Rhinoplasty Abroad Nose Jobs Abroad Nose Surgery Prague

What is a nose job?

A nose job or rhinoplasty is one of the most common but technically most difficult plastic surgery procedures. Anyone is eligible for a nose job, as long as their nose has finished growing. Rhinoplasty can reduce or increase the size of your nose; correct the shape of the tip or the bridge or narrow the span of the nostrils. The plastic surgeon can shorten or prolong the nose, although more often it is a complex surgery that changes nose asymmetry.

Why nose job in Prague?

Prague has many attractive features for those considering rhinoplasty abroad. Its location in Central Europe is easy to access; its mild climate is conducive to healing and its experienced clinics and nose job surgeons ensure you'll receive the best possible care. Nose job Prague costs are often much more affordable than in the UK or with the NHS. For more information about getting to and around the Czech Republic, please visit our handy cosmetic surgery Prague info guide.

Nose Job Surgery

Types of the surgery

Closed method:

Rhinoplasty is performed through inner incisions; scars are in such case invisible inside the nose.

Open method:

Second type of the surgery is open rhinoplasty. The surgeon leads the incision across the nasal septum. The incision is not straight but in shape of letter W. The scar is visible but very inconspicuous.

Advantaged and disadvantages of open method

Better approach and easier modeling leads often to this method. Necessary insertion of augmentation (refilling of tissue) is also an indication to choose this method. One of the disadvantages is long lasting swelling and visible scar. Usage of this method is very discussed and surgeons choose it mainly during re-operative procedures.

Nose is formed from cartilaginous and bony part. If the surgeon shapes only the cartilage and surrounding skin, it is then a surgery of soft nasal parts.

Shaping the columella

SURGERY OF SOFT NASAL TISSUES

The lateral wall of the nose is formed by nasal bone, cartilage of septum and wing cartilage. Incisions below, between and inside the cartilages are basic incision in surgery of soft tissues.

SURGERY OF FIRM NASAL TISSUE

Surgery of firm nasal tissue is associated with a change of bone structure. Special position has so-called septoplasty, when only a nasal septum is shaped and this procedure can be undertaken beside plastic surgery also at Otorhinolaryngology (the medical specialty that deals with diseases of the ear, nose and throat).

The surgeon decides if the surgery will be performed also with another surgical procedure. Usually performance of two plastic surgeries in the face at the same time is not recommended though. This part of human body is very sensitive to swellings and it could bring further complications.

Surgery of the tip of the nose: It is one of the most difficult procedures in rhinoplasty.

Surgery of wide nose: If nose is too wide from its root then the only possible technique is cutting part of the bone from the middle of nasal tip.

Surgery of hump on the nose (gibus): At first the surgeon tries to separate skin on the bridge of the nose and the mucosa from the bony part. He/she uses one of the access incisions: incision below the wing cartilage or across nasal septum. After that an incision is lead inside the nasal cavity above the wing cartilage and the surgeon gets between the skin and nasal bridge. He /she chops nasal hump with cutter. In some cases the chopped part of the tissue is used to reshape the bridge of the nose. It is then necessary to fix the tissue implant against its shift with for example special glue, micro screw or suture. Sometimes as a prevention of dislocation serves only external plaster. In smaller odds it is possible just to grind the bone.

Septoplasty: According to approach it is possible to operate through open or closed method. Septoplasty is a complicated procedure. One of the techniques is breaking the bony part of nasal septum and its fixation (through tamponade or other devices) in the right position. Less frequent is the method with taking out of the cartilage, reshaping it outside of the nose and then implanting it back. The easiest technique is with tiny incisions that help the surgeon to shape the septum well with tamponade. Sometimes outgrowths and humps occur on the septum, they can be easily removed by chopping.

Shortening of the nose and turning the tip upwards: This result can be achieved by removal of wedge part of lateral side of wing cartilage.

Surgery of movable nose by mimic: Movements of nose cause tiny mimic muscles that are connected to nasal cartilage. Movement of nose is totally physiological although in some cases the muscle is too short and causes excessive movements. This movement can be eliminated by breakage of the spot where the muscle is fixed. The surgery is performed through inner method with incision across cartilage of nasal wing. Second muscle that pulls the tip of the nose downwards can be cut by access from the mouth cavity between upper gum and lip.

Others: Lateral cut-out of the bone serves to reshape and lower the nose. Shaping of the change from forehead to nasal bridge can be deepened by side removal of a bone from lateral wall of the nose. Depression of nose is a complex procedure that needs cut-out of part of the bone from nasal septum and lateral sides.

Secondary rhinoplasty

It is a reoperation. The tissue is changed from one or several rhinoplasties and therefore its reoperation brings significant risks. One of them is insufficient blood supply of the tissue. As a rule for plastic surgeons serves not to perform the surgery sooner than one year after the last procedure. We try to have the secondary surgery as least reductive as possible because tissues heal longer. Most often we encouter with so-called parrot nose, piggy nose, nose in a shape of ski ramp, nose with invereted nasal wing, nose with sagging tip.

Parrot nose: It forms as a consequence to reproduction of ligament in healing nose.

Solution: Removal of ligament

Piggy nose: It is formed by excessive removal of septum or wing cartilages.

Solution: Usage of graft.

Nose in a shape of ski ramp: It is caused by removal of larger part of nasal bone.

Solution: If the profile and shape of face allow it, we lower the tip. If the deformity is too large we use graft.

Inverted nasal wing: It is caused by narrowing of the outer part of wing cartilage.

Solution: We cannot avoid transplantation mostly from ear or septum.

Sagging tip: It is caused similar like parrot nose. Sometimes it can be caused by uncareful intervention into structures of the tip.

Solution: It is more complicated than by piggy nose.

Deviated septum surgery

Anesthesia

In most cases, a nose job is done under general anesthesia. It can be done under local anesthesia; the decision depends on the extent of the treatment along with the preference of the patient and the advice of your surgeon. With local anesthesia, the nose will be numbed with an injection and you will not feel any pain during the treatment. However, the surgery can be more noticeable and may be annoying. With general anesthesia, you will sleep through the rhinoplasty surgery. The patient is usually requested not to drink, eat or smoke for about six hours before general anesthesia and may need to remain overnight in hospital.

Procedure of a nose job (rhinoplasty)

A nose job usually takes one or two hours, more complicated treatments can take longer. By classic process of the surgery a nasal skin is loosened, cartilages of the bridge and wings are partially removed and eventually reshaped, nasal hump is removed and bony part of the nose is narrowed, if it is the situation. The surgeon is able to refill part of the tissue so the shape and desired esthetic result would be perfect. Refilling is performed mainly with own body tissue, best suitable are those that have similar structure and color of the own nasal tissue. For replacement of the cartilaginous part is used cartilage from nasal septum or ear and exceptionally cartilage from rib connection. Skin around nose is very tolerant and strategically lead incisions contribute to a perfect result. Nose is fixed in its final shape with plaster. A tamponade is put into nostrils that stops bleeding. A patient with tamponade can breathe only with mouth.

Are you a good candidate for a nose job – rhinoplasty?

The best candidates for rhinoplasty abroad are people who are looking to improve their look. If you are healthy, psychologically stable and realistic in your expectations, you may be a good candidate for a nose job. Rhinoplasty can be performed to meet aesthetic goals or for remodeling purposes to correct birth defects, such as cleft deformities, or breathing problems. You can view before and after photos of nose jobs abroad in our photo gallery. Age may also be a consideration. The surgery should not be performed before the development and growth of the person is finished. Usually, this is around 18 years of age for men and 16 years of age for women. Upper age limit is not strictly set; it depends on the quality of the skin, which is getting worse after 35 years. It is hard to heal oily and very porous skin. Patients with disposition to scars are not recommended to undergo rhinoplasty. Surgeon will not perform the surgery if you or in your family occurred bleeding disease or thrombosis (blockages of arteries or vessels). It is possible to change the state of patient by medicaments so that he/she will be able to undergo the surgery. In patients with internal problems significant surgical procedures are not recommended at all.

Before rhinoplasty

During the first consultation, your surgeon will explain the operational procedure in detail, assess your case, discuss with you the possibilities of surgery and choose the most appropriate one for you. This part of preparations is very important. You and your surgeon should try to be open and both agree on final result. Many clinics work with software modeling or with photography. Nose surgery presents change in total facial expression and you should be ready for this change. Surgeon has to take into account your individual facial proportions. They form total profile and therefore larger impacts into shape of the nose are followed by change of lower jaw and chin.

Remodeling of noses with humps

During facial analysis following proportions are assessed:

Be sure to tell the surgeon if you have had any previous nose surgeries or any injuries to your nose, even if it was many years ago. You must also inform the doctor if you suffer from breathing problems. It is assumed that no acute illness (viral illness, cold etc.) will have occurred in the period preceding the surgery. Inform your surgeon about any illness.

You will be sent to internal pre-surgical examination. If you take warfarin, aspirin or other medicaments against inflammation, you should stop at least one week before the surgery. Talk to your surgeon that prescribes these medicaments to you, whether to replace them with others that will not complicate rhinoplasty. You should limit smoking for at least two weeks before the surgery and for the recovery period. While preparing for your nose job, be sure to arrange for someone to drive you home after your surgery and to help you for a few days, if needed.

After the nose job

Immediately after the surgery, a small plaster splint will be placed on your nose to stabilize it. It will be removed approximately seven to 14 days after your nose job, depending on the type of treatment. Patient puts it over night for approximately one more month. He/she spends the first night at the medical clinic. The wound is re-bandaged the third to fourth day and the tamponade is removed. If non-absorbable sutures are used during the surgery they are removed 7-9 days after the surgery. During the first couple of days after surgery, be prepared for swelling of the face, especially in the area of the eyelids. These swellings worsen usually by sudden temperature changes. Often occur also blood hematomas. The swelling can be easily reduced with cold compresses. Small swelling can last for weeks or months. Your nose may feel stuffy for some time; this is caused by the swelling of your nasal mucous membrane. It isn't recommended to drive for at least a week following your nose job. Most patients do not complain about major pain following their rhinoplasty procedure. The healing process can be accelerated by pressure massages that work as prevention against complications. Right procedure of pressure massages explains the surgeon after the surgery. In general, pressure massages are performed three times a day. Patient presses on the operated nose for 30 seconds and the pressure is repeated on each spot at least 10times. The type of massages is chosen according to the type of surgery that they underwent. Many people return to work when the plaster is removed, which is usually in about two weeks. Heavy physical activity is not recommended for about three weeks. Especially dangerous are ball games, when threatens nose injury. The operated nose forms and it does not reach its final shape until one year after the surgery. Therefore it is good to postpone ball games, box and other combat sport until the nose is not steadily formed. In the summer the patient should not expose to the sun for at least 3 months after the surgery because there is a threat of unnatural pigmentation of corrected nose. In winter the nose is more likely to freeze. Some medical clinics use food complements (nutrimax, wobenzym) and/or biostimulation lasers to moderate swellings and to accelerate healing of bruises.

To discuss other's experiences with nose jobs abroad, visit our forum.

Nose augmentation

Complications

Severe complications are fortunately not frequent by this surgery. Although as less severe can be mentioned change of color of nose, cracking of tiny vessels, slow healing of the wound and headache. Some patients describe small asymmetry after the surgery, which they get rid of during the recovery process though.

Client should count even with more severe complications, such as bleeding, formation of keloid scars (visible cicatrization of a tissue, when the scar is firm, impossible to massage). Inflammations and infections close to nose are also dangerous (although it can be only temporary). Sometimes patients complain on bad breathing, which is caused by blockage of the nostrils and/or on chronic pain. Injury of inner cranial structure including eye is rare.

How to choose a good surgeon

Invest enough time to choose a good surgical clinic and surgeon that you trust to. Do not measure only the price because even in the most expensive and most famous place you have no guarantee that you will get along well with the surgeon and that you will be able to express your expectations. On contrary at clinics that are much less expensive than the others there is danger that you won’t get complete care that the procedure desires. Find out where in your vicinity is rhinoplasty performed. Make an appointment in two or three of these clinics. This way you can find out how they differ from your own point of view. You will assess professional attitude of the surgeon and the way of communication with him/her. Total costs may increase a little bit, although the initial consultation ranges from 300 to 1000 CZK, which is not such an investment. Do not be afraid to ask the surgeon on his/her qualification. Choose a surgeon that is professionally trained in the field of plastic surgery and has several years of experience with nose job surgeries. Ask how often he/she performs rhinoplasties and ask for some sample pictures.

Financing

In some case rhinoplasty is indicated and therefore even covered by insurance company. Patient has the right for rhinoplasty after an injury or with congenital deformity like cleft of nose or upper jaw or with breathing problems that are caused by asymmetric position of nasal septum. In all these cases insurance company covers the surgery. Only problem could occur if the clinic that you chose does not have a contract with your insurance company. Septoplasty is often performed in ordination of otorhinolaryngologist. If the patient desires septoplasty and cosmetic nose surgery at the same time, it is good to visit clinic, where otorhinolaryngologist cooperates with the specialist from plastic surgery.

How long will the effect of nose surgery (rhinoplasty) last?

The results of a nose job are lasting. It is however necessary to realize that the final result may not be apparent for up to one year after the operation.

This text has been created with the kind assistance of Tomas Dolezal, M.D.

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