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The Target For Rhinoplasty: Beautiful And Functional Nose
by PlacidWay | Anadolu Medical Center

Nose is the most prominent part of the face! That’s why deformities of the nose make people miserable and unconfident. Haluk Duman, M.D., Professor of Aesthetic, Plastic and Reconstructive Surgery at Anadolu Medical Center, says that aesthetic surgery provides very successful results with contemporary technology. He answered our questions about nose surgery, ie. rhinoplasty.

Importance of rhinoplasty
Professor Duman underlined the importance of rhinoplasty: “being at the center of your face, your nose is not only a functional organ, but also it is the most attention grabbing part of the body. If the nose is ugly or abnormal, the person goes through psychological and functional problems. After rhinoplasty, many people experience an improvement in their psychology and social relations, as well as an increased self-esteem and success. People, who had problems in their relationships due to negative feelings for their noses, often end up in healthier relations after surgery. Rhinoplasty has no functional aspect, yet for the nose’s important role in breathing, it is of utmost importance to function normally. Recently, functionality is considered to be a part of aesthetic. Physical beauty is not enough; the change should be meaningful with regards to the function as well.” Haluk Duman asserts that during rhinoplasty surgeries the functionality of the nose should not be harmed, on the contrary, if there is a problem, it should be ameliorated.

What is an aestheticly pleasing nose?
“A beautiful nose does not necessarily have to be small.  For each face it takes a different nose to create an appropriate harmony and balance. That’s why a perfect nose may not be perfect on its own. On the contrary, sometimes you find a nose ugly but when you consider it together with the rest of the face, it does not irritate you. You can even find it pretty. Yet, you cannot get the same feeling when you juxtapose the very same nose to somebody else’s face” says Haluk Duman M.D, Professor of Aesthetic, Plastic and Reconstructive Surgery  at Anadolu Medical Center, defining the beautiful nose.  Regarding the aim of rhinoplasty, he says, “to create a good looking nose which is in harmony with the other features of the face. Unpredictability is the key. The onlookers should not guess the surgery.” In response to the question whether everyone can have the surgery says Haluk Duman, “Nasal reshaping surgeries take up from what we have, and the result is always better. However, it is not always possible to meet the expectancies 100 percent. The patients should be informed in advance. This is especially important for big nosed men.  Since the nose is big, a lot of soft tissue is left. So, the end result depends heavily on the recovery of that tissue.”

Preparation for the surgery
Before the surgery the patients are photographed from three perspectives.  By means of a special software, amendments are made on the image and the most appropriate nose is determined.
Haluk Duman says that during the preoperative consultations, a detailed analysis of your nose and facial features will be performed and for some patients certain chin and forehead augmentations are planned to improve the balance between the face and the nose. “Seeing these images, the patient may expect the same result. We talk to the patient and agree for the optimum.”

Superiority of the open surgery
Rhinoplasty surgeon removes some of the excess bone and cartilage and reshapes the irregularities. Depending on the method, the size of the nose can be increased or decreased. The nostrils can be narrowed, unsightly humps can be shaved. The bridge or tip of the nose can be reshaped. Haluk Duman explains the methods with respect to their goals: “Hump resection is the technique of the removal of a cartilagenous-bony hump. Spreader grefts are placed on two sides of the septum. The angle and size of the tip can be altered. Sometimes, lower lateral cartilages are removed and supported. The upper lateral cartilages are also resected so that it looks harmonious. The height of the septum is shaved and balanced, if it is not enough, the procedure is repeated during the surgery.”

Haluk Duman says he prefers “open rhinoplasty” for the advantage of seeing the tip of the nose and performs surgical interventions to it. “We perform other procedures through closed technique”, says Haluk Duman, “Only disadvantage of the open rhinoplasty is that the recovery takes a longer time. In rhinoplasty, general anesthesia is preferred for both the doctor and THE patient. During surgeries under local anesthesia, the patient gets axious and his blood pressure increases. This increase may cause more bleeding. Although it is not life threatening, this situation makes it harder for the surgeon to operate.”

Importance of post-operative care
The patient can either be discharged from the hospital right after the operation, or stay at the hospital for the night, if he wants. he does not feel pain but edema and echymosis around the eyes are expected for the first 24-48 hours. Purple spots disappear in 7-10 days. The nose takes its final shape in 6-12 months.

A small plaster cast and tamps are required for the bones to settle. Tamps are removed on the third day after the surgery, while the plaster is taken after one week. For the second week, the doctor places a tape on the nose so that the patient does not forget about the surgery and reminds his nose. Haluk Duman points at the recovery period, “After the operation the patients should not smoke, since it triggers edema. Neither should they have bath or wash their faces. Otherwise water can leak under the plaster and cause inflammation. We also ask the patients to avoid activities and heavy work outs which can increase blood pressure.”

Retouches clear up the problems
Haluk Duman says that for the doctors the greatest risk is not achieving the desired result. “If problems occur, we can solve those though restorative operations performed in 6 months to one year after the initial surgery.  The doctor should establish an effective communication with the patient and the patient should not be obsessed with such situations. The catch of the rhinoplasty is patient’s happiness!”

Your nose will not prolapse!
There is a misconception that after a certain while the nose prolapses again. It is not true. The most important developments in recent years are the lessons learned from previous mistakes, abandonment of exaggeration and tendency towards a more conservative approach. In this respect, improper practices, such as removing whole septum, are no longer applied and rhinoplasty results are much more successful.

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