Frequently asked Questions about nouse surgery

I personally believe that a chef cannot master Italian, Japanese, French, Lebanese and Mexican cuisine simultaneously, and the same applies to plastic surgery - the subject matter is so complex, especially rhinoplasty, that it is not possible to be a universal genius. The more frequently you perform a procedure and take a real interest in it, pursue further training, etc., the better you can master the intricacies of the procedure and the complications. Herewith the patients are granted a security and a chance for a much better result, therefore I point out in the consultation that I do not perform nose surgery AS WELL AS other procedures, but I specialize in rhinoplasty EXCLUSIVELY.

I perform rhinoplasty almost exclusively in general anesthesia. The safety of anaesthesia is very high today and it is best to avoid unnecessary unpleasant experiences as in the case of a procedure in local anaesthesia.

The most common age limit is set from the age of 18, I personally prefer to perform this intervention only from the age of 21, as a certain level of maturity is necessary in order to have reasonable expectations of the surgical capabilities. Rhinoplasty beyond the age of 60 is associated with increased risks and limited prospects of success due to reduced skin and cartilage elasticity.

These are not operative techniques but only surgical access procedures. In the " closed " access procedure, the operation is performed through the nostrils. While the closed incision is preferred by some surgeons in order to avoid a potentially visible scar, the exposure of the nasal structures is much more restricted and consequently some modern surgical techniques cannot be applied. That is why more and more surgeons perform the incision at the columella in a length of 5-6 mm in order to have a complete overview of the entire surgical site. The complete overview of the nasal structures enables exceptional surgical precision in cases of challenging or pre-operated noses. To illustrate this, just imagine an engine bonnet in the workshop that is only 10-20 cm wide open in one situation or completely open in the other. The disadvantage of the "open" access is prolonged swelling, that usually does not affect the final outcome, and very rarely a tiny scar on the columella.

Prior to a nose surgery, you should definitely refrain from medications containing acetylsalicylic acid (ASA), supplements containing vitamin E, gingko biloba and fish oil, as well as large amounts of alcohol prior to and after the surgery. Smoking particularly impairs the healing process due to its vasoconstrictive effect. It is a must that you consult with us about all medications and stimulants that you are taking before the surgery.

My patients usually wear a nose splint for a week after the nose surgery. During this time, the facial swelling has largely subsided. If any bruising occurs, it will be visible for a few days longer, so you should anticipate a period of about 10-15 days. You should avoid sports activities for about 6 weeks after the procedure and intense sun exposure for at least 10 weeks.

I always operate without nasal tamponades, apart from rare exceptional cases. After more than 5000 performed nasal operations without tamponades, my patients mostly reported a "slightly stuffy nose like during common cold", an almost painless removal of the small silicone foils, if required, and almost all of them reported pressure on and in the nose without any pain.

A well-trained rhinoplasty surgeon will by no means compromise breathing, but in fact actually improve it in cases where it is necessary. However, there may be some temporary nasal obstruction due to the post-operative swelling.

A computer simulation implies that the shape of the nose can be modified on patient photos by means of special computer programmes. This is the best way for the surgeon and the patient to reach an agreement on how the new nose should look like. No surgeon can give a 100% guarantee for the result, as deviations may occur due to the healing processes. Basically, it is important to try to process the image as realistically as feasible due to the anatomical conditions and surgical possibilities, and not to show the patient an "embellished" image. Patients who are realistic in their expectations are willing to accept the possible deviations, as your new nose is by no means a finished product.

When a nose job is performed by highly experienced hands, it is generally a low-risk operation and risks such as post-operative bleeding or infection are extremely rare. However, there are certain risks associated with any intervention and these should be discussed with the patient individually, depending on the case.

As the name indicates, a health insurance fund only covers the costs of a nose operation if it relates to a disease of the nose with functional impairment (breathing impairment due to crooked nasal septum or extremely crooked outer nose, congenitally sunken nostrils, olfactory disorders, etc.) and/or disfigurement - congenital or post-traumatic - which is so severe that it leads to impaired nasal breathing. A nasal hump or a wide nasal tip do not constitute a disease at all and the costs for the operation are borne by the patient in this case.

Read more about costs of nose surgery >> 

There is no guarantee, even from the most experienced surgeons, that the nose will look exactly as the patient imagined. The most common reasons for this are:

• Asymmetric scarring in the course of the healing process, which cannot be controlled. The nose, even the most optimally operated one, swells initially, shifts the repositioned structures and heals slowly, which can sometimes lead to uncontrolled displacement of structures. Therefore, there are no two identical muffins or rolls at the same bakery, made from the same dough and baked in the same oven. In other words, there may not be a complete match between the photos you have submitted and the final result.
• The anatomical conditions are different in every patient and the nasal structures can be assessed reliably only during the surgery.

My patients wear a protective splint on their nose generally for a week after the nose job. Taping is recommended for several days afterwards.

In the rare cases of a revision surgery, the patient only bears the anaesthesia and accommodation costs, if it is necessary to stay overnight.

The surgical intervention can usually be carried out after about one year.

After the corrective procedure, the nose will usually require 6-8 weeks to heal and during this time you should avoid activities that are particularly stimulating to your blood circulation. These include exposure to the sun in a solarium, sports or travelling to southern countries where the temperature is much higher than here in Germany. Exposure to solar radiation may lead to increased pigmentation of the skin and higher temperatures lead to increased swelling, which may have a negative impact on the healing process.

This will vary from patient to patient, as it particularly depends on the thickness of the skin and any previous operations that may slow down the healing process. In most cases, the final result is achieved after 1-2 years.

A last remark:

There' s a great deal of information available concerning rhinoplasty, and yet this procedure still remains a great unknown at times, due to the lack of long-term medical experience and the fact that we are unable to control the healing process completely. The only thing that can give you confidence is the information about your surgeon's specialization and vast experience, and your own gut feeling.

And if you still have a lot of questions prior to the procedure and are very anxious as to whether everything will go exactly as you want it to, just imagine an airplane journey and the pilot's cockpit - notwithstanding the multitude of instruments, switches, buttons and confusing laws of physics, the pilot in front will be in charge and will take you safely to your destination.