Relevant information about rhinoplasty, plastic surgery of the nose, scars, techniques, results, recovery, everything about it provided by Dr. El Hachem.

By having a complex structure, the nose shows a wide variation between individuals. Rhinoplasty is the surgery that correct the  nose disproportions, making it more harmonious with the rest of the face and thus enhancing facial aesthetics.

Plastic surgery of the nose may be associated with surgery aimed in correcting respiratory function (e.g. septoplasty, turbinate) in patients breathing with difficulty.

Since each patient has their own genetics, you cannot choose a nose that you want to have (e.g. equal to one), but correcting and perfecting the nose itself, keeping the nose that you have more harmonious with your face.
Disproportion or disharmony between the nose and face, and unaesthetic nose.

Anesthetic type:
Local with sedation or general.

Length of stay:
Generally, 24 hours.

After rhinoplasty, the patient will have a plaster cast for 7 days and other tape for another 7 days.

It is common to have facial edema (swelling) and ecchymosis (bruising), which usually resolves within 21 days. A residual swelling persists for up to 6 months, which would be noticed by the patient like the hardening of the nasal tip.

Any trauma to the nose should be avoided for 2 months after rhinoplasty, because it may cause a nasal bone fracture, and can lead to the displacement of the bones.

One should avoid heat (sun bathing and warm environments, etc.), since it leads to increased edema (swelling).

Rhinoplasty (Nose Surgery)

They are very rare in rhinoplasty, may be cited: postoperative bleeding, hematoma, infection, nasal obstruction, irregularities, asymmetries and anesthetic problems.

Final result:
The final result of rhinoplasty is achieved between 6 months and 1 year, but there will be major changes from the first month.


Frequently asked questions to Dr. Charbel El Hachem

Rhinoplasty – Nose Plastic | Plastic surgery rhinoplasty

1) Is there any scar in Rhinoplasty?
There are no visible scars in the aesthetic surgery of the nose. This is because the incisions (cuts) made by Dr. El Hachem are “inside the nose” ; consequently, leaving unapparent traces. In special cases, when the ala of the nose (nasal wings) are treated, there are two small scars in the creases between the wings (ala) and the face, which over the weeks, become practically imperceptible. In other cases, (open procedure), an almost imperceptible scar is placed in the “columella” (lower nose).

2) In plastic surgery of the nose, can I choose how I want it?
No. There is an aesthetic balance between the nose and face, a balance that the surgeon must observe in order to preserve the naturalness and authenticity of the face. Each case is studied thoroughly by Dr. El Hachem, so that he can give your nose the best possible shape manner within the requirements of your face. Another limitation that exists is the nose skin type. e.g. a nose with thick skin can never become as thin and delicate as other with thin skin.

3) Is the final result of the “new nose” immediate?
No. There are several phases that characterize the postoperative period of plastic surgery of the nose. On the 1st stage (after removal of the plaster around the 7th day), we notice an edema (swelling) that decreases over the days and tends to disappear fully after the 6th month. The persistence or not of transitory edema for a longer period than normal does not interfere with the final result. Most edema (swelling) is reabsorbed in the first two months post rhinoplasty, but a large change can already be seen at the end of the first month after the surgery.

4) How will my breath be after Rhinoplasty?
Aesthetic Rhinoplasty also aims to improve the patient’s respiratory conditions, when these conditions are precarious in the original nose. There is some difficulty in the immediate postoperative period (a few weeks), because of the edema inside the nose, as well as the movement of “breathing valve” that will be impaired during this period, secondary to changes in the elasticity of the nasal wings. With time, it tends to normalize. Breathing problems are usually linked to the septum that in many cases is corrected in the same surgical procedure. Allergic problems such as rhinitis will not undergo any change with rhinoplasty.

5) How long does the result of rhinoplasty persist?
The result of a Rhinoplasty is practically definitive. Just to point out that after the 5th decade of life, any nose begins to show morphological changes due to the transformation of the quality of the skin that covers it.

6) What type of anesthesia is used in Rhinoplasty?
Both local anesthesia with sedation or general can be used, depending on the case.

7) How long does the surgery last?
Usually the rhinoplasty operation lasts from 90 to 120 minutes for the worst case.

8) How long is the hospital stay?
12 hours for surgeries performed under local anesthesia and sedation. 24 hours for general anesthesia.

9) Are there any dressings used? How many?
After finishing rhinoplasty, the nose is kept immobilized with acrylic dressing, which fully covers it. This dressing remains for about 7 to 10 days, after which it is removed in the clinic. Nasal packing may or may not be used and are left for 24 hours. After the first week a tape bandage is used for another 7 more days.

10) I heard that the nose “bleeds” in the early days. Is this true?
There is a little bleeding that is very normal in the first 48 hours after rhinoplasty. This, however, should not cause concern because a protective bandage is superimposed to the opening of the nose in order to stop this bleeding. This additional dressing can be changed at home as often as needed.

11) Is there pain in the postoperative plastic surgery of the nose?
Generally, not. Rhinoplasty has painless postoperative period.

12) Are there any dangers in this operation?
Rarely does rhinoplasty create any serious complications. This is because of the properly prepared process for each patient before the surgery, as well as considerations on the suitability of the surgery to the patient. The danger is not greater or less than a trip by plane or car, or even a simple cross of the public highway.

13) What position should I sleep in the early days after the operation?
The patient should always sleep with the head slightly elevated (pillow). Keep up with the side up (not sideways) so that the nose doesn’t touch the pillow.

14) When can I sunbathe again?
For long exposures (beaches, sunbathing), it is advisable to wait a minimum of 90 days, due to the increased edema (swelling) in this post rhinoplasty phase.

15) When can I exercise again?
The exercise can be conducted after one month. Contact sports should wait at least for two months, especially in cases where it was necessary to fracture the nose during rhinoplasty.

16) What is the postoperative evolution?
You should not forget that, until it reaches the desired result, several phases are characteristic of this type of surgery. So that edema (swelling), “spots” of blood infiltration, breathing difficulties in the early days, are common to all patients post rhinoplasty; Some present these phenomena with less intensity than others. Hopefully you are in this group. If not, do not worry. Give time, your body will take care of resolving all the little problems. Clearly, any concern on your part should be transmitted to Dr. El Hachem. There is usually a period of euphoria, as soon as you remove the cast (7 day). In rare cases, a discreet anxiety comes as a result of transient edema and appearance of blood stains. This is temporary and usually reflects the desire to achieve the final result as soon as possible. Be patient. Remember that no result of aesthetic surgery of the nose should be evaluated before the 6th postoperative month.

17) Can Rhinoplasty be associated with any other plastic surgery?
Yes, it can. Dr. El Hachem commonly associate rhinoplasty with nasal septum surgery or other plastic surgery, such as breast implant, liposuction,… The feasibility of the association will be discussed with Dr. El Hachem during the consultation, when he will provide you the operating time, the safety of the surgery, postoperative, etc.

18) Finally: will the result of rhinoplasty pays off?
Of course. Dr. El Hachem assures all patients that among the cosmetic surgeries, rhinoplasty is one of providing great satisfaction. Remember what we said earlier: each case is examined individually in the 1st consultation, during which all details are clarified and all mistaken beliefs are explained. Since you mutually decide to perform the surgery (Dr. El Hachem and patient), it is because the result pays off. Otherwise, he will be the first to refuse the operation. This unpretentious message was drawn up in order to inform you about the aesthetic rhinoplasty. Dr. El Hachem will be delighted to answer any further questions in detail.

Rhinoplasty recommendations (nose surgery) – Plastic Surgery
Rhinoplasty (Nose Surgery)

Preoperative recommendations:

1) Communicate with Dr. El Hachem until two days before surgery in case of flu, colds, runny nose or any symptoms that affect the mouth, nose or throat.

2) Arrive to the indicated hospital, according to the established schedule.

3) In case of hospitalization on the same day of the operation, attend the hospital fully fasting (8 hours fasting)

4) Avoid all alcohol or heavy meals, the day before surgery.

5) Avoid smoking for a period of at least 15 days prior to surgery.

6) Avoid any medication containing acetylsalicylic acid (ASA, aspirin, etc…) or any medication with anticoagulant effect at least fifteen (15) days prior to surgery.

Postoperative Recommendations:

1) Avoid sun (beach).

2) Change the external dressing as often as necessary.

3) Special care with the cast: do not traumatize the bandage, or avoid the temptation to “take it off to see how is the nose.”

4) Follow carefully the prescription.

5) Back to the office for changing the dressing on the day and time indicated.

6) Avoid the sun beach within 90 days.

7) Do not wear glasses until it is authorized.

8) Do not worry about the intermediate forms in various stages (the nose is swollen).

9)  Ask Dr. El Hachem about any concern. Avoid to be sensitized by opinions of friends at this early stage.

10) Avoid any medication containing acetylsalicylic acid ( aspirin, etc…) or any medication with anticoagulant effect at least fifteen (15) days after the surgery.

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