Nose surgery in South Korea: correction of the back and tip for harmonious facial proportions. Basic information about wide nose rhinoplasty

The dorsum is the part of the nose that significantly influences its appearance, as well as general facial perception. Availability of purchased or congenital deformities in this zone spoils the harmony of appearance and becomes a reason to contact a plastic surgeon.

The most common problems in this area are:

an excessively protruding area (“hump”);
violation of vertical symmetry;
saddle nose deformity;
curvature;
excessive narrowing;
excessively wide nose.

Narrow a wide nose, eliminate the retraction of the back, remove an unaesthetic “hump”, and also solve a whole series other problems is capable of .

Rhinoplasty of the nasal bridge - what is it?

This is an operation performed on the osteochondral area of the nose to correct imperfections. It can be open or closed. In the first case, incisions are made in the skin to access the area requiring correction. In the second, access is through the mucous membrane. Also, open and closed rhinoplasty is divided into primary and repeated correction of the nasal bridge. The operation is performed more than once in cases where the result of the first one did not satisfy the patient or the intervention initially had to be carried out in more than one stage.

Indications:

the presence of congenital or acquired defects;
patient dissatisfaction with appearance.

Contraindications:

inflammatory processes in the affected area;
oncology;
diabetes mellitus;
cardiovascular diseases;
age under 18 years;
pregnancy and lactation;
chronic diseases in the acute stage;
infections;
blood clotting disorder.

Preparation

Before the operation, the patient undergoes medical examination which includes:

visiting a surgeon, therapist, anesthesiologist;
general urinalysis;
general and biochemical tests blood;
blood tests for HIV, syphilis, hepatitis, coagulation;
fluorography.

If indicated, an x-ray of the nose may be performed.

Plastic surgery of the nasal dorsum: stages of surgery

When the deformity of the nose consists of protruding parts, they are removed. Most often used closed technology, that is, without visible cuts and scars. Instruments are inserted through the nasal passages to perform resection of the osteochondral areas. Plastic allows you to remove the “hump” from bridge of the nose, to correct partition etc. At the second stage of this operation, the nose is narrowed by moving the lateral bones, and a cartilage implant is implanted to level out irregularities.

If there is a lack of volume in the nasal area, implants are used. They can be either silicone or cartilage. The second option is preferable due to the absence of the risk of rejection.

Rehabilitation

Usually the patient is in the hospital for no more than a day.

For 10 days it is necessary to wear a splint and turundas placed in the nasal passages.

Bruising and swelling may occur, which will go away on their own after a few days.

sleep only on your back;
refusal of physical activity;
refusal to visit the bathhouse, sauna, solarium, swimming pool;
refusal to wear glasses.

Results

The effect of an operation such as nasal dorsum rhinoplasty is best seen in numerous photos before and after the intervention: surgeons successfully change the saddle shape, remove the “hump”, curvatures, etc. The preliminary result is assessed after two weeks, the final result - after a year. The achieved effect lasts for life.

Plastic surgery of the nasal dorsum is carried out for the purpose of aesthetic correction of such an important structure of the nose as the dorsum. Deformations of the nasal dorsum, depending on the degree of their severity, can be resolved surgically or non-operatively. TO aesthetic defects The dorsum of the nose includes:

hump (excessively protruding part of the bridge of the nose)
saddle-shaped deformity (pronounced recession of the nasal bridge
displacement of the line of symmetry of the back of the nose along the vertical axis
curvature of the nasal bridge
widening or narrowing of the nasal bridge

Plastic surgery of the back and removal of the nasal hump

The hump can be like hereditary trait appearance, and the result of a nasal injury. It is formed by a protruding part of the bone and cartilaginous parts nose, making up the skeleton of the dorsum of the nose. As a rule, the main part of the hump is made up of cartilage tissue.

With plastic surgery of the nasal bridge, there are various ways hump removal. I usually suggest closed access– that is, an operation without visible incisions on the skin. To remove excess bone and cartilage tissue the back of the nose, instruments are inserted through the nasal passages. Traditionally, a rasp, hammer and chisel are used for this. But only the use of modern ultra-thin instruments makes it possible to achieve pinpoint precision in carrying out such an operation for plastic surgery of the nasal bridge, when the surrounding tissues are almost not injured and no traces or fragments are left.

At the next stage of nasal dorsum plastic surgery, it is necessary to narrow the nose. After all, if you simply remove the hump, the bridge of the nose will turn out to be too wide and flat. Therefore, a so-called osteotomy is performed: the lateral bones are shifted and a new dorsum of the nose is formed, smooth and graceful. When carrying out such operations, use modern methods And .

With a wide and narrow bridge of the nose, the methods of plastic surgery of the bridge of the nose when correcting the hump differ.

After removing the osteochondral hump from the nasal dorsum, which does not require narrowing, a cartilage implant is used, which allows you to close all the irregularities and make the nasal dorsum smooth.

After removing the osteochondral hump on the wide dorsum of the nose, the lateral sections of the nose are brought towards each other, the bones are given correct position, which is then fixed.

In the photo you can see the patient before and after plastic surgery of the nasal bridge.

(removal of the hump and correction of the curvature of the nasal bridge)

When performing nasal dorsum plastic surgery, the techniques of the modern European school of rhinoplasty allow us, firstly, to obtain a more accurate and harmonious result, and secondly, to carry out the most complex manipulations, avoiding unnecessary injuries. While the standard technique requires one to several weeks of rehabilitation, our patients, after plastic surgery of the nasal bridge with microinstruments, can return to to the usual way life.

More complex is the operation to correct the saddle shape of the nose.

Some time ago, to correct this form, surgeons used silicone implants(you can read more about this on our website in the article nose transplantation). Today, most surgeons have abandoned them. The fact is that artificial implants take root rather poorly. In addition, they are quite vulnerable: even small impacts and minor injuries to the nose can lead to its deformation or even rupture of the implant shell.

Like most modern surgeons, we consider the most the right method correction of the saddle shape of the nose using the technique of transplantation of one’s own cartilage tissue. The cartilage for transplantation is taken from the cartilaginous septum of the nose, auricle or ribs. As a result of the operation, the patient receives a beautiful and, importantly, 100% “natural” nose. The transplant's own tissues take root well. The nose is naturally resistant to external influences. The recovery time after such an operation is two to three weeks.

If you only need a slight correction of the bridge of the nose, we can recommend non-surgical plastic surgery using fillers (fillers) latest generation. This non-invasive procedure, which does not require any rehabilitation. To carry out such corrections, we use the most modern drugs last generation. These fillers have completely natural composition. They went through everything necessary research, certification and have proven themselves in practice.

The number of operations on medical indications This also includes repositioning (restoration) of the nasal bones after “fresh” fractures. Timely rhinoplasty allows you to recreate the previous shape of the nose with maximum accuracy and minimize damage from a fracture (both in medical and aesthetic aspects).

A) Technique of rhinoplasty of the nasal dorsum. After exposing the tip of the nose and giving it the desired shape, it is possible to perform manipulations on the back of the nose. Soft tissues are separated by sharp or blunt means above the perichondrium of the upper lateral cartilages and the dorsal part of the nasal septum. After reaching the caudal edge of the nasal bones, the periosteum must be separated from it using a periosteal rasp.

Cartilaginous part nasal hump deleted sharp way. In this case, damage to the underlying nasal mucosa should be avoided to prevent the development of nasal valve stenosis. Large bone humps are removed using an osteotome; small humps can be cut down successively with a rasp.

Usually after removal of the bone part of the hump an “open roof” is formed up to the level of the nasal root (separation of the nasal bones along the dorsum), otherwise, for the final medial separation of the nasal bones on both sides, osteotomies are performed with a unilateral osteotome. To prevent collapse of the internal nasal valve after removal of the cartilaginous part of the hump, expansion grafts are installed between the upper lateral cartilages and the nasal septum on both sides.

Lateral osteotomies required to close the “open roof” and to narrow the dorsum of the nose. To do this, an incision is made in the mucous membrane immediately lateral to the anterior attachment point of the inferior turbinate, through which soft fabrics separated from the junction upper jaw and nasal bones. After this, osteotomies are performed. It is necessary to preserve a triangular-shaped area of bone (“Webster’s triangle”) located in the inferolateral corner of the pyriform aperture to prevent medial collapse of the nasal wing in postoperative period. Gradually, the osteotome moves upward, to the junction of the lateral osteotomy line with the medial osteotomy.

If medial osteotomy lines turned out to be located in a paramedial position, when completing lateral osteotomies, the osteotome should be turned inward. After this, the nasal bones become fully mobile, and the surgeon can give them the desired position. If the nasal bones are located asymmetrically or their width is very large, intermediate osteotomies are performed. To do this, after completing the medial osteotomies, but before starting the lateral ones, in the incision through which the lateral osteotomies will be performed, the osteotome is deployed medially along the caudal edge of the nasal bones.

Unilateral intermediate osteotomies are used for unilateral correction of abnormalities in the shape of the nasal bone, and bilateral intermediate osteotomies are used to narrow an excessively wide bony pyramid.

Excess tissue of the cartilage of the nasal dorsum
successively removed with a scalpel No. 11.

(a) After detachment of the periosteum from the nasal bones,
(b) An osteotome is used to remove a large bony hump.

a - Medial oblique osteotomies promote complete medialization of the nasal bones.
b - Osteotomies are used to change the shape and position of the nasal bones. Medial osteotomies are performed paramedially.
Lateral osteotomies pass through the ascending process of the maxilla, preserving a small triangular area at the inferolateral edge of the pyriform aperture.
Intermediate osteotomies are performed between the first two, either for a very wide nose or to correct the shape of the nasal bones.

When performing a lateral osteotomy, the bone is divided
from the level of the pyriform aperture to the line of the medial osteotomy.

The shape of the nasal bridge was corrected and the tip was gently reshaped.

b) Correction of the base of the nasal wings. The width of the wings of the nose should be in harmony with both the width of the tip of the nose and the width of its back; its approximate size corresponds to the distance between the vertical lines descending from the medial corners of the eyes. When viewed from below, the wings of the nose and the tip should form an equilateral triangle. The cause of widening of the wings of the nose may be thickening of their walls, widening and excessive rounding of the nostrils, or a combination of these two reasons.

Correction of the base of the nasal wings is usually performed after completion of manipulations with the tip and bridge of the nose. The incision is made along the nasal fold and continues into the vestibule of the nose. Then, to reduce the internal or external dimensions of the nasal wing (or both), triangular or wedge-shaped tissue fragments are removed; if necessary, the incision is continued further into the vestibule of the nose or along the nasal fold. Absorbable suture material is used to bring the cartilage segments together. The incision in the vestibule of the nose is also sutured with absorbable suture material. The external incision is sutured with 5-0 or 6-0 continuous monofilament sutures.

Correction of the base of the nasal alae can be used to reduce (a) the thresholds of the nostrils, (b) the edges of the alae, (c) the nostrils themselves.

V) Postoperative care . After placing absorbable sutures on the intranasal incisions and permanent monofilament sutures on the columella incision, a cast is placed on the dorsum of the nose. On the seventh day, the columella sutures and cast are removed, after which a bandage must be applied to the bridge of the nose and tip for another seven days.

G) Complications of rhinoplasty. Complications are quite rare, but do occur. Severe bleeding develops in less than 2-5% of cases, infectious complications are rare. Incomplete osteotomies result in an “open roof” deformity. If the lateral osteotomies were performed too high, a “rocker” type deformity is formed, in which the upper part of the nasal bones protrudes to the side, and the lower, on the contrary, is medialized, since the lateral osteotomy was performed along the concave part of the bone above the root of the nose.

Reason difficulty breathing through the nose may be excessive narrowing of the bony pyramid, insufficient correction of a deviated nasal septum or enlarged inferior nasal turbinates, stenosis or collapse of the external and/or internal nasal valves. A “parrot's beak” deformity is formed as a result of thickening of the soft tissues of the tip of the nose, excessive resection of the bony part of the nasal dorsum, and loss of the supporting function of the tip of the nose. Early or late deformities of the nasal tip develop either due to excessive resection of cartilage or damage followed by fibrosis, and are especially common in patients with thin skin, because in them any irregularities in the contour are quite noticeable.

Damage internal nasal valve, uncorrected deformation of the nasal septum or hypertrophy of the inferior turbinates, as well as excessive narrowing of the nose can lead to nasal breathing problems. As a rule, rhinoplasty is successful with patient satisfaction in at least 90% of cases. Repeated operations are successful only in 80% of cases, due to difficulties caused by previous surgery.

Patient before (a) and after (b) rhinoplasty.
The nasal dorsum was augmented, the projection of the nasal tip was increased, and the tip itself became more defined.
To restore the symmetry of the tip of the nose, correction of the base of the wings was required.

:
Septal hematoma
Perforation of the septum
Saddle deformity
Uncorrected hump
Crooked nose
“Open roof” deformation
Rocking-type deformation
Contour irregularities
Parrot beak deformity
Insufficient or excessive rotation/projection of the nasal tip
Difficulty in nasal breathing
Bleeding
Collapse/stenosis of the internal nasal valve
Nasal retraction
Sagging columella

G) Key Points :
It is necessary to know the main and minor mechanisms of support of the tip of the nose
It is necessary to understand the concept of the “tripod”
The function of the nose should never be sacrificed for its shape.
The height of the nose (from the root of the nose to the nasolabial angle) usually does not change. The position of the tip of the nose and its back largely depends on the height
It is necessary to remember the concept of the nose in the form right triangle"3-4-5"

Lateral curvatures of the nasal dorsum (deviations) are often the result of injuries, including birth injuries.

There are 4 degrees of lateral curvature of the nasal dorsum:

I degree. Lateral displacement of the nasal bridge by no more than 1/2 of its width.
II degree. The lateral displacement of the nasal bridge is no more than the value of its width.
III degree. Lateral displacement of the nasal bridge by more than its width.
IV degree. Excessive displacement of the nasal bridge to the side.

The external manifestations of a curvature of the nasal bridge may vary. With thin and long nose the same degree of curvature of the back will be more pronounced than with a thick and short nose.

For deformities of the nasal bridge II-IV degrees Patients are also diagnosed with trauma to the nasal septum (direct vertical fracture, C-shaped fracture).

Correction of the first degree of curvature of the nasal bridge

Elimination of even minor curvatures of the nasal bridge involves performing sufficient complex operation, the result of which is extremely difficult to predict 100%.

If the apex of the deformity is in its bone part, then in this case the optimal solution is to treat it with a rasp. If the deformation is more pronounced, then the plastic surgeon needs to perform intervention on all elements of the nose, which undoubtedly significantly increases the complexity of the operation.

Correction of II - IV degrees of curvature of the nasal dorsum

Most often, when correcting this kind of curvature of the nasal bridge, the plastic surgeon is faced with the task of eliminating the deformation at two levels: cephalic and caudal.

Cephalic deformity is located in the area of the fracture of the base of the nasal bones. The apex of the cephalic deformity is located in the area of the bridge of the nose and is often partially masked by soft tissues.

The apex of the caudal deformity is mainly located at the level of the osteochondral junction and/or the cartilaginous part of the nasal dorsum. In this case, as a rule, there is damage to the cartilaginous part of the back of the nose, deformation of the nasal septum, which causes disturbances in nasal breathing.

When eliminating lateral curvatures of the nasal bridge, the plastic surgeon faces the following list of tasks:

eliminate cephalic deformity;
eliminate caudal deformation;
correction of the location of the nasal septum.

Surgical correction often involves performing certain sequences of actions:

application of open access;
submucosal excision of deformed parts of the nasal septum and vomer;
submucosal separation of the elements of the cartilaginous part of the nasal dorsum;
osteotomy with comparison of displaced areas of the nasal bones;
elimination of deformation of the cartilaginous part of the nasal dorsum;
final manipulations on the back of the nose.

First of all, correction of the nasal septum is performed, which subsequently creates conditions for successful comparison of displaced sections of the nasal bones. At the same time, the elements of the cartilaginous part of the nasal dorsum are separated. Afterwards, the position of the bones and cartilage of the nasal dorsum is corrected.

Correcting the position of the nasal bones involves performing an osteotomy.

Correction of deformities of the cartilaginous part of the nasal dorsum

Often, when correcting the cartilaginous part of the nasal dorsum, the plastic surgeon is faced with the following tasks: eliminating deformation of the cartilage of the nasal dorsum; correction of the position of the lateral cartilaginous walls of the nose after osteotomy; change in the height of the nasal bridge; in case of deformation of the caudal part of the nasal septum, it is eliminated.

Elimination of curvature of the cartilage of the nasal dorsum can be achieved by straightening it in the opposite direction. If this is not enough to eliminate the deformation, then additional manipulations are performed.

Correction of the position of nasal cartilage. After an injury, as a result of displacement of the lateral walls of the nasal pyramid, a significant difference in their height may occur. This is most typical for the consequences of perinatal trauma.

With severe curvature, moving the lateral walls of the nose into the desired position leads to the emergence of counteracting forces, which are eliminated after submucosal separation of the superolateral cartilages and nasal septum. In this case, after comparing the displaced areas, one of the cartilages is located above the level of the nasal septum, the other below. Subsequent partial excision of the protruding sections of cartilage makes it possible to obtain the nasal dorsum of the required height. Such manipulations are effective both in eliminating lateral displacement and in reducing the height of the nasal bridge.

Change in the height of the cartilage of the nasal dorsum. IN in rare cases due to the crushing of the cartilage, depression of the nasal bridge is observed at the level of its cartilaginous part. To eliminate such deformation plastic surgeon installs cartilage grafts, thereby restoring the damaged relief of the nasal dorsum.

What makes our face beautiful is the balance of its features, when all the lines are harmoniously combined with each other. And the nose is one of the main components of attractiveness. IN South Korea its correction is the second most popular aesthetic procedure, which is sought after by people of all ages. The Opera PS clinic employs an experienced team of surgeons with many years of experience in this field plastic surgery. We reasonably guarantee that each of our patients will be satisfied with the results. Nose surgery allows you to get an attractive profile, but it is important to understand: ideal proportions are very individual.

Even if doll faces are a trend in show business fashion, a miniature nose is not always what will decorate you. What looks good on a celebrity or another patient may not work for you personally. This is why preliminary consultations before plastic surgery are so important. Trust the professionals: our doctors will help you choose the ideal proportions that will make your face stunningly beautiful.

The essence of rhinoplasty at the Opera clinic: an attractive profile without problems

Correction of the back and tip of the nose leads the list of plastic surgeries associated with this part of the face. The essence of the manipulation, as a rule, comes down to leveling the profile and raising the tip to a height that will make the face expressive and aesthetically attractive. Sometimes during rhinoplasty, the contours of the nose are narrowed, sharpened or rounded, which doctors at the Opera Plastic Surgery clinic have also been successfully practicing for several years. Excess cartilage and bone tissue are easily eliminated. The result is graceful aristocratic features that adorn your face.

What we use to model the nose:

advanced silicone implants of the latest generation;
We also widely use the technique of harvesting the patient’s own cartilage tissue; this technology for nose surgery gives the most natural effect.

Note: the cartilage is excised from the back of the ear. This safe procedure, there will be no trace left of the micro-incision after 3-4 weeks.

The tip and bridge of the nose are usually corrected together; it is also possible separately, but less frequently. A beautiful, sophisticated profile requires balance - these nose surgeries are usually performed together. Our specialists will provide you with details regarding your specific individual case during a preliminary consultation.

If you don’t want to completely reshape your nose and only plan minimal changes, we offer a non-surgical technique using innovative fillers. In Korea and other countries of Asia, Europe and America, this method is recognized as the most gentle plastic surgery option - it does not require surgical intervention and, accordingly, rehabilitation. Our clinic uses only certified drugs from trusted manufacturers; we use medications and fillers for plastic surgery that have proven themselves in practice.

Indications for plastic surgery of the back and tip of the nose

There are many reasons for seeking correction of the back and tip of the nose, from congenital imperfections and defects to deformities resulting from injuries.

What problems do we help solve:

low back;
violation of symmetry;
too dense, “heavy” tip;
distortion of facial proportions;
curvature, flatness;
"hump";
change in length (using rhinoplasty, you can correct a nose that is too short, elongated or widened, as well as defects in the nostrils);
“saddle-shaped” deformities (retraction of the back).

Our main goal is to give you the perfect profile while maintaining functionality organ and the individual charm of your facial features, bringing them into harmony with each other. South Korean specialists always stand for individuality: at the Opera clinic, doctors do not work as carbon copies, but always take into account your wishes.

This is interesting: in the Land of Morning Freshness plastic surgery Most often performed on the eyes and nose. More than 80% of the entire aesthetic transformation industry is concentrated on these parts of the face. Most patients, both from Korea and from other countries, seek eye and nose correction.

Why Opera PS

We have been working in the field of aesthetic changes to the nose for many years. During this time, we have formed a team of the best professionals in our field with extensive experience in this profile of plastic surgery. You can view the regalia and insignia of each surgeon at the link.

The Opera Clinic is one of the leading organizations in South Korea providing services in the field of plastic surgery in general and nose modeling in particular. We offer the services of experienced medical staff and personal translators who accompany medical tourists.

We work for the latest equipment, we use only certified and practice-tested drugs. All this allows us to confidently give guarantees to each of our patients: we will do everything to ensure that the results of any nose surgery performed with us please you for many years. You will be satisfied. We use safe unique technologies corrections that give brilliant results.

Distinctive feature aesthetic procedures on the nose in our organization - virtual modeling on 3D-CT equipment, which we carry out at the stage of preliminary consultation. You will be able to evaluate how your face will transform after surgery, and, under the guidance of experienced doctors, whose opinions are taken into account not only in Korea, choose the optimal shape, height and length of your future nose.

We guarantee a natural, neat result. For each patient, we select the optimal technique, sizes, preparations and implants in accordance with the structure of the nose, health status and the desired effect. We help achieve excellence with a minimum of intervention.

Operations on the back and tip of the nose at Opera: features, preparation, recovery

Before surgery in our clinic, you must undergo free diagnostics, including blood and urine testing, as well as an ECG. The surgeon will advise you based on the results.

The procedure lasts from 1 to 1.5 hours under local anesthesia. The stitches are removed on days 5-7.

Gentle nose surgery techniques used in Opera PS can reduce the rehabilitation period to up to a week. Depending on your health condition and the chosen correction technology, you will need to see a doctor 2 or 3 times after the procedures.

The correction is carried out closed or open method(the method is selected individually).

After rhinoplasty, do not touch the stitches.
Do not be alarmed by nosebleeds, bruises and slight swelling in the first days; this is the body’s natural reaction to the intervention.
Try to sleep on your back, on several pillows, so that your head is elevated and supported.
Until the swelling goes down, your nose may look swollen, all this will go away along with the swelling, be patient.
Strictly follow all the recommendations of your doctor - follow your diet, use all ointments, drops and medications that are prescribed to you. This will speed up healing after nose surgery and help you quickly return to your normal life.
Avoid the first week physical activity, stick to bed rest.
For the first month, do not visit saunas, fitness centers, solariums, baths and swimming pools.
Avoid foods that are too hot or cold.
Wearing glasses should be postponed for 3-4 months.
Drink more water, temporarily go to light food. Also try to avoid bad habits for the first 4-6 weeks after the aesthetic procedure.

Cost of correction of the back and tip of the nose at Opera

The price for nose surgery is from $3,000 or more, depending on the complexity and number of manipulations, as well as on the reoperation you are about to or are applying for correction of the back and/or tip of the nose for the first time.

The price includes doctor's consultations, examinations, pain relief and post-operative care.

If you need to stay in South Korea for more than one day, use the services of hotels located next to our clinic. The cost of a night's stay is from $50 and above.

Check with our managers for all details or receive them immediately correspondence consultation surgeon by phone +8210-3487-4300 (Telegram, WhatsApp, Viber and KakaoTalk instant messengers are available). You can also contact us by mail: [email protected].

At the Opera clinic you will become the owner of an ideal harmonious profile. Contact us.