a nose with a potato, or a very thin tip of the nose;
• large diameter nostrils.

Functional - include changes in the shape of the nose, in which the passage of air through it worsens:

• curvature of the nasal septum due to trauma;
• congenital changes in the nose, leading to a narrowing of one of the nostrils;
• congenital defect of the cartilaginous part of the nose.

Contraindications

As with any other surgical intervention, in rhinoplasty there are a number of contraindications to its implementation:

• children's age up to 18 years, when the formation of nasal tissues is still ongoing, its growth and development (with the exception of pronounced congenital defects in the shape or nasal septum) and age after 40 years, due to poor postoperative tissue regeneration;
• inflammation in the skin or tissues of the nose;
• acute infectious pathology, regardless of the localization of the process with symptoms of general intoxication (fever and fever);
• chronic somatic pathology of internal organs in the acute stage (relapse);
• pathological processes in the organs of the cardiovascular system with an increase in blood pressure or cardiac insufficiency;
• diabetes mellitus type 1 or 2 with marked fluctuations in blood glucose levels;
• oncological pathology with the development of a malignant tumor of any localization;
• diseases of the blood system with a decrease in its coagulability.

Depending on the technique of surgical intervention and the volume of the operation, there are several main types of rhinoplasty:

• closed - correction of the shape of the nose is carried out through an incision in the mucous membrane from the side of the vestibule of the entrance to the nose, while there are no postoperative scars on the skin of the nose;
• open - a more voluminous operation with a skin incision in the area of ​​\u200b\u200bthe vertical fold separating the nostrils (columella);
• plastic surgery of the nostrils - an incision in the area of ​​​​the wings of the nose (the lateral part, which is the wall of the vestibule of the nasal cavity and nostrils) in order to correct the diameter and shape of the nostrils;
• columella plasty - incisions and excision are performed in the area of ​​​​the columella (the skin part of the nasal septum, located between the nostrils) in order to change its shape and size;
• plastic wide nose - is to make an incision in the area of ​​the base of the wings of the nose with partial excision of the skin, which makes it possible to make the nose narrower;
• rhinoplasty is a complex surgical intervention with small skin incisions to correct the shape of the tip of the nose;
• secondary rhinoplasty is a surgical intervention that is performed after some time (not earlier than six months) in case there have been unsuccessful rhinoplasty operations earlier.

Open rhinoplasty technique

Operation access

The technique of performing surgical intervention for nose correction implies two main types of access to the bone and cartilage base of the nose and its subcutaneous tissue:

• closed access - the incision is made from the inside, on the mucous membrane of the vestibule of the nose, the skin remains unaffected from the outside, such an access is performed during a non-volume operation, since there is limited visibility of the base of the nose for the surgeon, a closed access option is endoscopic rhinoplasty, in which microinstruments, a manipulator are inserted under the skin and microcamera;
• open access - an incision is made in the skin of the nose, most often in the area of ​​the columella, this access allows you to clearly see the structures of the nose, it is used for volumetric operations - the hump of the nose or its cavity, nose plastic surgery after a fracture.

Access for closed rhinoplasty

How it goes (stages)

Rhinoplasty is performed in several stages, which follow in strict order one after the other, these include:

1. preparation for surgical intervention - includes a consultation with a plastic surgeon with a joint determination of the type of rhinoplasty and surgical access, passing a mandatory laboratory examination;
2. anesthesia - depending on the volume of the operation, it can be carried out under local anesthesia (pain relief of tissues in the area of ​​the operation while maintaining the patient's consciousness) or general anesthesia (complete absence of all types of sensitivity and consciousness);
3. access - a stage of surgical intervention in the form of an incision, providing the surgeon with the possibility of subsequent manipulations based on the nose;
4. modeling - the process of directly correcting the shape of the nose or part of it;
5. suturing the wound - depending on the size and location of the incision, it is sutured with catgut (absorbable material) or silk (removed after a while);
6. rehabilitation - includes the early and late postoperative period and the implementation of measures to prevent complications of the operation and achieve a stable result.

What anesthesia is used

The choice of anesthesia during rhinoplasty is determined by the volume of surgery and the amount of tissue trauma.

• plastic surgery under local anesthesia - an anesthetic (novocaine or lidocaine) is injected into the tissues of the nose in the area of ​​incisions and manipulations, which blocks their pain sensitivity, while consciousness is preserved;
• surgery under general anesthesia - this anesthesia is performed with volumetric interventions on the nose, a special drug is injected intravenously, which leads to the development of anesthesia during the operation.

Rhinoplasty Implants

Use of implants

To correct the shape of the nose with an increase in its volume, special implants are used, which are implanted under the skin of the nose or its base.

In rhinoplasty, 2 types of implants are used:

• autograft - a section of the patient's own tissue (a piece of a rib or its cartilage, adipose tissue);
• heterotransplantation - a silicone implant is mainly used.

Rehabilitation

Recovery after rhinoplasty includes 2 periods:

1. early period - before the removal of stitches, lasts about 7-10 days, an aseptic bandage is applied to the nose;
2. late postoperative period - the time of convergence of edema, complete healing of postoperative wounds.

Complications, side effects, consequences

Rhinoplasty is a surgical intervention that can cause certain side effects and complications - bleeding, swelling on the bridge of the nose, hematomas (bruises).

Therefore, the doctor must inform the patient about the risk of their occurrence, after which he gives written consent to the operation.

There are several points to consider when agreeing to surgery:

• pros and cons - you need to carefully weigh the need for such an operation, its implementation is evidenced by pronounced changes in the shape of the nose, bringing psychological discomfort or impaired function, against - the presence of contraindications or improper preparation;
• alternative - non-surgical rhinoplasty is used, based on the introduction of a special gel (filler) under the skin, which includes hyaluronic acid.

Effect persistence

The result of rhinoplasty remains for a long time and lasts for years. With age, slight changes in the shape of the nose are possible, associated with a decrease in the elasticity of the skin and tissues of the nose.

Compatibility with other operations

Under certain indications, rhinoplasty is combined with other surgical interventions:

• vasatomy - surgical treatment of chronic rhinitis by removing part of the lower shell, with the same access, can be combined with rhinoplasty;
• septoplasty - correction of the nasal septum, if necessary, joint performance with rhinoplasty is indicated.

The average cost of rhinoplasty in Moscow clinics is presented in the table:

Photos before and after rhinoplasty

Frequently asked Questions

What are the consequences of rhinoplasty?

In the early postoperative period, bleeding from damaged vessels, swelling of the tissues of the nose and cheeks, and hematomas (bruises) are possible. Subsequently, scarring is possible with residual scars in the area of ​​incisions.

At what age is this operation performed?

Rhinoplasty is done from the age of 18, when the growth and formation of the base of the nose has already been completed. At an earlier age, this operation is performed only according to strict indications - injuries, fractures.

What time of the year is best?

Nose reshaping has no seasonal contraindications, so it can be done at any time of the year.

Do they give sick leave after surgery?

A disability certificate is issued for the duration of the operation and the rehabilitation period, usually for 7-14 days, depending on the volume of rhinoplasty.

When is smoking and alcohol allowed after rhinoplasty?

After rhinoplasty, it is advisable to refrain from smoking and drinking alcohol for at least 3 weeks. The correct solution would be to completely abandon them.

Is it possible during pregnancy?

Carrying out this operation in pregnancy is possible in the case of a small amount of intervention with local anesthesia. But still it is better to refrain from the operation, and carry it out after childbirth.

What you need to know before the operation?

Before starting the operation, the patient should be aware of the preparations for it, the implementation of recommendations in the early and late postoperative period, and possible complications and consequences.

How long does a postoperative wound heal?

The healing process lasts an average of 7-10 days. Then there is the formation of a scar and its gradual resorption over several months.

Video: Complete rhinoplasty

Video: When is rhinoplasty needed?

Video: Closed rhinoplasty technique

Hello. I always had a wide nose tip, a classic “potato nose”, so I decided to do plastic surgery of its tip. The operation was performed under local anesthesia, then another week went for dressings until the stitches were removed. Only then did I consider the result, since before that the swelling of the nose was terrible. Now the tip of the nose is sharp, the doctor said that the result is for a long time.

Good afternoon. I have a nose from my father, with a large hump on the back. I decided to have a rhinoplasty and remove it. The operation was performed in the clinic under general anesthesia. After the operation on the 2nd day, during the dressing, she looked into the mirror, was horrified. The nose was swollen, swelling of the cheeks and bags under the eyes. The doctor said he would. After the stitches were removed, the swelling slowly subsided as well. The nose is now even and more feminine.

Hello. I play soccer. A year ago I got a nose injury. At first I did not pay attention, then I noticed that the nostril on the right was practically not breathing. The doctor recommended surgery. A month ago, I had rhinoplasty and corrected the shape of my nose, now I breathe evenly and through both nostrils. I also continue to play football.

The nose is not only a respiratory organ, but also an important detail of our appearance, which, unfortunately, is often far from an aesthetic ideal. A crooked or hooked nose, too big or too small a nose - this is what our patients very often complain about, because any, even the most insignificant, flaw in appearance can lead to the development of complexes, and generally pretty spoil life. And that's not to mention that a deformed nose can make breathing difficult or cause snoring. Agree, not the most pleasant things either. To solve all these problems, rhinoplasty, or, more simply, nose plastic surgery, is called upon.

How is rhinoplasty performed?

There are two types of rhinoplasty: open and closed. The second option is considered more preferable, since all incisions during the operation are made from the inside of the nose and after rhinoplasty there are no visible marks left on your nose - they are all inside. An open method (that is, a dissection on the outside) is rarely used - with very complex plastic options.

The operation in most cases is performed under general anesthesia and lasts from half an hour to two and a half hours. It all depends on the specific case. At the end of the operation, you will have self-absorbable sutures that will disappear within a week, and cotton swabs will be inserted into your nostrils (they will be removed in a day). In difficult cases, a plaster splint is also applied.

What is rhinoplasty capable of?

Correction of the tip of the nose

This version of the operation allows you to make the tip of your nose thinner or thicker, to correct the angle or protrusion. It is carried out internally. The surgeon corrects soft tissues and cartilage.

Correction of the nasal septum

This correction is also called septoplasty. It is carried out with the help of an endoscope, which is essentially a micro-camera that allows you to "look" inside the nose and makes it possible to apply the internal variant of plastic surgery even when it comes to the nasal septum.

Nose alae correction

There are two options: decrease and increase. In the first case, part of the wings on the outside is removed (as shown in the figure). In the opposite situation, the main task of the surgeon is to restore the support of the wings of your nose. For these purposes, a small piece of cartilage tissue is taken either from the auricle or from the nasal septum.

Nose reduction

In this case, the part of the nasal bone that "spoils" your nose is removed. Thus, the operation allows not only to reduce the nose, but also to correct its shape.

What to do before rhinoplasty?

If you decide on rhinoplasty, then you will have to follow some simple rules:

• within a week before the operation, do not drink alcohol and drugs that thin the blood;
• if you are taking any medication prescribed by your doctor, you will need to inform our specialist about this during the preliminary consultation;
• at the time of the operation, your nose must be completely healthy (no SARS or acute respiratory infections - this will also need to be taken care of).

About computer simulation

Many of our patients are concerned about the question: how exactly the nose will look after plastic surgery, and this is quite justified, because sometimes it is very difficult to imagine all the details of the future appearance, guided solely by one's own imagination. To solve this problem, we use computer modeling, which will allow you to see what your future nose will look like during the consultation.

What to do after?

Already a day after rhinoplasty, you can go home. The sutures, as we have already said, will dissolve on their own, and the splint can be removed after ten days.

You will be able to return to the usual rhythm of life at the latest in a week, however, for several months after that, you will need to observe some restrictions:

• do not sunbathe in the sun or in a solarium;
• exclude thermal procedures, first of all, a sauna and a bath;
• limit physical activity;
• in addition, it is not recommended to wear glasses at first, as they will put pressure on the bridge of the nose, so if you need constant vision correction, get contact lenses for this time.

As you can see, nothing complicated. Moreover, the reward for following these rules is a perfectly shaped nose.

Questions and myths

Rhinoplasty, as well as any other operation related to appearance, raises questions in patients, the answers to which, for some reason, many prefer to receive not from specialists, but on the Internet. Hence the many myths that accompany rhinoplasty. Let's try to figure it out.

Myth #1 – Rhinoplasty is painful

As we have already said, the operation is performed under anesthesia, so there is no pain. Moreover, in comparison, for example, with breast plastic surgery, rhinoplasty is considered a fairly simple and non-traumatic procedure.

Myth #2 – The effectiveness of rhinoplasty depends on the season

Some people think that rhinoplasty is best done in the summer so that the nose is not in the cold, while others consider rhinoplasty to be an exclusively winter operation, because in winter it is easier to protect yourself from the sun's rays. This is not true. Rhinoplasty is equally effective at any time of the year. When exactly to carry it out is up to you.

Myth #3 – It is very easy to identify a person who has had a rhinoplasty.

Of course, it's easy, because his nose will become more beautiful and better. But seriously, rhinoplasty, as already noted, leaves no visible marks behind, so the likelihood that someone will find out about the operation is practically absent.

Finally

It should be understood that rhinoplasty requires not only professionalism from a plastic surgeon, but also the talent of a sculptor, because the doctor, in fact, creates a new shape of the nose. In this case, we are talking not only about the proper functioning of the respiratory organ, but also about its beauty. That is why it is very important to choose the right clinic.

Clinic "GENESIS" is a staff of qualified specialists with a worldwide reputation. For more than ten years, plastic surgeries of any level of complexity have been carried out within the walls of our clinic. Our clinic consists of hundreds of patients who, with our help, have already solved problems with their appearance.

Clinic "GENESIS" is always a comfortable visiting schedule. Your visit will be scheduled at the most convenient time for you. Modern sparing techniques allow us to minimize the length of stay in the hospital - a day after the operation, we will let you go home.

Clinic "GENESIS" is a maximum of attention. Our specialists will take into account all your wishes regarding the upcoming rhinoplasty and answer any questions you may have.

Are you unhappy with the size or shape of your nose? Call the Clinic "GENESIS" and we will help you solve this problem!

Rhinoplasty (before and after):

Immediately, let's define what a columella is. Columella, or, as it is also called, the column of the nose, is a fold located between the nostrils. It is formed by the skin component and the legs of the large alar cartilages. The aesthetic appearance of the nose, the contours of its nostrils and their symmetry depend on the columella. According to modern canons of beauty, it is generally accepted that it should be slightly below the level of the nostrils.

In addition to the aesthetic function, an anatomical load is also assigned to the columella - it must maintain the tip of the nose in an elevated state and form an adequate lumen of the nostrils, ensuring unhindered entry of air into the nasal cavity.

When is columella plastic surgery performed:

• Too upturned tip of the nose due to high columella.
• Descent of the tip of the nose.
• Too sharp or too obtuse nasolabial angle.
• "Dangling columella" is an anatomical feature when the columella is lowered too low compared to the level of the nostrils.

The columella is enlarged by transplantation of the patient's own tissues or biocompatible transplants. With a decrease, on the contrary, its partial excision is required. However, changes in the appearance of the columella do not always imply surgical work with it; most often, complex plastic surgery of the tip of the nose, including its wings, is required. Let's look at the operations in a little more detail.

You can enlarge the nose column in one of the following ways:

• Install cartilage grafts.
• Suture the medial crura of the alar cartilages.
• Introduce fillers or the patient's own adipose tissue into the columella area.

If the patient has a smoothed nasolabial angle, a partial excision of the columella or resection of the edge of the quadrangular cartilage is performed.

With a pointed nasolabial angle, an increase in the nasal septum is performed using biocompatible expanding grafts or suturing is used on paired alar cartilages.

The operation on the columella is performed under anesthesia or with the use of local anesthesia, depending on the volume of intervention, the duration of which is 20-40 minutes. Long-term hospitalization is not required.

Contraindications for columella plastic surgery

Contraindications are standard, as for most plastic surgeries:

• Chronic diseases in the stage of decompensation.
• Violation of the blood coagulation system.
• The presence of skin diseases in the area of ​​intervention.
• Acute respiratory diseases.

Postoperative period

Recovery after columella plastic surgery is much easier than with rhinoplasty, because. in the case of this operation, the bone structures of the nose are not affected. Difficulties in nasal breathing are not observed. For the first 1.5-2 months, swelling and pastosity of the operated tissues are possible, but visually this is noticeable only in the first weeks.

There are also no special restrictions in the postoperative period. Recommend reasonable abstinence from excessive physical exertion, exclusion of the action of thermal procedures - baths, saunas, hot baths. You also need to protect the nose from physical injury, in particular,
In order not to accidentally damage the tip of the nose during sleep, it is better to sleep on your back.