Rhinoplasty - cosmetic nose surgery

Rhinoplasty is a cosmetic surgery procedure we perform in our clinic to form a nicer and more elegant nose shape. We adjust the shape size of the nose to the patient's facial features, making one's face more harmonious and elegant. In case of breathing difficulties, cosmetic surgery can be combined with functional nose surgery – septoplasty.

Rhinoplasty - before and after surgery
Rhinoplasty is a cosmetic surgery procedure we perform in our clinic to form a nicer and more elegant nose shape. We adjust the shape size of the nose to the patient's facial features, making one's face more harmonious and elegant. In case of breathing difficulties, cosmetic surgery can be combined with functional nose surgery – septoplasty.

Proven and refined methods of nose surgery

Our surgeons' sophisticated surgical skills enable them to create more elegant and natural-looking nose, which is in line with the rest of your face. Carefully listening to our patients' wishes and having ample knowledge about/on a variety of operating methods, enable us to achieve optimal and desired results in each individual case.

Dr. Rajko and dr. Dinko Toncic have perfected modern rhinoplasty methods, some of which were perfected and developed by themselves and adapted them to the individual needs of each patient. Within our clinic we successfully perform the following procedures on the nose:

This is the method which enabled us to reach the highest level of modern nose surgery. We have improved this method of raising the drooping i.e. collapsed nose tip by implanting a piece of ear cartilage.

DROOPING TIP OF THE NOSE

Quite many people complain about the drooping tip of the nose. This irregularity comprises the acute columella-labial angle, which can damage the aesthetic aspect of the nose. This irregularity can be natural or a consequence of improperly performed aesthetic or functional nose surgery.

In order to fix and support the tip of the nose and achieve desired height, we need a support at the nasal base which raises the tip of the nose. For a long time, artificial materials had been used as the support (silicone, Medpor, etc.) but they were not acceptable due to many disadvantages.

One of few reliable methods which we can use today to raise the drooping tip of the nose is adding a part of the ear-cartilage to make the nasal tip support. It is a small, but for surgeon very demanding procedure, which we combine with other rhinoplasty techniques. In this procedure, we shape the ear cartilage and implant it at the nasal base, to make the support.

Behind the ear, there is a small, unnoticeable scar left. After the recovery period, there will be no visible traces of the performed surgery. The ear will retain the identical shape it had before the surgery, because we take cartilage from the area that is not relevant for the appearance of the ear.

In the nasal area, there are either no scars at all or they are hidden on the inside of the nose.

Aesthetic and functional nose surgeries are quite common nowadays. Accordingly, the number of surgeons has also risen. Therefore, it happens quite often that nose corrections are unsuccessful or partly successful, being performed by less experienced surgeons or by surgeons who aren’t specialized for this procedure and don’t perform it regularly.

Over the years, we have, therefore, taken the opportunity to specialize in revision rhinoplasty, i.e. re-operation of the nose.

Re-operations or revision rhinoplasty procedures are the terms used for correction of the noses that have already been operated. These procedures are much more demanding than the initial nose operation, and it is crucial for the surgeons to have extensive experience and an array of methods available, like our surgeons have.

We have had extensive experience with revision rhinoplasty, and we can precisely analyze the possibilities and realistic expectations in every individual case.

Many patients suffer for years because of the impaired image and function of the nose that were caused by injuries. The corrections of injured, boxer’s and broken noses are among the most demanding nose surgeries, but for us, they are also the most challenging.

Our surgical team has had extensive experience in this field too. We often encounter bent noses, broken nasal septum, collapsed tips of the noses and multiply broken nasal bones.

When dealing with these deformations, we mostly use a combination of basic nose surgery methods with the corrections of nasal septum or with ear cartilage implantation to raise the tip of the nose. By any standard, these are complex procedures that make the highest point in nose surgery, and they demand highly skilled and educated aesthetic surgeon.

HEAVY NOSE BREATHING

Operation of nasal septum is one of very important segments in nose surgery. There are two reasons that indicate the necessity for operation of septum:

First reason is heavy nose breathing caused by nasal septum deviation. It needs to be mentioned here that there is no perfectly straight septum. During the examination, we have to determine whether the septum is deformed up to the point that it significantly blocks nasal holes. If not, nose operation will not solve the main problem – heavy breathing. Therefore, we must look for the causes of heavy breathing elsewhere, for example look for allergies, non- allergic rhinitis, etc.

RHINOSCOLIOSIS

The second reason that calls for a septum operation is aesthetic nose surgery. If the nose is asymmetrical, meaning not in the central position but bends to one side, the most likely cause of this deformation is irregular and deformed nasal septum, which pulls the outer nose to one side.

In order to reposition the nose in the central position, beside the standard aesthetic nose operation, we usually need to place the nasal septum to the central position. These situations require combination of standard rhinoplasty and nasal septum correction.

One of the procedures that have been extremely successfully performed in our clinic, led by Dr Toncic, is ethnic rhinoplasty. The majority of our patients that require this surgery are of Afro-American and Asian origin. The anatomy of their noses is specific; the bony part of the nose is less projected and the tip of the nose is drooping and quite soft, with wide nostrils.

Drooping or soft tip of the nose is irregularity that can pretty much impair the appearance of the nose. The columella-labial angle is acute in such situations. The tip is collapsed and soft and it lacks natural, cartilage support.

In order to fix and support the tip of the nose and achieve desired height, we need a support at the nasal base which raises and fixes the tip of the nose. For a long time, artificial materials had been used as the support (silicone, Medpor, etc.) but they were not acceptable due to many disadvantages.

One of few reliable methods which we can use today to raise the drooping tip of the nose is adding a part of the ear-cartilage to make the nasal tip support. It is a small, but for surgeon very demanding procedure, which we combine with other nose surgery techniques. In this procedure, we mold the ear cartilage and implant it at the nasal base, to make the support.

Behind the ear, there is a small, unnoticeable scar left. After the recovery period, there will be no visible traces of the performed surgery. The ear will retain the identical shape it had before the surgery, because we take cartilage form the area that is not relevant for the appearance of the ear.

Beside the drooping and soft tip of the nose, these patients often have less projected bony part of the nose – so called rhinolordosis, which appears as imperfection. In such cases, we make substitute for the missing bony part.

In most cases, we substitute the bony part with a small part of a bone we take from patient’s pelvis. We shape the bony part and implant it in the bony part of the nose, where it supplements the inborn lack of the bone. There is a tiny scar left on the place where we take the implant from.

This is a very demanding operation for a surgeon, but by the extent, it is considered to be a minor operation. This procedure solves the problem of less developed bony part of the nose (rhinolordosis) mostly for our patients of the Afro-American, Asian and very rarely Caucasian origin.

Ethnic rhinoplasty often comprises the narrowing of the wide nostrils, at patients with wider nasal base, and wide nostrils. The majority of the patients who have this surgery are of Afro-American origin. To solve this problem, we use simple method, often combined with other nose surgery techniques.

Generally, we combine all of the mentioned methods, which enable us to achieve a beautiful nose that fits the facial features.

Rhinoplasty of ‘ethnic nose’ is just one of the techniques we have been successfully applying in our clinic for years.

Smaller number of patients sometimes has less projected bony part of the nose – so called rhinolordosis, which appears as imperfection. In such cases, we make substitute for the missing bony part.

Generally, we substitute the less projected bony part with a small part of a bone we take from patient’s pelvis. We shape the bony part and implant it in the bony part of the nose, where it supplements the inborn lack of the bone. There is a tiny scar left on the place where we take the implant from.

This is a very demanding operation for a surgeon, although by the extent, it is considered to be a minor operation. This procedure solves the problem of less developed bony part of the nose (rhinolordosis).

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Two main nose surgery techniques

There are two main approaches to nose surgery: open and closed

CLOSED technique – without visible signs of surgery

Closed technique comprises surgical incisions inside of the nose, under the nostrils, so there are no visible traces of the performed surgery on the nose. We use this technique primarily for nasal bump removal, narrowing of the nose, nose reduction and correction of nasal septum.

Advantages of the closed technique:

  • no visible signs of the surgery
  • quicker recovery
  • reduced postoperative swelling

 

OPEN technique – used mainly for nose tip correction

Open access comprises small incision on columella – lower part of the nasal septum. The incision heals quickly. It is sewed according to the principles of aesthetic surgery, leaving minimal, almost invisible scar. The main characteristic of the open approach is that the skin is lifted off the nasal cartilage of the nose tip.

Advantages of the open technique:

  • enables better view of the cartilage in the nose tip
  • especially when it comes to reconstructive nose surgery or a more complex correction of the nasal tip.

Open and closed rhinoplasty methods are standard techniques in cosmetic nose surgery. The choice of the method mainly depends on our surgeons' evaluation of each individual situation.

We can combine these two basic methods with other techniques, which enable us to successfully resolve various nasal deformities.

What can we do to improve your nose?

In order to find out what we can do in your individual case, please feel free to contact us. You can send us some photographs of your face and a brief description of what you feel is wrong and needs to be improved regarding your nose. If you make an appointment for your individual examination, we will welcome you in our clinic and make sure the surgeon is here for you. During preoperative examination and consultation, we will carefully listen to your wished and problems and you will receive an expert evaluation of your situation and all the options that are available through cosmetic surgery.

Useful instructions for our patients

FREQUENTLY ASKED QUESTIONS:

The price of rhinoplasty procedure is defined during preoperative examination and consultation with our aesthetic surgeons. Rhinoplasty cost is defined according to the indication and the extent of the procedure. Please note, the price of rhinoplasty in our clinic includes the anaesthesia and all postoperative check-ups, nasal packing and splint removal. The price of a standard rhinoplasty procedure is lower than the price of revision rhinoplasty or a reconstructive nose surgery.

Cosmetic nose surgery is performed in local anaesthesia with IV sedation. This means that, beside local anaesthetic, the patient gets light intravenous sleeping medication. Throughout the surgery, the patient is asleep and the procedure is pain free.

If necessary, rhinoplasty can be performed under general anaesthetic, too.

The patient spends around 5 hours at the clinic: preoperative preparation takes about an hour, the operation itself around 1 – 1,2 hours and immediate postoperative recovery at the clinic takes 3 – 4 hours. After that, the patient is sent to homecare in Zagreb.

To determine whether you are a good rhinoplasty candidate, we need to see you in the clinic for consultation. After listening to your wishes and individually assessing your case, we give you our expert opinion and the possible solutions that cosmetic surgery can offer. During the examination we also decide on the best surgical method that we can use to achieve the goal in your individual case. If you live far from Zagreb or Croatia, you can send us the photos of your face and a brief description of the problem and what you would like to achieve with the surgery. We will review your case carefully and reply in a timely manner to inform you about your possibilities, expected results and all the costs involved in a rhinoplasty procedure in our clinic.

Generally, the patients in our clinic are over 16 years old, healthy and honestly reply to our medical questions on their individual health and habits.

Although rhinoplasty is not an extensive procedure is surgical sense, it requires a top education, years of experience and a sense for aesthetics from the surgeon. Nose is pretty noticeable on the face and it counts for overall expression and looks. Therefore, during the surgery, a surgeon needs to make sure the new nose will fit in the bigger picture.

You can put on make-up after the splint is removed from the nose, seven days after the surgery.

Immediately after the surgery we put on a splint that protects the new structure of the nose. The splint stays on the nose for 7 days, when all the structures are healed in the nose. Beside the splint, we also put nasal packing in the nose. Nasal packing consists of tampons that stay in the nose for 3-4 days and whose function is to prevent bleeding and to support the new structure of nose from the inside.

A week to 10 days after the surgery, patients can resume their everyday activities and get back to work. However, for two months following the surgery, patients should refrain from sports or strenuous exercise.

Required stay in Zagreb is 3 to 8 days. The nasal packing needs to be removed from the nose on the third or fourth day after the operation. The nasal splint remains on the nose until the 7th day after nose job. The patient can go home on fourth or the fifth day, after the nasal packing is removed, but we recommend going home on the 8th day after the operation, after we remove the splint and do the final postoperative check up.

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Rhinoplasty - cosmetic nose surgery