The face is the most prominent part of a person’s appearance, and the nose plays a crucial role in defining facial harmony. When people look at someone for the first time, the nose is often one of the first features they notice, making its shape and structure very important.
Rhinoplasty, also known as nose reshaping surgery, is one of the most commonly performed cosmetic procedures worldwide. In some countries, such as Iran, it is considered a symbol of beauty. This procedure can be performed surgically or non-surgically to correct the nose’s shape and improve facial aesthetics.
Patient Evaluation
When a patient visits the clinic for rhinoplasty, a detailed assessment is performed, including:
- Tip Analysis: Checking for a broad tip, thick skin, droopy tip, low projection, or tip deviation.
- Alar Analysis: Evaluating the lateral sides of the nose (alae) for thickness, width, or excessive flaring.
- Nostril Symmetry: Assessing nostrils for any asymmetry.
- Dorsum (Bridge) Analysis: Checking for width, deviation, depressions, elevation, or the presence of a hump.
- Septum Evaluation: Identifying any deviation of the septum.
- Surrounding Areas: Analyzing adjacent facial features for a balanced aesthetic outcome.
After a thorough assessment, the procedure, recovery time, and expected outcomes are discussed with the patient. Baseline investigations are recommended to ensure anesthesia fitness.
Types of Rhinoplasty
1. Non-Surgical Rhinoplasty (Liquid Rhinoplasty)
This is a non-invasive, office-based procedure where dermal fillers are injected into the nose to improve its shape. It has minimal downtime and provides immediate results.
2. Surgical Rhinoplasty
This involves permanent surgical correction and includes:
- Augmentation Rhinoplasty – Enhancing the nose structure, often for a flat nose.
- Preservation Rhinoplasty – Maintaining natural structures while reshaping the nose.
- Reduction Rhinoplasty – Reducing the size of the nose for better proportions.
- Turkish Delight Procedure – Breaking down cartilage into small pieces, wrapping it in Surgicel or fascia, and placing it in the nose to augment the dorsum (bridge), especially in flat noses.
Surgical Procedure
Rhinoplasty is typically performed under general anesthesia. The key steps include:
- Marking & Infiltration – The nose is marked, and local anesthesia is injected.
- Incision & Skin Elevation – An incision is made on the columella, and the skin is lifted to expose the nasal structures.
- Assessment & Corrections:
- Separation of Cartilage – Preparing the nose for reshaping.
- Hump Removal – Removing any nasal hump.
- Septoplasty – Correcting a deviated septum if present.
- Osteotomies – Narrowing a broad nasal bridge by reshaping the bone.
- Tip Refinement – Elevating and reshaping the nasal tip.
- Columellar Strut Placement – Supporting the nasal tip for a long-lasting lift.
- Alar Reduction – Narrowing wide nostrils if necessary.
Advanced Techniques:
- Turkish Delight Procedure – Used for flat noses by augmenting the dorsum with processed cartilage.
- Cantilever Graft – Inserting rib cartilage to build the nasal bridge.
After all corrections, hemostasis is secured, the wound is closed, and dressing with a nasal splint is applied.
Post-Operative Care & Recovery
- The patient stays 1-2 days in the hospital.
- Nasal packing is done, and the patient breathes through the mouth.
- The patient is advised to sleep with an elevated head.
- Swelling & bruising under the eyes subsides in one week.
- Nasal packing is removed after 2 days, but external dressing remains for one week.
- Stitches & dressing are removed after 7 days.
- Major swelling subsides in 2-3 weeks, but internal swelling takes 2-3 months to fully settle.
- After removing the dressing, gentle nose massage is recommended for symmetry.
- No physical trauma (e.g., contact sports) should occur for 3 months.
- Final results are visible in about 3 months, with minor changes continuing for up to 6 months.
Benefits & Risks
Benefits
- Improved nose shape
- Increased self-confidence
- Symmetrical nostrils
- Elevated nasal tip
- Removal of humps & bumps
- Better harmony with facial features
Potential Risks (Minimal if performed by an experienced plastic surgeon)
- Temporary swelling & bruising
- Short-term breathing issues due to swelling
- Asymmetry (rare)
- Recurrence of deviation in some cases
Cost of Rhinoplasty in Pakistan
The cost varies based on the procedure type:
- Non-Surgical Rhinoplasty (Liquid Rhinoplasty): 30,000 – 50,000 PKR
- Surgical Rhinoplasty:
- 130,000 – 165,000 PKR (depends on complexity)