The nose is the central element of the face, and therefore its cosmetic remodeling improves the facial general appearance. This procedure is also used for reconstructive purposes to correct traumatic injuries, congenital malformations and breathing problems. Rhinoplasty is the most demanded aesthetic surgery nowadays.

What are the indications for rhinoplasty?

Patients, both women and men, choose rhinoplasty for a variety of reasons, which often include one or more of the following:
To reduce or enlarge the size of the nose
To change the shape of the tip or of the nasal pyramid
To narrow the nostrils
To change the angle between the nose and the upper lip
To correct congenital malformations
To repair traumatic injuries
To solve breathing problems

Ideal candidates for rhinoplasty are generally healthy men and women with realistic expectations about the procedure. It is best to have at least 15 years of age before considering a nose job, to ensure that it’s growth is completed.

First consultation

During the first consultation, before planning your surgery, Dr. Sinescu will carefully evaluate your nose and facial structure to establish the best therapeutic strategy. We will discuss what you can expect from this surgery and we’ll review all the existing options. You will be given a detailed explanation of the procedure, steps to be followed before and after surgery, potential risks and complications, costs and payment methods. We will answer all your questions. We’ll ask for medical history, information on cigarette and alcohol consumption and a list of all the medicines you use, including the over the counter ones. If you are dissatisfied with the results of a rhinoplasty performed by another surgeon, we will discuss the additional details associated with secondary rhinoplasty.

Surgical procedure

The operation will take place in one of the ultramodern clinics where our surgeons work. The intervention can be performed either in general anesthesia or with local anesthesia and sedation, depending on what you and your doctor prefer. With general anesthesia you will be completely asleep throughout the procedure. With local anesthesia you will be slightly sedated, and your nose and surrounding area will be numb. You will be awake, but you will be relaxed and you will not feel uncomfortable. The type of anesthesia used will be discussed with you prior to surgery.

There are two ways to perform rhinoplasty: the closed technique, in which the nostrils are incised on the inside, and the open technique, in which the incision is made at the level of the structure that joins the two nostrils. Regardless of the technique, the surgery usually lasts for about two hours.
Once the incision is made, the skin is separated from the supporting structures, namely bone and cartilage. If one of the surgical goals is to reduce the size of the nostrils, small incisions are made at their base. The bone and cartilage are then carved in the shape that you have agreed with your doctor and the skin is repositioned above. An external splint is used to maintain the new nose structure and special dressings are inserted in the nostrils to stabilize the septum.

In secondary rhinoplasties, many of the structural elements of the nose might have been over-resected. This can lead to breathing problems because a large part of the airway support structure has been altered. Our surgeons believe in recreating the structure of the nose to restore integrity and function and to improve breathing. Thus, cartilage grafts are used to reconstruct the nasal structure and give it a new form. There is usually an insufficient amount of septal nasal cartilage, so the surgeon has to get the cartilage either from the ear or from the cartilage of the ribs. The type of cartilage used by the surgeon depends on the problem to be corrected, and options will be discussed extensively in preoperative consultations. Our surgeons do not use artificial implants for secondary rhinoplasty because of an increased risk of infection and extrusion of artificial material. Sometimes the open approach is useful, a small incision on the columella, which allows for better access and better visualization. Therefore, the doctor can provide better symmetry, maximizing the likelihood of a good cosmetic result. If properly closed, the columelar incision will heal with a virtually imperceptible scar.

Recovery after rhinoplasty

Bed rest- 24 hours
Extraction of internal dressings – 48-72 hours postoperatively
Removal of the external splint – 7-10 days postoperatively
Suture extraction – 7 days postoperatively
Return to school / work – 7-10 days postoperatively
Driving – as soon as you feel comfortable
Local contact – as soon as you feel comfortable
Intense physical activity – 3-4 weeks postoperative
Using reading glasses – 6-8 weeks postoperative
Contact sports – 6- 8 weeks postoperatively
Fading of the scars – a few months to one year

What are the possible side effects or risks?

All surgical interventions have a certain degree of risk; however, major rhinoplasty complications are rare. During the first consultation, the individual risks will be evaluated and discussed. You can help reduce risks by carefully following the pre- and post-operative instructions provided. Our staff will be at your side at every step of the way to ensure a safe and aesthetic result.

The most likely side effects include the following:

– infection
– persistent edema
– epistaxis – nose bleeds
– asymmetry
– necessity for another surgery

How long do the results last?

Nasal surgery can reshape, resize and improve the appearance of the nose. In most cases, these results are permanent. Of course your face, including the nose, will change with age.

Frequently asked questions

Does my health insurance cover the costs of the intervention?
In most cases, rhinoplasty is considered cosmetic surgery and is therefore not covered by insurance. You are responsible for the full payment of the procedure. Cost and payment information will be fully discussed with you during your initial consultation. Sometimes, insurance will cover the cost of the intervention if it is considered medically necessary, to improve breathing problems.

What other procedure could be associated with rhinoplasty to improve the result?
Several surgical procedures can enhance your facial appearance and give you a more youthful, rested look. These include: facelift, blepharoplasty, brow-lift, remodeling of the chin, cheekbones, and lips.

Are there alternatives to rhinoplasty?
There are currently no non-surgical alternatives for correcting deformities treated by rhinoplasty. For minor changes in shape, remodeling with hyaluronic acid can be used.
How long after rhinoplasty do I have to wait for a revision surgery?
The general guideline is to wait at least 12 months to allow edema to completely disappear. There are situations in which the appearance is unlikely to improve over time, as in the case of crooked or crashed nasal pyramids, and waiting can make the correction surgery difficult. Our team will advise you on the best moment and the ideal approach.

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