Rhinoplasty is also commonly referred to as nose job. In Montreal, it’s French-language equivalents are rhinoplastie et chirurgie esthétique du nez. At Rhinoplasty Montreal, treatment objectives are to maintain the nasal airway respiratory function while creating a symmetrical nose in harmony with the face. Dr. Chen Lee performs both surgical and nonsurgical rhinoplasty to achieve these desired functional and aesthetic nasal outcomes.
Rhinoplasty or nose surgery is one of the most common surgical procedures in cosmetic surgery. In addition, rhinoplasty is considered one of the most complex cosmetic surgeries and is sometimes a “challenge” for plastic surgeons. It is a day surgery, it is done under general anesthesia is lasting about 2 to 3 hours.
The nose is the most conspicuous facial structure, a nose too prominent, too small, too large and poorly proportioned with the rest of your face can have a negative impact on your self-confidence. Being the central element making facial balance, it plays a very important role in the personality and harmony of the face. Thus even a slight surgical modification such as reducing an unsightly hump can produce a significant improvement in the well being of a person.
There are several different techniques to change the appearance of the nose.
A rhinoplasty can :
• Modify nasal tip, considered too wide, too saggy, too round
• Refine the base of the nose
• Remove an unsightly bulge
• Change the angle between the nose and the upper lip
• Reduce the width of the nostrils
• Increase the size of the nose
Open Rhinoplasty Technique
Open rhinoplasty is the surgery most practiced by plastic surgeons. It allows better visibility for the surgeon during the operation and thus to have more visible and satisfactory results.
In addition, open rhinoplasty offers a considerable advantage during secondary nose surgery or complex surgery to remodel the entire nose. Sometimes cartilage grafts taken from the inside of the nose or other areas of the body may be recommended to help reshape the structure of the nose.
The incisions are made inside the nostrils and outside on the pillar that separates the two nostrils (columella). However, it is not very visible and measures about 2 to 3 mm depending on the nose. As a result, the scar is rarely a problem. The convalescence lasts about 2 to 3 weeks. This is a little more painful because the swelling lasts longer, however, the changes are more visible.
Closed Rhinoplasty Technique
Closed rhinoplasty is the least common surgery. Surgeons can not see the inside of the nose during surgery. The surgeon accesses the inside of the nose by passing his instruments under the skin.
As a result, the improvement is minimal, this method is not suitable for a more complex nose correction such as remodeling. However, this rhinoplasty technique can be effective for a slight correction. It depends on each patient and the recommendations of the specialized plastic surgeon.
The incisions are made inside the nostrils, there are no incisions outside since the skin of the nose is not removed. As a result, the scars are imperceptible. Changes and changes are made under the skin. The convalescence lasts 2 to 3 weeks, however the swelling and the discomfort hard less.
What you must remember
The risks of using these types of implants whether it is silicone, the Medpor implant (Porex) or the implant in the form of silicone sheet as the Medpor presents a risk of complications higher on secondary rhinoplasty or more so than on people with thin skin at the level of the nose. Implants are basically used to increase, enhance the dorsum of the nose. It is not recommended to use them for nasal tip surgery only. There are still disadvantages and benefits from the use of nasal implants, each patient is different and therefore unique. During your personalized consultation, Dr. Chen Lee, facial reconstruction surgeon will propose a plan to adapt according to your profile and your expectations. As a result, he will recommend the best options for a satisfactory and safe result.
Silicone nasal implants
Prostheses are smooth implants that are to say non-porous. As a result, the tissue does not cling to it, instead of scar tissue forms around the implant. The highest risk is the displacement of the implant. Sometimes after years, the body will reject and try to expel the implant through the tissues because of its non-porosity. There are many different shapes and sizes of silicone nasal implants.
MEDPOR - Porous polyethylene
This prosthesis, unlike that of smooth silicone, is very porous, so that the tissues adhere very well around the implant. The material is very rigid and allows a good reconstruction of the nasal stop. The risks of displacement are rare. However, revision surgery to remove this implant is sometimes very complex and difficult due to the tenacity and the integrity of the tissues around the Medpor.
GORE-TEX - polytetrafluoroethylene
It is also a porous implant, so the tissues adhere very well around the surface defined by the specialized plastic surgeon. This implant is in sheet form of different thicknesses allowing a more precise shaping and a good fixation of the tissues. The risk of displacement is low. Some surgeons use it to replace the cartilage transplant.
PDS PLATE - Resorbable implant
PDS ™ Flexplate is a resorbable implant that provides structural support and simplifies cartilage management during nasal reconstruction procedures. Studies have shown that the risks and complications of this method are low. The biodegradable implant remains intact during the healing process but is completely absorbed within 25 weeks. Dr. Chen Lee uses this implant when there is not enough cartilage in the nose. This is to minimize another.
RECOVERY AND RESULTS OF RHINOPLASTY
Convalescence is rarely painful, you will be rather bothered by the locks (package that will support the inside of the nose) that prevents you from breathing properly. Not everyone has locks after surgery. Dr. Chen Lee decides during the operation if it is necessary to put or not. If you have wicks the follow-up appointment will take place the next day to remove them for more comfort.
It is possible to have edema or bruising close to the eye, cheeks or nose, they can be more or less important but will disappear in a few days. A moderate headache is usual and you will have to sleep in a semi-sitting position. Rest is essential after your nose surgery.
Your nose will be swollen and you will experience some discomfort to breathe that will also gradually lessen. You will probably feel better 7 to 10 days after surgery, however your nose will be very fragile for 4 to 6 weeks. It will, therefore, be necessary to avoid any risk of shock. Sport and other violent activities must be prohibited for the first 3 months. The skin covering the nose will have to be readjusted and shrink thanks to its elasticity on this osteocartilaginous framework which has been modified. This last point emphasizes the importance of the quality of the skin in obtaining the final result. The thicker the skin, the less the result will be optimal.
Six months will be needed to judge the appearance of the corrected nose. The final evaluation is done around one year.
The final result of a rhinoplasty is long to get: it takes a few months to get the maximum cutaneous retraction.
Rhinoplasty is a surgical procedure that changes the appearance of the nose or its airways. Most rhinoplasty procedures transform the appearance of the nose through surgery by adding or removing bone, transplanting tissue from other parts of the body or simply implanting a synthetic material. Improving the appearance of the face with well-performed rhinoplasty is highly desirable in modern culture. In North America, rhinoplasty is one of the five most common plastic surgery procedures.
A well performed surgical rhinoplasty offers a definitive and permanent change in the desired shape of the nose. In addition, any functional airway obstruction caused by the nose can be addressed by the same rhinoplasty procedure. However, the benefits of surgical rhinoplasty are sometimes diminished by the risk, cost, and cure associated with surgery. The adoption and application of injectable fillings in the soft tissues of the face for cosmetic facial improvement have been generalized and offer the possibility of rhinoplasty without surgery for some.
Non-surgical rhinoplasty with the use of injectable fillers is an alternative for people who are looking for a minimal improvement in the appearance of their nose. Note that it is not possible to improve the respiratory function of the nose with injectable fillings. Dr. Chen Lee recommends injectable hyaluronic acid fillers for non-surgical rhinoplasty. Well-known brands such as Restylane ® and Juvéderm ® are commercially prepared with a hyaluronic acid base. The duration of the effect of a non-surgical rhinoplasty with injectable hyaluronic acid varies from person to person and the specific project used. Most injections of hyaluronic acid are resorbed by the body in the year of injection. To maintain the appearance of the desired nose with injectable fillers, periodic re-injections would be required at 6 to 12-month intervals. Although not a substitute for cosmetic rhinoplasty, non-surgical rhinoplasty offers a less invasive procedure, performed in less than an hour, less expensive, with a minimal recovery period, less discomfort, and does not require a specialized surgical facility (eg hospital or surgery center)
Patients who desire non-surgical rhinoplasty should have realistic expectations and understand the need for reinjections at 6 to 12-month intervals to maintain the desired appearance.
Experience of our patients
FAQ - Surgical Rhinoplasty and Nonsurgical Rhinoplasty
1 – Is rhinoplasty surgery painful?
No, rhinoplasty surgery is not really painful. You will feel discomfort because of the swelling, locks and dryness inside the nose. It may be that breathing through the mouth also hinders you. Headaches can be relieved with tynelols.
2 – In case of transplant, where the cartilage is removed?
If a cartilage transplant is necessary, it will be taken first from the nasal septum. Nevertheless, if this cartilage is insufficient or has already been taken during a first rhinoplasty, the surgeon may need to take cartilage in the ear or use a PDS Plate (resorbable implant). Finally, if a larger amount of cartilage is needed, the surgeon can sometimes remove cartilage from a rib with a 3 cm incision hidden in the under breast furrow.
3 – Will I have stitches to remove?
After an open rhinoplasty, the sutures below the columella will be removed between 6 to 10 days. The sutures inside the nostrils that are resorbable do not need to be removed.
4 – Will I have wicks?
It depends on Dr. Chen Lee during the surgery. If Dr. Chen Lee puts locks on you during the surgery (package) usually remove them the day after the surgery.
5 – Can I have a nose piercing after a rhinoplasty?
It is recommended to wait 8 to 12 months after the surgery before piercing your nose. The risk of battery or infections is lower if you wait 1 year.
6 – When can we resume the sport?
Sports such as walking, stationary cycling can be resumed 3 weeks after the intervention. On the other hand, sports that involve a risk of trauma to the nose such as racket sports or contact sports will have to be suspended for about 3 months minimum. The total consolidation of a nose after a rhinoplasty takes 3 to 6 months.