What criteria should a good rhinosurgeon consider?

In rhinoplasty surgery, the goal is not just to shrink the nose. The surgeon should consider the following in rhinoplasty:

Before the surgical procedure begins, the rhinosurgeon can draw a surgical plan in her mind with careful examinations and examinations.
All surgeons who move in the process of rhinoplasty in accordance with professional principles warn her of all the dangers and problems of the client's path and ask her to take a conscious step in this path.
Fortunately, many of the best rhinosurgeons try to give the client a realistic look so that they do not have any problems.
In this way, the rhinosurgeon tries to eliminate all the unreal dreams and fantasies that the client has from the result of the surgery and wants to look at the category of rhinoplasty with a precise and scientific view. This will prevent the person from becoming frustrated after the operation and will be able to look at the outcome of the surgery as it really is.
Maintaining beauty standards: Do not make the nose too small or too high (the so-called pig nose model)
Strengthens the nasal tissues and does not reduce the tissues behind the nose
Eliminates sagging tip of the nose and its defects
Do not shrink the nostrils too much
Care in surgery and no damage to the olfactory nerve

Types Of Rhinoplasty

In general, rhinoplasty is divided into two types of open surgery and closed surgery according to the doctor's diagnosis and the method she/he chooses, which we will examine in the following:
For the past 15 years or so, one of the most important issues for a rhinosurgeon has been which method is more appropriate and results in a better outcome. Open or closed nasal surgery? It should be noted that these two ways are actually 2 functions in order to access the desired area for surgery and not the surgical technique. We cut the incision at the inner edge of the blades so that the tip and back of the nose are accessible and the surgeon sees the entire area and the entire structure of the nose (cartilage, bone and soft tissue) is clearly visible. Then we subcutaneously separate the upper lateral cartilage from the middle septum and perform rhinoplasty. Open rhinoplasty is usually preferable to closed rhinoplasty and is more acceptable. In reconstructive nose surgery, noses that are very fleshy and the tip of the nose is very large, a tumor that needs surgery, and congenital defects (cleft lip) surgery is performed openly.
*TIP* :
Cutting or not cutting the nasal fins has nothing to do with the open and closed method and is related to the size of the nostrils and its fins. In fact, if the nostrils are large and need to be shrunk, there is no choice but to cut the sides of the nose. It should be noted that rhinoplasty should be performed in an open manner.

* Benefits of Open Rhinoplasty *

Surgery is performed under direct vision, thus reducing the risk of asymmetry.
Prosthetics or bone and cartilage catches are easier to place.
The nasal surgeon has more maneuverability and a more comfortable work environment.
In malformed noses, the result of open surgery is associated with greater satisfaction.
In noses that are crooked and twisted, the open method is preferred.
Secondary nose surgery is performed by open method.
There are no traces left from the sutures under the base of the nose.

Closed nose surgery

Closed Rhinoplasty: Today, rhinoplasty has gained countless fans all over the world. Rhinoplasty in Iran has also made significant progress and the number of applicants is increasing every year. Therefore, Iranian rhinosurgeons have a lot of experience and expertise in the field of rhinoplasty due to the increase in the number of rhinoplasty surgeries, so that people from many other countries come to Iran for rhinoplasty. In this method, all surgical incisions are made inside the nose and the skin of the nose is separated from the nasal skeleton to a very small extent and held high by a special tool, and the nasal surgeon makes changes on the nose. Advantages of Closed Rhinoplasty Closed-nose rhinoplasty is the first choice of rhinoplasty surgeons in some rhinoplasty surgeries because of some of its benefits. The benefits of closed nose surgery include:

• Reduce the duration of rhinoplasty
• No incisions in the clomella area
• Low swelling of the tip of the nose and as a result the swelling goes away in a very short time

Suitable candidate for closed nasal surgery

In closed nose surgery, only the apparent defects of the nose are removed and there are not many changes in the structure of the nose, so people who apply for nose surgery in this way should have realistic expectations from the results of this surgery. The most suitable people for this rhinoplasty are people whose nose bridge is symmetrical and their nose tip is proportionate and their nasal defects are generally minor.

Is open surgery better or closed?

In the last decade, the best rhinosurgeons around the world have tended to perform open surgery because with the surgeon's direct vision, more complex changes are technically possible and the results of the operation will be more desirable and stable. In the closed method, the operation time is shorter, the swelling of the nasal tip is less after surgery, but the amount of changes, especially in the nasal area, is less possible and as a result, the surgery will not have an ideal result.

Is rhinoplasty possible without surgery?

For a group of people who want to make changes in the shape of the nose, but without surgery, there are ways.Today, by injecting various fillers such as Botox injections, gel injections, etc., some nasal corrections can be done without any incisions or surgery.

Secondary surgery and nasal repair

Many people who intend to have rhinoplasty undergo rhinoplasty to correct the defects and abnormalities of their first rhinoplasty. However, secondary surgery and rhinoplasty are much more difficult and complex than primary surgery. Therefore, the best rhinoplasty is the one that does not need to be changed or reoperated. It should be borne in mind that in the secondary practice, the chances of achieving the desired results are very low, because it is not possible to overdo the change and transformation of the nose. Therefore, choosing a highly skilled and experienced surgeon for this task is very important and vital. Rhinoplasty requires the expertise and skill of a doctor, so be sure to see a good rhinosurgeon in your city.

What age is suitable for rhinoplasty?

People, both men and women, at any age and under any circumstances can have rhinoplasty, provided they do not have a background problem, disease, or specific limitations. The most popular surgery in Iran, especially among young people, has no special restrictions and complications, so when the nasal surgeon evaluates and evaluates the initial tests and the patient has not had any physical or health problems, he can solve his nasal problems with surgery when When we reach puberty, there are many changes in appearance and face. These changes make us feel that we are not beautiful and seek to perform beauty practices. One of the things we quickly decide to change is the nose. . If you want to get the best results from rhinoplasty, you should take action after closing the nasal growth plates. These pages are for 15-year-old girls and 17-year-old boys. The best time for nose surgery is for 16-year-old girls and 17-year-old boys. Sudden changes in puberty make rhinoplasty more common among adolescents. But for nasal surgery, we have to wait for the nasal growth plates to close. However, if a person is younger than this age and due to fractures, accidents and respiratory and congenital problems, it is necessary to perform rhinoplasty, he can perform rhinoplasty with the diagnosis of a doctor and his discretion.

Note: ♦ The most suitable people for rhinoplasty are healthy and non-smokers who are not satisfied with the appearance of their nose and are looking to improve and change its shape.

Types of nasal models and their surgery

Types of noses: Noses can be divided into two categories: bony nose and fleshy nose based on the general structure and type of skin and cartilage of the nose.
The nose is the central organ of the face, and the slightest flaw in it will overshadow the beauty of the rest of the face.

Bone nose

* In terms of appearance, it has a hump on the nose.
* In terms of cartilage structure and strong bone tissue * In terms of skin, it has a thin skin so that the nasal bone is palpable.

Bone-shaped nose surgery

Rhinoplasty has satisfactory results because it has the most ideal features for rhinoplasty. The result of bony nose surgery can be a fancy or puppet nose.

Fleshy nose

* In terms of appearance, the shape of the tip of the nose is generally round and wide
* In terms of structure, they have weak tissue and cartilage.
* In terms of skin, they have thick skin and active sebaceous glands under the skin of the tip of the nose, so that if we press the skin of the nose with two fingers, we will see the secretion of some fat.

Flesh nose surgery

In order for the surgery of different types of fleshy noses, such as bony noses, to have desirable and lasting results, it will be performed by grafting and strengthening weak tissue and cartilage. Swollen fleshy noses are more common after rhinoplasty. The result of fleshy nose surgery in most cases are noses with a natural shape. Below you can see a real example of a fleshy nose before and after surgery:

Fleshy Nose Rhinoplasty in Tehran by Dr. Bayat Shahbazi

This operation is considered one of the most difficult and important surgeries in which success depends on the skill of the rhinosurgeon and his experience and expertise. In this surgery, the doctor strengthens the cartilage and with cosmetic surgery, removes the defects of the nose, such as the wide tip of the nose and its fleshiness, and according to the appropriate model of the nose, makes its shape more beautiful. The width of the tip of the nose is reduced in this surgery.

Is fleshy nose surgery reversible?

One of the most important concerns in fleshy nose surgery is its reversibility. Usually, people who have a fleshy nose and want to achieve their ideal beauty with rhinoplasty, this concern causes them to give up their decision. In the past, this problem was common, but today, with the help of new techniques, this problem can be solved. Of course, if the choice of rhinosurgeon is done correctly and with sufficient research. The more information you have about fleshy nose surgery, the better you can find the right rhinoplasty surgeon.
The cartilage of the fleshy nose is weak, which in rhinoplasty, the bone tissue and cartilage are shaved and thinned and become weaker. Therefore, as a result of skin interactions, the gravity of the earth also tends downwards. For this reason, fleshy noses are likely to return after surgery. But today, by strengthening the cartilage tissue, shaping and rearranging it, the reversal of the fleshy nose can be prevented. As a result, the phenomenon of receding fleshy noses has decreased and may not occur as in the past. In these noses, thinning of cartilage is avoided as much as possible, and doctors try to make the nose stronger and more stable by thinning the skin. Of course, this issue is also related to the experience and expertise of the doctor, because the fleshy nose in a new way requires a certain delicacy and precision that only an experienced doctor can handle.

Bone Rhinoplasty Dr. Bayat Shahbazi in Tehran

Bone Rhinoplasty Dr. Biatabini's bone will have a much more beautiful result after surgery due to its thin skin. In this surgery, the physician's expertise is of great importance. As mentioned, this nose model usually has a hump. The surgeon must have enough skill and experience in his work to remove the defects of the nose and also to operate the nasal hump well. Shahbazi in Tehran The best surgeon in Tehran.

Types of rhinoplasty models by Dr. Bayat Shahbazi

The ideal nose is different for everyone. This difference in taste has led to a variety of nasal models for surgery. In general, the types of nose models for cosmetic surgery are divided into three categories.

*Natural nose model
*Semi-fancy nose model
*Fancy nose model

Natural nose surgery in Tehran

Many men and women like this nose model. In normal nasal surgery, external defects such as nasal hump, apparent deviation, drooping tip of the nose, and the width of the tip of the nose are naturally coordinated with each other. The main point in this type of operation is to pay attention to the so-called artificial "impractical" appearance of the nose; In this operation, the angle between the tip of the nose and the lips will be between 90 and 100 degrees. The nasal fins are natural and symmetrical. The person's breathing will be very suitable due to the correct and scientific structure of this model, and the person will not have any breathing problems after the operation. This nose model is suitable for both people with fleshy and bony noses.
However, in the above cases, we mentioned the invisibility of surgery as one of the advantages of the normal nose model. However, some people like this to be recognizable for various reasons, so this can be expressed as both disadvantages and advantages according to personal taste. Another disadvantage is that changes in cosmetic practice. The normal shape of the nose is limited. It is not possible to reduce or remove the anatomical tissues of the nose. In the following, you will see the sample of natural rhinoplasty work of Dr. Bayat Shahbazi, a specialist in plastic and cosmetic surgery in Tehran.

Fantasy Rhinoplasty in Tehran

Most fans of puppet and fantasy nose models are women. In the fantasy nose model, the nose blade is thin, the tip of the nose is high and the nostrils are small. In addition, the nasal arch in the upper-headed doll nose model is larger than the semi-fancy nose model. This nose model was especially common in Iran in the early years of rhinoplasty. The fancy nose model, also known as the doll nose, is characterized by a high arch and a high tip. Due to structural weaknesses and problems, skilled surgeons do not recommend this model in terms of respiration. On the other hand, due to the subtlety of this nose model, not everyone can choose it. Doll nose is suitable for people with bony noses and delicate facial parts and is never recommended for people with fleshy noses.
Respiratory problems are very common in this model of nose, which is due to the excessive arch and narrow blade. It also destroys the fit and harmony between the various components of the face. But one of its most important advantages is that if the tissue and cartilage of the nose are strong and the skin is thin, it will show the delicacy of the work on the nose better.

Semi-fantasy rhinoplasty in Tehran

This nose model has many fans today, most of whom are women. A semi-fancy or semi-puppet nose has both the features of a fancy nose and a natural nose. The nose blade in this model has a slight arch. The blade of this nose is not very narrow, but its thickness is not as big as a normal nose blade, and the semi-fancy nose model has less width from the front, and the size of the nostrils is slightly narrower than normal. This nose will not cause any respiratory problems, but it has a poorer function than a normal nose. Another advantage is that in semi-fancy nose surgery, the arch behind the nose is not exaggerated and does not find a slippery slope.

Steps Beauty nose surgery.

1- Anesthesia: Depending on the complexity of the operation and the surgeon's opinion, local anesthesia is used by injecting medicine into the nose or general anesthesia is done by inhalation or intravenous injection. In fact, general anesthesia is done by breathing or intravenous injection (in some cases Suggests local anesthesia)
2- Type of operation and nose incision: Rhinoplasty is performed according to the anatomy of the person's nose and the changes that must be applied, according to the treating physician, both open and closed. In closed surgery, fewer changes are made to the nose and the operation is lighter than in open surgery.In this type of operation, the incisions are hidden inside the nose and are usually performed on an outpatient basis. Another method is revision surgery. In this procedure, the entire strip of thin tissue that separates the nostrils (septum) is cut, and a small incision is seen under the nose from the outside. Through this incision, the skin that covers the bones and cartilage of the nose is gently lifted so that the surgeon can rearrange and redesign the bones and cartilage under the skin. Choice of open method in surgery)
3- Deformation and structure of the nose Make the necessary changes to the structure of the nose: In the process of rhinoplasty, even for large noses, the surgeon may need extra cartilage to transplant the nose. This cartilage is removed from the middle wall of the nose and, if necessary, from the cartilage of the ear.
4- Correction of the shape of the nose and elimination of its defects:If the nasal septum is crooked and the nose is so-called deviated; The deviated nose operation is performed and during the operation, this deviation is corrected and the defects of the nose shape are eliminated. This change also improves a person's breathing.
5- Complete the operation and close the created incision and suture the created incisions: When the structure and shape of the nose changes to the desired shape, the skin and covering on the nose are returned and the incision is sutured according to its type. If other incisions need to be made due to the extent of the operation, they will be incised in the natural folds of the nose so that the traces are less visible.
6- Postoperative care and observation of results: According to the doctor's recommendation and preference, the nose is placed on the nose after the atelier operation and the nose is bandaged. The intensity of this dressing depends on the surgeon's procedure and discretion. After the operation, if you are anesthetized, you will be in the recovery room. In this room, the staff monitors your return to wakefulness. Depending on the doctor and the complexity of the operation, you may be discharged the same day or spend the night in the hospital. However, people who are operated on in the clinic are usually discharged a few hours after the operation.

The average duration of surgery is 1 hour and a half to 2 hours, for more information you can talk to Dr. Bayat Shahbazi , a cosmetologist.

What surgical rhinoplasty can treat

• Nose size in relation to facial balance
• Nose width at the bridge or in the size and position of the nostrils
• Nose profile with visible humps or depressions on the bridge
• Nasal tip that is enlarged or bulbous, drooping, upturned or hooked
• Nostrils that are large, wide or upturned
• Nasal asymmetry

If you desire a more symmetrical nose, keep in mind that everyone’s face is asymmetric to some degree. Results may not be completely symmetric, although the goal is to create facial balance and correct proportion.

Rhinoplasty to correct a deviated septum

Nose surgery that’s done to improve an obstructed airway requires careful evaluation of the nasal structure as it relates to airflow and breathing.
Correction of a deviated septum, one of the most common causes of breathing impairment, is achieved by adjusting the nasal structure to produce better alignment.

What should I expect during my rhinoplasty recovery?

During your rhinoplasty recovery, a splint and/or packing may be placed inside your nose and a splint or bandages placed on the outside to support and protect the new structures during initial healing.
While initial swelling subsides within a few weeks, it may take up to a year for your new nasal contour to fully refine. During this time you may notice gradual changes in the appearance of your nose as it refines to a more permanent outcome
Swelling may come and go and worsen in the morning during the first year following your rhinoplasty surgery.

• A first week visit is required to remove the splint. Also, a slight correction may be needed in this session
• In the open method, the swelling of the tip of the nose is longer than in the closed method, and in both methods corticosteroids may be needed.
• The final results of the operation will be obtained after six months to two years. For this reason, the earliest time to decide on a possible corrective operation is six months after the operation (except in rare cases).
• The swelling may increase for up to three days, which is normal. However, in case of significant pain, call.
• The amount of swelling varies and is more in the morning, which is minimized by keeping the head higher at rest.
• Minimum salt intake for 10 days
• Take your medication to the end
• Smoking delays recovery and increases complications for several weeks after surgery.
• For two days, apply a cold compress on the face, then a warm compress to accelerate the absorption of bruises and swelling. The pain peaks for up to three days and then subsides, during which time painkillers will respond.
• To reduce facial swelling, keep your head higher than usual when resting.
• Avoid strenuous activity and bending for a few weeks.
• If the above is not observed, there is a possibility of long-term inflammation.
• Mild bruising is normal.
• Fresh pineapple (not compote) contains bromelain and vitamin C, which is effective in accelerating the absorption of bruises and inflammation.
• Fruits, fish, shrimp and omega-3 are highly recommended.
• Bloody discharge is normal for several days. But in case of obvious and significant bleeding should be reported (this is possible up to two weeks after surgery).