Rhinoplasty

HOW IS THE PROCEDURE PERFORMED?

Usually, a controlled IV Anesthesia is utilized. The patient usually arrives early and medications are administered and supplemented with intravenous medication. During anesthesia your vital signs are determined as safe and stable. Surgery generally lasts between one to two hours depending on its combination with functional surgery breathing improvement. The patient experiences no pain during the surgery. A splint or cast is applied and will be removed between 4 to 6 days. After the procedure is completed, the patient then recovers in a relaxed ward environment for about half day before being driven home by a companion.

WHEN CAN RHINOPLASTY BE PERFORMED?

Nasal surgery is generally avoided in children. There are some exceptions to this rule including major deformities which could influence the mental and emotional health of a child. In such situations, correction of these deformities could be done before school age. For lesser deformities surgery is deferred until after the child stops growing (about 14th year of life). Proper Rhinoplasties performed on teenagers could be beneficial to the social development and self-confidence of the individual. The aging process is reflected in many ways in the nose and its correction can make appearances look younger.

HOW IS THE PROCEDURE PERFORMED?

Usually, a controlled IV Anesthesia is utilized. The patient usually arrives early and medications are administered and supplemented with intravenous medication. During anesthesia your vital signs are determined as safe and stable. Surgery generally lasts between one to two hours depending on its combination with functional surgery breathing improvement. The patient experiences no pain during the surgery. A splint or cast is applied and will be removed between 4 to 6 days. After the procedure is completed, the patient then recovers in a relaxed ward environment for about half day before being driven home by a companion.

WHEN CAN RHINOPLASTY BE PERFORMED?

Nasal surgery is generally avoided in children. There are some exceptions to this rule including major deformities which could influence the mental and emotional health of a child. In such situations, correction of these deformities could be done before school age. For lesser deformities surgery is deferred until after the child stops growing (about 14th year of life). Proper Rhinoplasties performed on teenagers could be beneficial to the social development and self-confidence of the individual. The aging process is reflected in many ways in the nose and its correction can make appearances look younger.

WHEN WILL I BE ABLE TO SEE THE RESULTS?

The nose will be very sensitive for approximately a month. The patient will start to see a difference immediately but it will still be swollen. Generally the swelling starts to disappear about a week after the cast is removed. Most of swelling and discoloration are usually gone by 2 weeks after surgery. About 90% of the swelling is gone by three months after surgery and the rest slowly disappears over two years. Although the nose is still swollen after the first month, most people would not recognize this fact. The patient will not notice this swelling. Instead, the patient will notice that the nose becomes more refined with better definition over the first year. The inside of the nose may be swollen for approximately three weeks after the surgery. Nasal breathing may be difficult during this time. If surgery is performed to straighten the nasal septum, an improvement in breathing will be appreciated after a month.

WHY ARE PICTURES TAKEN BEFORE AND AFTER SURGERY?

Pictures are taken prior to surgery to help plan the procedure. They are useful guides which surgeon will use in planning and preparing for the surgical procedure. In addition, postoperative photos are taken to enable you and the surgeon to evaluate the results of the procedure

I HAD A RHINOPLASTY THROUGH ANOTHER SURGEON 6 MONTHS AGO. I COULD NOT BREATTHE NORMALLY THROUGH NOSE, IS THIS NORMAL?
Usually at this time the breathing should be mostly restored. I would suggest that you have a follow up with your surgeon and ask his advice or determine if the lack of airway is indeed from a problem inside nose. If you had no results, I recommend that you have a diagnostic nasal endoscopy to define clearly all of internal problems of your nose.

WHAT IS DIAGNOSTIC ENDOSCOPY OF NOSE?

Diagnostic endoscopy of nose is a simple diagnostic tool to observe all of details inside the nose to determine every abnormal condition which causes difficult breathing. I perform it routinely on every patient whose problem demands further investigation. With the better observation and better understanding, we can treat problems more effectively.

HOW RHINOPLASTY IS DONE?
The nose is the central feature of the face, its position could affect the whole of the face. Surgery to reshape the nose is a very common plastic surgery procedure and it can either increase or decrease the size of nose. The shape of the tip, the bridge and the angle between the nose and the upper lip can be changed. Breathing difficulties can be corrected at the same time. There is usually some bruising and swelling, particularly around the eyes, which can take up to three weeks to completely disappear. By the end of the third week, swelling will have settled sufficiently for you to look normal to others and as if you have not any recent surgery. You can go to your school, university or job a week after surgery.

Since 1992 thousands of aesthetic nasal surgery procedures have been performed by him which have been appreciated for their long term stability and the best natural aesthetic results. Dr. Naraghi is a member of multiple international professional societies including European Academy of Facial Plastic Surgery (EAFPS), American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS), American Rhinologic Society (ARS), and European Rhinologic Society (ERS). More than thirty international scientific papers and over one hundred journal articles and chapters in Rhinology were authorized and published by Dr. Naraghi. He has presented numerous scientific papers in many international congresses in Europe, US and Australia, introducing several new methods in nasal surgery. Dr. Naraghi is the author of six books, most of them are in the field of Rhinology.A two-volume Rhinology book has been appreciated by the President of ISO-HNS as the first comprehensive Rhinology textbook in his native language. Dr. Mohsen Naraghi have earned three national first rank awards for the best surgeon in research, the highest rank in speciality board and the first rank in the comprehensive national medical examinations. Mohsen Naraghi MD has had extened experience and appreciated innovations in the field of Rhinology. He was recognized by the president of ISO-HNS as an innovator of minimally invasive surgical techniques in the field of Rhinology. He has been the pioneer of the Endonasal Endoscopic Laser Surgery in Iran.Recently, he was the presenter of the article in LosAngeles which won the 2005 International Award of the American Rhinologic Society. He presented his lecture in Rhinoplasty Course at the American Academy of Facial Plastic and Reconstructive Surgery Annual Meeting in Los Angeles.Hereby you can read a published interview with him about his new work.

As you know, many people have long noses with a long skin covering, making them difficult cases for the aesthetic nose surgery. The problem with these noses is maintaining the stability of the results in the long term, because the long skin covering and the functions of the muscles that pull the nose downward makes a propensity for the nose to hang down. The expert surgeon must be familiar with the best techniques to solve this problem and to ensure good long term results.

I have named my technique “Dynamic Rhinoplasty Spring” because it is based on dynamic correction of the nose based on a spring model in contrast to the traditional static techniques. I presented a method of dynamic technique using the elastic forces of the cartilage as a spring to compensate forces of the muscles of the nose which tend to pull down the nose.

I prepare a piece of cartilage from the septum inside the nose and in a special method I insert it in a narrow canal which I had made it in the base of the nose. I perform special procedures to make this piece of cartilage acting as a dynamic rather than static piece. Here is embedded the mystery of dynamism and long term durability of this technique. As you could observe in the before and after surgery photographs, the nose is stable even with the strongest facial movement during a vigorous laugh, and no falling down is observed during laugher. The nose also is stable with age, it is a younger nose with a younger face appearance and more stable to the ageing changes.

HOW COULD YOU ACHEIVE THE BEST RESULTS IN YOUR RHINOPLASTY SURGERIES?
The goal of aesthetic Rhinoplasty is reconstruction of the nose in harmony with other features of the face. Every correction in the nose should be made with consideration of all aesthetic components of the face. The nose would seem natural if the surgeon has a perfect cosmetic facial analysis.

WHAT IS THE BEST AGE FOR RHINOPLASTY?
Rhinoplasty could be done at any age after 15 in the girls and 17 in the boys. Some reconstructive nasal surgeries could be performed earlier.

IS THERE ANY PAIN IN RHINOPLASTY?
My patients do not often complain of any pain after surgery.

DO YOU PERFORM SURGERY ON OLD PATIENTS?
With advances in surgical techniques, there is no age limit in the elderly. In older patients, Rhinoplasty could create a younger appearance and better breathing.

DO YOU PERFORM SURGERY ON OLD PATIENTS?
With advances in surgical techniques, there is no age limit in the elderly. In older patients, Rhinoplasty could create a younger appearance and better breathing.

WOULD THERE BE ANY SCAR AFTER RHINOPLASTY?
No trace of surgery would appear on the nose in expert surgeon hand. People would not find any clue of surgery. This nose is just the same as a natural nose.