SURGICAL ART FORM
It is one of the most common facial plastic surgery procedures performed. This is because the nose has the greatest impact on how a person looks. Nasal surgery aka rhinoplasty can be performed to change the consequence of genetics, birth defect or nasal injury. It can be done to enhance your appearance and/or to improve your nasal breathing. Modern rhinoplasty is a surgical art form.
Kambiz Golchin is a renowned rhinoplasty surgeon based in London.
Nose reshaping and contouring is commonly described as having “a nose job”.
The medical term to describe plastic surgery on this part of the face is Rhinoplasty. To achieve a natural looking nose that complements your facial features can be achieve surgically or non-surgically.
Surgery involves an invasive procedure; the approach or technique used is determent by individual needs, anatomy, injury or revision from previous surgery. Approach can be described as either an open or closed Rhinoplasty, which is based on a joint consultation determent by your consultant.
Having Rhinoplasty surgery can change the overall appearance of the face. To enable patients to make an informed decision on having nose surgery Mr. Golchin preforms 3 dimensional (3D) photography of the full face prior to any treatment. This enables patients to realistically see visually what the final result will look like following treatment.
Mr. Golchin also preforms a non-surgical approach for nose contouring achieved with fillers. This approach is a good option for an individual who needs minimal contouring but provides a non-permanent pre-surgical visual for patients if surgery where to be opted for at a later date.
How Nose Cosmetic Surgery is done
- Nasal surgery (Rhinoplasty) is performed as an inpatient in a private hospital. It may be combined with other procedures such as facial or chin surgery.
In most nose surgeries general anaesthesia is used. However, in some cases, local anaesthesia with intravenous sedation may be sufficient.
- Mr Golchin uses the computer imaging photographic references in the operating theatre to provide direct evaluation of the intended goal during the procedure.
Rhinoplasty can be accomplished using an internal or external surgical approach. The internal surgery approach allows all the incisions to be hidden inside the nostrils. Therefore there is no evidence of any cuts or scarring on the outside of the nose after surgery.
- The external (Open) approach to surgery leaves a small scar under the nose. The external incision is placed under the nostrils. In Mr Golchin’s practice this generally only applies to very complicated cases only with twisted nose or abnormalities of the tip.
- Mr Golchin uses the internal approach for most surgical cases whenever possible. This approach provides more delicate control of the final shape of the nose because the skin is not loosened up very much during the surgery. This permits a more accurate assessment of the shape during surgery.
- After anesthesia is given, small incisions are made inside the nose. Specialized instruments are used to separate the skin from the underlying supporting framework of bone and cartilage. The bone and cartilage are then sculpted to the desired shape.
- The nature and extent of the sculpting are dependent on individual nasal anatomy and the desired contour with the aim of providing a good long-term outcome for both breathing and the shape. Accordingly a more conservative approach is sometimes suggested with grafts and/or sutures used to increase the strength of the nose. Some patients require building up of the nasal bridge.This may be due to injury, previous overzealous surgery or just having a small nose. In such cases an “Augmentation rhinoplasty” is performed. Materials for building up the nose can be natural materials, such as the patient’s own cartilage and bone, or else foreign material, such as high-density porous polyethylene. These materials are sculpted and placed in appropriate areas.
- Natural materials have the advantage of being better tolerated and very safe. However sometimes natural materials are not the right shapes or there may be an inadequate supply for the extent of the augmentation that’s required. The main risk of foreign materials is that of infection and rejection. These materials have been modified over the years so that materials available now have a much lower risk of these complications. Mr Golchin will discuss these pros and cons with you very carefully.
- When the rhinoplasty is completed, a plaster is applied to protect and maintain the new shape of your nose. It also limits the amount of postoperative swelling. If the nose surgery involves straightening your septum, soft nasal splints may be placed in your nostrils to stabilise the septum. The rhinoplasty operation takes one to three hours depending on the complexity of the nose surgery.
Pre-operation notes for Nose Surgery (Rhinoplasty)
At your initial consultation, you will be asked to express your concerns about your appearance and describe your symptoms. Digital photographs of your face will be taken and computer imaging will be used to analyse your nose and enable you to view your current appearance and realistic outcomes following surgery.
Your medical history will be reviewed and a physical examination will be conducted to determine if nasal surgery is best for you. Physical characteristic such as the size and shape of your nasal bones and cartilage as well as the thickness of your skin may affect the technical considerations.
You may be required to visit your GP for a check up & for any necessary blood work & x-rays. Precise preoperative instructions are provided, and all necessary prescriptions are given to you in advance of the surgery. You will be provided with a complete list of which medications to avoid.
Risks of Surgery
As with any operation, nasal surgery has minimal risks and potential complications. However, with highly trained cosmetic plastic surgeons and nurses making up the surgical team, complications are extremely rare. Like all surgeries, the risk of bleeding, infection, scarring or an anesthetic problem is present.
Healing affects the nose in different ways. With heavy skin, the nose is likely to drop a little over time, and there is a higher risk of scar tissue under the skin. Consequently, the experienced surgeon makes a shape during surgery that allows for these inevitable changes. Mr Golchin sometimes uses medicines in the postoperative period to reduce scar tissue and permit sculpting of the tip on the months after surgery.
Since all of the incisions are inside, there are no visible scars. When the External (open) technique is employed, the small scar underneath the nose becomes inconspicuous after several months. Should the unusual situation occur that the incision is noticeable, revision and dermabrasion procedures are available.
In about five percent of rhinoplasties, a second procedure may be required to correct a minor deformity such as a small residual bump on the bridge. The corrective surgery is usually minor in nature.
Before you begin with the procedure, the doctor will have to examine your physical well-being to decide whether or not you’re suitable for the surgery. Mr Golchin will revise your medical history (to see your previous operations, allergies, medications you use, etc.) and make an assessment. Some other things he takes into consideration are the thickness of your skin, as well as the size and shape of your nasal bones. If need be, you may have to visit your GP for further check-ups and blood work.
As for the procedure itself, you will need to prepare yourself. The doctors will treat you as an inpatient in a private hospital. If you’re a smoker, we advise you to abstain from smoking six weeks before the procedure; it can negatively impact your healing capabilities.
Additionally, for a week before the surgery, you have to avoid using any medication containing Aspirin. Finally, you must not eat on the day of the procedure. But don’t worry — the doctor will inform you thoroughly about all of this.
Rhinoplasty as a procedure carries on for one to three hours, subject to the job at hand. There are two types — external and internal. Internal (closed) surgery is the most common one, as the surgeon cuts the skin inside the patient’s nostrils. That way, your scars will be inside your nose, and therefore, not visible. The external (open) rhinoplasty consists of making an incision on the vertical strip that separates your nostrils (the columella). The scars from the open approach are visible but not that noticeable. Mr Golchin opts for this approach only when there are complicated cases involved, such as a twisted nose or tip abnormalities.
Beginning the Process
When you arrive, an anaesthesiologist will apply a general anaesthetic. That will make you go to sleep, and together with local, intravenous anaesthesia, you won’t feel any pain. So basically, you’re in for a three-hour nap, and you’ll wake up with a new nose. Closed rhinoplasty, Mr Golchin’s preferred method, doesn’t make your skin loose. That allows the doctor to make more accurate assessments of your nose shape.
Depending on what you’re looking for, the doctor will build up your nasal bridge using either your cartilage or high-density porous polyethylene. During the procedure, the doctor will work on achieving the desired shape while not impeding your breathing process.
After they finish the surgery, you will wear a plaster over your nose. If the doctor straightens your septum (septorhinoplasty), you will also have to wear soft nasal splints for stabilisation.
Before and After
Mr Golchin and his surgical team of highly trained professionals will make sure that potential complications and possible risks (including bleeding, infection, rejection of foreign material, etc.) don’t occur. Around five per cent of all rhinoplasties require additional procedures to work on minor deformities. Some of the side effects that you’ll probably experience include:
- Stuffy nose
- Bruising around your eyes
- Swelling around the nose
- Minor difficulties with breathing
The recovery time lasts for about two weeks, and everything mentioned is a perfectly normal reaction. Sometimes, the doctor recommends medicines that help reduce scar tissue. In the first 6–12 months after the procedure, the nose can alter its shape slightly (not noticeable by others). Thanks to Mr Golchin’s experience, he counts on that during the operation. Therefore, he will make millimetre-long changes to make sure that you still have the desired look years after the procedure.
What to Expect
If you’re looking for rhinoplasty in London, you can make an appointment with Mr Golchin at the Rita Rakus Clinic, in Knightsbridge. They also have a clinic centre in Dublin. At the consultation session with Mr Golchin, you will describe what you’re unhappy with and how you’d want your nose to look. The clinic uses state-of-the-art imaging technology in order to produce a 3D rendering of your entire face. That will help you with visualising the results. Additionally, the doctor will be able to provide you with the idea of what’s realistically possible.
Bear in mind that you can’t let your imagination go wild. There are limits to how much your nose can be changed, and the doctor will assist you with deciding on a realistic goal. You also need to check whether you’re suitable for a surgical rhinoplasty. First of all, our noses grow and develop until after puberty. So unless there’s a medicinal need for it, you shouldn’t have a nose job until you’ve reached the minimal right age (16 for women, 18 for men).
What’s more, the award-winning Mr Golchin also performs what we call filler rhinoplasty. Essentially, it’s a non-surgical (therefore, non-invasive) approach to a nose job. He applies fillers for nose contouring, which can reshape your nose and cover some of the deficiencies you notice. This method, however, is non-permanent, and the effects usually stick around for about 9–12 months. If you’re not quite sure about making a definite choice, this procedure can greatly help you visualise your post-surgery nose and see if you’re happy with it before you commit to a surgical approach.
Once you have all the information needed and have decided on your nose’s new shape, it’s time to visit the operating theatre.
I was very nervous about getting lip fillers for years, but I got recommended to Mr Golchin and I cannot recommend him enough! He made me feel at ease about the treatment and gave me exactly what I wanted! It was painfree and my results are amazing! – SarahSarah
I have been attending Mr. Golchin at his clinic in Dublin for Botox & Fillers for quite a few years, with great results. I am never concerned about trying fillers in any new areas of my face or trying any new treatments suggested, as I have complete confidence in Mr. Golchin and his team. It’s very important to me to achieve a natural result while still noticing an obvious improvement and I am never disappointed. – MichelleMichelle
I contemplated rhinoplasty for a number of years and after extensive research I finally decided to go ahead with it in August 2017. To say it was a decision not taken lightly would be an understatement. I wanted the best results and the best surgeon and I can honestly say I got both. Mr Kambiz Golchin is a true professional and perfectionist and it is clear he takes great pride in his work. Mr Golchin established exactly what I wanted and delivered, surpassing my expectations. BexBex
I had decided many months ago to get rhinoplasty and had since visited a number of the top surgeons in London, after being dissatisfied a friend referred Mr Golchin. From start to finish, including my pre operative care to my end result I could not be happier and would highly recommend Mr Golchin as a wonderful surgeon who has changed my life and I could not be happier with my new nose. – cmbrowneC Browne