Rhinoplasty Germany

Reasons for rhinoplasty

The central position of the nose in the face imposes an important role on it: it is responsible for the general perception of balanced and unbalanced proportions; whether a face appears younger or older, more friendly or harsh.

 

If one's own nose is perceived as too large, too wide, too crooked or even as too narrow, too small or too uneven, people are often dissatisfied with their face and therefore wish to change the shape of the nose to achieve a more aesthetic overall appearance. 

 

The focus on your eyes should not be distracted by your nose.


What is aesthetic rhinoplasty?

Rhinoplasty is the aesthetic modeling of the outer nose by means of plastic surgery. The nasal structure underneath the skin is altered and formed into a new shape. The objective of the procedure is to create a natural-looking nose that fits the face - while at the same time paying attention to the preservation or improvement of nasal breathing.

 


Rhinoplasty is one of the most challenging procedures in the field of aesthetic surgery because of the particularly exposed position of the nose and its complex anatomy and functionality.

In our practice in Hamburg, we specialize exclusively in aesthetic nasal surgery. Our specialization offers you additional assurance due to the long-standing experience and increases the probability of obtaining a very good aesthetic result.

 

The photo shows the aesthetic result after an operation in our practice.


Overview of the most relevant facts:

Consultation 2 appointments, including detailed consultation,
computer simulation, functional examination
Duration of the surgery 90-240 minutes depending on the level of complexity
Anaesthesia General anaesthesia
Your stay at the clinic 1-2 nights
Recovery period and social activity Usually 2 weeks, sports and sunbathing about 6 weeks
Follow-up / aftercare After 2-3 days, 1 week, further check-ups for a total of 1 year
Removal of the sutures and the nasal splint After 1 week, the sutures in the nose are self-dissolving
Financing Possible
Costs Available on request, depending on the level of difficulty

Basic information about rhinoplasty in our practice in Hamburg

The first appointment - personal consultation, facial analysis and computer simulation, before and after photos

Facial analysis and a detailed consultation obviously precede the performance of a rhinoplasty. Therefore it is essential that you are absolutely sure about what you want and that you communicate your ideas. Thus, it can be determined during the conversation to what extent your wishes are medically feasible and what your motivation is. We will also discuss and analyze possible functional problems and include them in our assessments and recommendations. 

 

A computer simulation will give you an idea of the expected result, since a simulated image will demonstrate the change much more clearly than a description alone. A picture is worth more than a thousand words. A simulation result cannot obviously be confused with the final outcome and regarded as a kind of guarantee. The surgeon can accurately assess the possibilities of the modification only in the course of the procedure. The healing process after the operation can take an unfavorable turn which is beyond our control.

 


Apart from the simulation of your own nose, we will also show you before and after photos of patients who have undergone surgery with us and who have given us their permission. This will give you an idea of what is actually possible surgically in a particular type of nose. Furthermore, all important questions concerning the nose job will be discussed. As your operating surgeons, we will naturally dedicate enough time to the consultation prior to the nose job so that all your questions and wishes can be addressed.



This is a simulation.

Prior to the surgery - examination, clarification, blood sampling

Once the surgery date has been fixed, the detailed preparation for the procedure takes place during a separate appointment. These include detailed surgical information about potential risks and side effects potential risks and side effects as well as several examinations: measurement of the air flow through the nose (rhinomanometry), a blood test (especially coagulation values), allergy tests if necessary or a computer tomography if a chronic sinus problem is suspected. Clarification regarding the conduct before and after the surgery is also part thereof. The preparation will take a few hours. 

 

All your unanswered questions will, of course, be addressed.

Advice on conduct before and after rhinoplasty

Additionally, you will receive information about the medications that must not be taken under any circumstances before or after the operation. These include, specifically for the two weeks prior to the surgery, blood-thinning  substances such as acetylsalicylic acid (the most important ingredient in aspirin, Thomapyrin, ASS), vitamin E, etc. Moreover, other important habits will be addressed that should be avoided for a few weeks, such as the consumption of alcohol and smoking as well as sports or intense sun exposure after the operation.


 

Apart from the appointment in our practice, there will also be a consultation with the anaesthetist about the anaesthesia in our outpatient clinic. All potential risks will be discussed with you in detail. You will also receive precise instructions concerning food and fluid intake prior to the surgery: You are not allowed to drink or eat anything six hours before the surgery.


Where will the surgery take place?

The safety of our patients is the most important prerequisite for a successful operation and this is conditioned by the choice of the surgical centre. Mutual trust and exchange with the entire team in the operating theatre facilitate a complication-free process. Fortunately, there has not been an anaesthetic incident in my career so far.

 

We perform surgeries in the following clinics and hospitals:


On the day of the surgery

On the day of the procedure, you will arrive at our surgery centre at the time specified by us in advance. It is important that you appear sober – this means that you have not eaten or drunk anything for at least six hours – since this is required for the operation to be possible. 

 

Then the preparation procedure for the surgery will begin. You will be administered a medicine that has a calming effect, provided with special surgical clothing and given the opportunity to lock up your personal belongings. 

 

Now it's time to move on to the operating theatre. We will welcome you there personally together with the medical and nursing colleagues from the anaesthesia department. We will briefly discuss the planned procedure once again and then the anaesthetic will be administered.


What will happen during the nose surgery?

A rhinoplasty is performed exclusively under general anaesthesia, so that you as the patient will not suffer any pain or have any unpleasant memories of it. Anaesthesia is administered by an experienced specialist in anaesthesiology. 

 

Your cardiovascular and pulmonary functions will be continuously and rigorously monitored during the operation. You will by no means be left on your own in the room at any time; everything will be documented and recorded in detail. We adhere to the internationally valid guidelines.

 

Fortunately, there has not been an anaesthetic incident during rhinoplasty in our whole career so far and we are grateful for the experienced colleagues who perform the anaesthesia.
 


 

Basically, the operation of a nose that has not been pre-operated takes between 90-150 minutes.


Correction of the structures

After the administration of anaesthesia, disinfection is carried out in the facial area and if necessary also in the auricle or - if rib cartilage is removed in complex cases - also in the thoracic area, in accordance with all the rules of hygiene.

 

Now, the nasal structures are exposed by a small incision at the columella. The first step is the exposure of the nasal septum with straightening and the removal of cartilage for the stabilization grafts. Afterwards, the structures in the nose are reduced, straightened, fixed, reconstructed or rebuilt - depending on what is necessary.

 

Nose surgery without tamponade

After the nose has acquired the desired shape and all functional problems have been eliminated, the small incision at the columella is sutured up, thin silicone foils are placed inside the nose to stabilize and control the swelling, and a plastic or metal splint is glued onto the nasal bridge. This does not correct the shape of the nose.

 

Experience has shown that you can already breathe through your nose right after the surgery due to the general avoidance of nasal tamponades.


After the procedure

The release of the anaesthesia takes place at the end of the operation while the patient is still in the operating theatre. Afterwards, you will be taken to a specially designated "recovery room" where your heart function and blood pressure will be further monitored. You will be taken to the ward only when your circulatory functions are considered stable enough. The nursing staff will welcome you there personally.

 

You will have a contact person available at all times who will provide you with care in consultation with us. This includes, above all, the targeted and sufficient administration of pain medication. We are committed to ensuring that you feel adequately cared for.

 


Generally, you will stay in the clinic for one night as a precautionary measure. After being discharged, we recommend that you are accompanied home or to your hotel.

 

You will be given a telephone number to contact us directly in the event of a possible complication.

Respect the time for recovery

An important prerequisite for successful healing after rhinoplasty is a rest period of 10-14 days. Under normal circumstances, you should have little or no pain. There is rather a feeling of pressure due to the blocked nose, as with common cold. Swelling and bruising (around the eyes) are normal as after any surgery.

 

The silicone foils are removed from the nose in our practice two to three days after the operation. This is usually not painful. You will be able to breathe much better through your nose afterwards.

 

The nasal splint and the sutures on the columella and, if necessary, on the auricle and the thorax will be removed one week after the nose surgery. Tapes will now have to be applied to the nose for a few days, and later you will be able to replace them on your own at home.

You will receive detailed instructions from us in the practice and in the form of a video on the homepage.

Complete recovery

After about two to three weeks, your nose will only be moderately swollen. The bruises will have almost completely disappeared, so that you are able to socialize without any problems. Most of your friends, colleagues or family members will not even realize that you have been operated on.

From that point on, you will see us for regular check-ups at our practice.

 

It may be necessary for you to receive medication from us to deal with the swelling or skin, or other measures may have to be taken to achieve the best possible result both permanently and quickly.



The photos show the result after surgery on a hump nose.


More info on nasal surgery technique

A harmonious and straight nasal bridge with distinct lines is a characteristic feature of an aesthetically beautiful nose.

 

In the past, it was common to remove the nasal bridge by using a chisel, to break it on the sides and to flatten it with various kinds of files. The soft tissue surrounding the bone was partially compromised, resulting in severe swelling and haematoma. The cartilage structure was completely disassembled and reconstructed. Frequently, more or less visible irregularities became apparent in the course of the operation, and severe post-operative pain was also the consequence.

 

Dorsal preservation by means of modern rhinoplasty

Today's modern rhinoplasty attempts to preserve the natural nasal bridge as far as possible and to bring it into the desired position by means of specific reshaping. Our practice is an international pioneer and forerunner of the so-called piezo technology. In this technique, the bone is no longer broken in the classical sense, but rather cut and modeled exactly and precisely by means of an ultrasonic scalpel.

 

The natural unit of cartilage and bone, i.e. the nasal bridge, remains intact and is primarily shifted into the facial plane. The procedures for this are called Let-Down or Push-Down – depending on how far the nasal bridge has to be shifted. The advantage is that there are significantly fewer irregularities in the area of the nasal bridge.

Special case of nose recorrection (revision rhinoplasty)

Sometimes a nose operation does not deliver the desired result and you would prefer to have a revision rhinoplasty performed by another specialist.

 

Revision surgery is frequently an even more complex procedure than the initial surgery, and the decision about who should perform it can be of great importance. A revision surgery should only be carried out by a highly experienced surgeon who specializes in rhinoplasty, as having the surgery done again by less experienced hands can lead to even greater problems due to the aggravated conditions (such as scars, few supportive structures, etc.) resulting from the previous surgery. However, an experienced surgeon is often able to achieve a very good result after a preceding intervention.

Specialization in complex revision surgeries

One of the distinctive features of our practice is our specialization in complex revision surgeries by means of the most advanced state-of-the-art techniques. Thanks to the extensive experience and daily performance of this kind of nose surgeries, the chances for a considerably better result are significantly higher.

 

You can find more information on rhinoplasty here >>

Your nose specialist

Dr. Milos Kovacevic