Rhinoplasty surgery in Tallinn

Think about it calmly.

The first step when considering rhinoplasty is to take some time and calmly think about what you want to change your nose for. What will it change in your life for the better? The surgery should not be done on the spur of the moment or at the behest of someone else. If the decision to change the shape of your nose is quite firm and comes from the heart, it is worth going ahead with the planning of the surgery.

How should the nose change?

The next step would be to think in more detail about the changes you want to achieve with the surgery. In most cases, you already know this in general terms, but it is worth thinking about the details. For example, if you want to have a hump removed, you should also think about the tip of the nose and nostrils. Once you have come up with a plan for the changes at home, the further work during and after the appointment will be easier.

Book an appointment

The next step is to visit the surgeon. Together we can review the external and internal anatomy of your nose, assess the desired changes, the technical possibilities for their implementation, the consistency with the rest of the facial features and the harmony with the general beauty ideals. During the appointment, we will take a series of professional photos, which I will also edit after the appointment to simulate the goals of the surgery. Not every photo is suitable for this work - for example, close-up photos taken with a smartphone distort the facial features and are therefore not suitable for rhinoplasty. You can conveniently book an appointment HERE.

Choosing an operating time

After a nose surgery, you need to allow time for recovery from the surgery. Depending on the specifics of the surgery, the length of the healing period varies. Major swelling and possible bruising under the eyes usually disappear within 2 weeks. During the same period, you should avoid physical exertion and this time should also be planned as time off from work. It is often believed that the summer months are not suitable for surgery - this is a myth that is not true in modern times.

Preparation for surgery

You should prepare mentally and physically for the surgery so that your body is as well prepared as possible to recover from the surgical trauma. Among other things, you should limit your alcohol consumption, quit smoking, and get enough sleep. You can find more detailed pre-surgery recommendations here. HERE.

Often, the aesthetic goal of the surgery is to remove a hump, change the shape of the nasal tip, or correct a curvature. Improving the external shape of the nose can be combined with improving nasal breathing, and this is even preferred.

Rhinoplasty is technically one of the most complex operations in plastic surgery. There are many different techniques used. Below I will give a brief overview of the surgical techniques.

Open nose surgery

Used for more complex deformities when the plastic surgeon needs full access to the structures of both the tip and the bridge of the nose. The open method is distinguished from the closed method by the incision on the columella – the narrowest area between the nostrils. This is often the only external incision made during rhinoplasty. Usually, after healing, the scar in this area is barely noticeable. The advantage of the open method is a high degree of precision, as the surgeon has the best possible visibility and access to the structures of the nose. 

Closed nose surgery

In this method, no external incisions are typically made on the nose, and all access to the cartilaginous and bony structures of the nose required to change the shape of the nose is achieved through incisions made inside the nostrils. The advantage of this technique is the absence of an external scar, but there is a slightly higher risk of undesirable shape changes and asymmetries, as the surgeon has less visibility and access to the nasal structures. 

Excisional rhinoplasty excisional rhinoplasty

Surgical techniques that remove tissue from the nose to achieve the desired result. For example, the cartilage of the tip of the nose is reduced. This results in scarring, which causes a subsequent change in shape. Many of the well-known complications of rhinoplasty, such as a pinched-looking tip, are associated with these techniques.pinched nose". Therefore, excision techniques are no longer commonly used.

Structural rhinoplasty

While excisional rhinoplasty attempts to change the shape of the nose by removing excess, structural rhinoplasty has the opposite philosophy: the shape of the nose can be improved by strengthening the nasal cartilage in the right areas. By strengthening the nasal cartilage in the right areas, it is possible to correct, for example, an over-rounded nasal tip, a crooked or sunken nasal bridge, nasal wings that collapse when breathing, and many other nasal deformities.

Retained rhinoplasty

English Preservation rhinoplasty, is a subtype of nose surgery that has gained popularity in recent years, with the advantage of a reduced risk of certain complications and a faster recovery time. It can be performed using both open and closed methods and consists of three main stages:

• Maximum preservation of the soft tissues of the nose by using only the least traumatic tissue layers for incisions.
• Preservation of the connective tissue ligaments of the nasal tip, which ensures faster recovery, better nasal tip position, and final result.
• Maintaining the natural smoothness of the nasal bridge. With conservative rhinoplasty techniques, it is possible to change the shape of the nasal bridge without damaging the outer surface of its cartilage and bone. This reduces the likelihood of unevenness.  

This is just a brief and general summary of the most common rhinoplasty techniques. There are many variations, thousands of pages of professional literature have been written, numerous conferences and trainings have been held. Surgical methods are constantly evolving and changing.

Every nose is unique and therefore the surgical technique is often individual and may contain elements of several of the described surgical techniques.

We will prepare an individual surgical plan that suits you during the appointment and subsequent analysis based on photos.

Photo editing is a tool to help the surgeon and the patient understand the operation in the same way. It is important to remember that the real result of nose surgery is almost never exactly the same as the photo editing. There are still small differences. Secondly, photo editing suffers from everything - some irresponsible surgeon may, in order to convince the patient, edit the nose in the photo to something that can never be achieved with surgery due to anatomical and technical limitations.

The patient's individual characteristics, such as the strength of the cartilage, skin type and thickness, must always be taken into account. There are certain limits to how radically we can change the shape of the nose. For example, if a patient wants to significantly reduce the nose, but their nose tip has very thick skin and the cartilage of the nose tip is weak, the right choice is to improve the shape of the nose rather than trying to radically make the nose smaller - this can have unwanted consequences. This is all very individual and when processing photos, these nuances must be remembered and taken into account so that the patient's expectations for nose surgery are realistic.

Not every image is suitable for photo editing. The basis must be high-quality, technically correct images taken with standard techniques and lighting that better highlight the peculiarities of the patient's anatomy. Images taken before and after rhinoplasty must be photographed under technically similar conditions so that the images are comparable.

Sometimes I am asked to perform a closed or open rhinoplasty during a consultation. These are requests from patients who have already studied the technical nuances of rhinoplasty on their own and have developed a clear preference for a particular surgical technique. I will explain in more detail what is meant by “open” and “closed” rhinoplasty and what are the advantages of each.

Both terms are generic terms that describe a variety of techniques. They describe the surgeon's approach to the nasal skeletal structures. The main difference between these techniques is the presence of an incision on the columella - the area below the tip of the nose, directly between the nostrils.

The skin incision in this area allows excellent access to the cartilage of the nasal tip and the cartilage and bone of the nasal dorsum. The surgeon can make all necessary changes to the shape of the nasal structures under conditions of good visibility and manual freedom of action. At the end of the operation, the internal incisions of the nostrils and, in the case of open rhinoplasty, the external columella incision are carefully sutured.

Closed rhinoplasty is performed without making an incision in the columella. In this case, the cartilage of the nasal tip is accessible through each nostril separately, and in the final phase of the operation through only one nostril. Since the nasal bridge is located further from the nostril, it is difficult to influence it through the nostril, and this technique is not suitable for more complex changes on the nasal bridge that require a high degree of precision. The advantage of the closed approach is the absence of an external skin scar after healing.

How noticeable is the columella scar after healing?

I perform rhinoplasty using both closed and open methods. The closed method is better suited for work on the tip of the nose and more typical changes to the bridge of the nose, such as lowering a symmetrical hump. For larger work, it is more reasonable to prefer the open method, which allows for greater precision - you should not be afraid of this because of the external incision. Noses are very different and it is important to choose the right surgical technique and access for each one in cooperation with the surgeon.

A certain nose shape, the so-called Barbie nose, has gained popularity on social media, especially Instagram, in recent years. Barbie nose). A look inspired by a well-known doll is a dream for many women. Looking at the doll itself, we see that it is slim in relation to the rest of the face, with a pronounced concave bridge of the nose and a straight tip. In addition, the smallness of the nose is emphasized by the cartoonishly large eyes.

However, there are certain problems with this popular Instagram nose shape, which is why many responsible surgeons are hesitant to perform this type of surgery. First, the nose must fit into the context – the rest of the face and personality. For example, a Barbie nose, with its slightly childish elements, fits a young adult's face, but may look odd on a more mature woman.

Another problem with Barbie noses is breathing, as the radical lowering of the nasal bridge and reduction of the nasal tip support framework can drastically reduce nasal breathing. This means a significant decrease in the patient's well-being and quality of life after surgery, which is not considered important before the surgery.

In terms of appearance, it should not be forgotten that a change in the side view always leads to a change in the front view. Thus, the patient's preferred upright nasal tip may be accompanied by unpleasantly visible nostrils in the front view. Therefore, moderation and a compromise between beauty and function are important in a Barbie nose type rhinoplasty.

Some well-known surgeons who advocate the Barbie nose refer to it as a “one size fits all” nose job. Unfortunately, the reality of rhinoplasty is not that simple. It is important to remember that the shape we can achieve with rhinoplasty depends on each individual patient’s anatomy, initial nose shape, skin type, and other factors. The nose must fit the proportions of the rest of the face, and you must also consider the fact that you will have to live with this nose until old age.

When planning rhinoplasty, it is important to be aware of these risks and plan the surgery individually.