Of nose surgery | دکتر مجید راستی

Anesthesia in rhinoplasty

Nasal polyp surgery

20OctMay 29, 2022

Nasal polyp surgery

علائم پولیپ بینی

Nasal polyp is a fleshy swelling in the inner lining of the nose and paranasal sinuses (Spaces filled with air, related to the nasal cavity) contract. In other words, they are non-cancerous growths of internal tissues. Polyps have different sizes; They may be yellow-brown or pink in color and shaped like drops. They eventually grow like grapes on a stalk in the nasal cavity.

Polyps may have grown in one or both nostrils at the same time. They can grow by themselves or in a cluster. Polyps or large clusters of masses can cause breathing problems and can affect the patient's sense of smell, they can also block the sinuses and cause problems such as nasal infections..

About 4 to 40 percent of the general population of a society suffer from nasal polyps, and men are 2 to 4 times more likely to suffer from nasal polyps than women, patients are usually young and middle-aged.. People with asthma, frequent sinus infections, and allergies are more likely to develop nasal polyps. Some children with cystic fibrosis may also develop nasal polyps.

Causes of nasal polyps

The exact cause of nasal polyps is not known, although a significant number of cases leading to polyps are related to non-allergic asthma, but in some cases, no signs of respiratory or allergic disorders have been found in patients.. Nasal polyps have nothing to do with colon or uterine polyps that are found in the digestive tract or uterus.
The exact mechanism of polyp formation is unknown, but many researchers believe that polyps are the result of swelling (inflammation) They are in the nose or sinuses (Swelling and inflammation of the nose or sinuses are not diseases)

Some experts believe that inflammation causes the accumulation of mucous fluids in the interstitial space (The space between the mucous cells) from the nose and sinuses and finally, the gravity of the fluids pulls these heavy cells down, which leads to the formation of polyps.. Scientists believe that the factors that cause polyps may be a bacterial or viral infection or an allergy and an immune response to a fungus by our body..
Nasal polyps are often found near the sinus opening (in the passage of the nose) However, they can form anywhere throughout the nasal passages or sinuses.

درمان پولیپ بینی

The treatments that are commonly used for nasal polyps are as follows:

Steroids

The doctor may prescribe a steroid nasal spray or drop, which will shrink the polyp by reducing inflammation. This treatment is more common for patients who have one or more small polyps. The side effects of this treatment include sore throat, headache, and nosebleeds.

Steroid pills

In larger polyps or more severe inflammation, the doctor may. prescribe a steroid pill for the patient; this pill is taken alone or together with a nasal spray. Although steroid tablets are very effective in shrinking polyps. But there are risks of more serious side effects such as excessive weight gain, so it should be taken weekly.

Other drugs

Other medications may be used to treat conditions that make inflammation worse. These drugs include antihistamines that are used to treat allergies.. Antibiotics that are taken for bacterial infections and antifungal medications that are used to treat fungal allergies.

Nose surgery

Surgery is only used if the polyp is very large. Or if other treatment methods do not respond well to the patient's treatment.

Polypectomy operation

Polypectomy is the most common method to remove polyps. that the patient is given local or general anesthesia and a long, thin tube with a video camera is sent to the patient's nose and sinuses. After cutting the polyps using a micro telescope and surgical instruments. Sometimes, the nose surgeon may remove or remove a small piece of bone from the nose to open the nasal passage.
After polyp surgery, the patient may be prescribed a corticosteroid spray. that this spray from re-inflammation of polyps (Relapse) prevents. Some doctors use salt water to help recovery after surgery (Sterile washing serum) prescribe.

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Fear of rhinoplasty

Anesthesia in rhinoplasty

Anesthesia in rhinoplasty

17OctJune 9, 2022

Investigation of anesthesia in nose surgery

What type of anesthesia is used in nose surgery?

Rhinoplasty is one of the most popular cosmetic surgeries that many people do today. Whether you are looking to improve the appearance of your nose or want to perform a rhinoplasty to correct respiratory or sinus problems, this surgery can bring balance and beauty to your face and restore your health.. Before undergoing rhinoplasty, it is better to know about the types of anesthesia used in most plastic surgery procedures: General anesthesia and anesthesia with sedation, each of which has its own uses and characteristics.

Types of anesthesia for nose surgery (رینوپلاستی):

Anesthesia with injectable sedation

Another type of anesthesia is that it is usually done by intravenous injection of drugs prescribed by a specialist, which causes the person to fall asleep during surgery. .

Usually, along with that, local anesthesia is administered in the nose itself to minimize the pain.

The drugs and the level of anesthesia are adjusted in such a way that the patient can breathe on his own, and as a result, there is no need to put a tube in the airway..

This method is not suitable for long-term rhinoplasty, which takes several hours, because patients can become restless and experience muscle pain or bladder filling..

Place of execution :

Accredited hospital or surgical center.

Advantages:

No need for general anesthesia and respiratory intubation. Less nausea and vomiting, faster recovery time; Less chance of bleeding during rhinoplasty.

Cons :

In some parts of the operation, such as breaking the bones of the nose, this method may cause discomfort to the patient after the operation

General anesthesia:

One of the types of anesthesia is this method, which means that the patient becomes completely unconscious. It requires placing a tube in the airway and breathing through an anesthetic machine.. General anesthesia has a much higher numbing and anesthetic power compared to its two previous types, and doctors usually use it for people who need to make major and more invasive changes..

In fact, in this type of anesthesia, the person completely loses consciousness and falls into a deep sleep.. In many ways, general anesthesia creates the most controlled situation possible during rhinoplasty. With breathing tubes, the anesthesiologist can prevent blood or fluids from leaking into the patient's airway.

Also, in this method, the specialist has complete monitoring and control over your breathing using a breathing machine. In addition, a deeper level of anesthesia can be set that can keep the blood pressure low to minimize bleeding, bruising and swelling. This method is used when the surgery requires more time and may take hours. takes.

Place of execution :

Accredited hospital or surgical center.

Advantages :

Painless method, more control over respiratory activities during surgery by an anesthesiologist, protection of airways by breathing tube..

Cons :

Long anesthesia period, nausea, feeling tired after regaining consciousness

بی حسی موضعی

Regardless of which type of anesthesia is chosen, rhinoplasty surgery is always performed under local anesthesia (Lidocaine mixed with epinephrine) It is done to numb the nose directly and reduce the amount of bleeding during surgery.

Anesthesia is needed to perform nose surgery so that the patient does not feel pain during the changes on the nose.
The type of anesthesia is determined according to the nose surgery method and the duration of the surgery.
For example, local anesthesia is used for surgery that requires less time .
General anesthesia is used when the surgery requires more time and may last for hours.

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Fear of rhinoplasty

Definition of nasal abnormalities

Fear of rhinoplasty

14OctJune 9, 2022

Fear of rhinoplasty

Fear and worry about the operating room is completely normal. And despite the great advances in anesthesia, surgery and its care, fear and concern about them has remained stable, but its intensity is different in different people.. Also, the fear of pain and complications after the operation is the biggest obstacle that discourages many from doing the operation. But the reality is this. Most of the patients after the operation are surprised by their high level of comfort during the recovery period and have a more pleasant experience than they expected.. In the following, we will examine the types of fear of nose surgery :

Fear of nose job pain

All those who have operated their nose. They spent days when they were afraid of nose surgery, bleeding, nasal tampons and anesthesia. And now all those who want to operate their nose. They face these fears. If we look realistically at nose surgery, it is possible like all surgeries. Bleeding, pain or even complications. But you should pay attention to the fact that there are subtle and important points about how to choose a doctor and surgery. which will help you a lot so that you can spend this time safely. And finally get the desired result and shape that you expect.

The pain of all patients is not the same and the intensity of the pain depends on the surgery. The time to resume activities depends on the patient's pain tolerance, and some patients start their activities much earlier than others. Plastic surgery, like any other operation, has its own recovery period, but it is shorter than you think and maybe more than it is afraid. For example, many patients can return to work in less than two weeks. But there is no need to worry because after any surgery, there is some discomfort, and pain relievers will be prescribed for all people who undergo surgery.. However, compared to many surgeries, rhinoplasty has the least amount of pain possible.

Fear of nose surgery anesthesia

If you are afraid of anesthesia, be careful that anesthesia is very easy in the operating room and takes less than a few minutes, most people who have undergone surgery say that they do not remember anything about nose surgery.. It is unlikely that the patient will not worry about anesthesia before surgery, but fortunately, the probability of complications for patients who have good general health is less than in the past.. In addition, there are effective drugs that reduce post-operative nausea and vomiting. However, it is necessary to consult an anesthesiologist before the operation and inform him of your medical history.

The possibility of death in anesthesia

Another concern of people when visiting is the possibility of death in unconsciousness. This possibility will not exist at all, considering the significant progress of medical science and the expertise of anesthesia specialists, it can be said that this possibility is close to zero.. As you know, all necessary tests before and during rhinoplasty are for this purpose. To determine the possibility or impossibility of unconsciousness in a person by carefully examining important matters. Be sure that if anesthesia causes the slightest damage and disturbance in the surgical process. or there is a danger for the person, the surgeon will note this point and prevent the nose surgery .

Fear of failure

Choosing an experienced and expert cosmetic surgeon in the field of cosmetic nose surgery minimizes the possibility of complications. However, a percentage of operations performed by the most skilled surgeons also require restoration. Complications rarely occur due to unexpected problems during recovery. Or that the patient is not satisfied with the result. Secondary reconstructive surgery is necessary in this situation.

Relieve anxiety before surgery

If your fear of surgery has reached such a level that it has disturbed your peace and prevented your positive thoughts. It's time to find ways to deal with it.
Relaxation methods such as acupuncture, massage, yoga, hypnosis and meditation are somewhat effective in treating some types of fear and anxiety.. Studies show that activities such as listening to relaxing music, reading a book, taking a bath, or even exercising can help reduce surgical anxiety.. You can also read articles and materials about your feelings and fears to help you find the root of your unhappiness.

You can talk to other patients who have the same fear and anxiety as you. Or talk to those who have found more satisfaction and life expectancy after any rhinoplasty, eyelid lift, breast prosthesis, body contouring and weight loss surgeries.. Consulting a therapist is also a very effective way to deal with any anxiety or fear. And it can make a big improvement in your mood. Counseling, especially when you have had a bad experience with surgery. It can be helpful. Finally, remember that emotional anxiety is temporary and that these bad and scary feelings and your physical reactions to fear will eventually pass.. Learn how to deal with your emotions sometimes.

Have a comprehensive plan for managing your anxiety

If you are not feeling well and anxious now, give yourself time. And wait until you are mentally prepared. One way to overcome your negative feelings is to think about the good results after the operation. How much younger and fresher you will be than before, how much more beautiful your nose will be, how much more fit your body will be..

You can also reduce your fears and anxieties. Make an appointment with your surgeon before the procedure. If the patient has any fear or concern about the procedure. It is better to postpone surgery until the person is well informed about the procedure and his fear disappears..

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Definition of nasal abnormalities

Stages of rhinoplasty

11OctJune 9, 2022

What are the stages of rhinoplasty?

بیهوشی:

Intravenous sedatives or general anesthesia are prescribed for your comfort during surgery. Your doctor can suggest the best choice for you.

برش:

Rhinoplasty is performed using closed or open method. The difference is that if the incisions are inside the nose, the surgery is closed. But if the incision is outside the nose (In the skin between the nostrils) Be open surgery.

Deformation of the structure of the nose:

After the incision is made, the surgeon begins to deform the nose by removing or reducing the bone or cartilage.

Correction of deviated septum (nose deviation):

If your septum is distorted, it can be repaired and nasal protrusions reduced to improve breathing..

Suturing incisions

After the surgeon completes the nose correction as desired, the skin and tissue of the nose return to their place and the incisions are sutured..

View surgery result

After a week of waiting, the plastic surgeon removes the splint and sutures so you can see the results of the surgery, but the nose is still swollen so the end result will be known in a few months..

Main surgery for rhinoplasty:

In general, there are three main methods for rhinoplasty that are used to achieve specific goals.

سپتوپلاستی : This procedure alone can improve breathing, but does not change the appearance of the nose!
Septorhinoplasty : This method can improve breathing and the appearance of the nose!
رینوپلاستی : This method is to change the appearance of the nose, but occasionally and rarely improves breathing!

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Complications and benefits of rhinoplasty

Definition of nasal abnormalities

08OctJune 9, 2022

What are nasal abnormalities?

Nasal abnormalities in the shape or function of the nose may interfere. This problem is relatively common and many of them do not cause any symptoms. However, many patients are not satisfied with the appearance of their nose. However, in some cases, nasal abnormalities can make it difficult to breathe and treatment may be needed to improve function..

Do all nasal abnormalities need treatment?

Treatment of nasal abnormalities is not necessary because it will often not be a serious threat to people's lives. But the problem is that rhinoplasty improves the quality of life, improves the shape of the nose, increases self-confidence and sometimes improves nasal breathing..

Some types of nasal abnormalities include::

انحراف تیغه بینی : Cartilage that divides the nostrils (One way) It bends.
Enlarged adenoids: Lymph nodes behind the nose (Adenoids) They can grow and block the airways and cause sleep apnea.
Swollen forks or turbines : The turbines next to each nostril clean and humidify the breathing air. Swelling of these tentacles prevents breathing.
Saddle-shaped nose : There is a depression in part of the bridge of the nose. Various factors, including trauma, can cause it.
Nasal hump : Nasal protrusions are relatively common, and there may be extra bone or cartilage, depending on where the protrusion is made.. Often this type of abnormality is inherited or can be due to trauma.

There are other types of congenital nasal abnormalities, some of which, like cleft palate, affect more than the nose..

Can nasal abnormalities be treated?!

For most people, there are things in their appearance that bother them and they wish they could change it.! This factor may be related to their face and smile, weight or body. In fact, when different people are asked about this issue, more and more people prioritize correcting their appearance..

Maybe you are one of those people who do not like the look of your nose. And you may have decided to have rhinoplasty to make your nose look smaller, bigger, slimmer or whatever you want. Rhinoplasty is a safe surgery that can permanently change the appearance of your nose and create the face you want..

Nasal abnormalities can be genetic or acquired.

Acquired causes:

In acquired cases, the most common causes are injuries. Sports injuries, accidents, fights and in general any type of trauma can cause nose deformity.

Congenital causes (genetically):

The most common reasons for people who refer to a rhinoplasty specialist is that they say, "My nose looks like my father's." / It's my mother and I don't like it". Patients sometimes do not like the shape of their nose, which can be influenced by different ethnicities.

In general, when examining the appearance of a person's nose, it is possible to understand whether it is a congenital or acquired problem, since facial asymmetry is very common.. However, the treatment of nasal abnormalities, regardless of the cause, is very similar. Some patients are unhappy with the hump and ridges of their noses, others have drooping of the tip of the nose, some consider the thick skin of their nose to be the reason for the surgery, and some are concerned with the width of the nose and large wings, etc.

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Complications and benefits of rhinoplasty

Rhinoplasty to treat respiratory problems

05OctJune 9, 2022

Rhinoplasty to treat respiratory problems

In general, the shape, size and structure of each person's nose directly affects the balance, proportion, symmetry and beauty of the face.. Rhinoplasty is an excellent option for those looking to correct nasal structural defects that have resulted in cosmetic or breathing problems.

The benefits of nose surgery include the following:

Improvement in the shape, appearance and symmetry of the nose
Creating harmony, proportion and balance in the face
Increase the level of self-confidence
Reduction of the width of the nose ( On the bridge or tip of the nose)
Reducing the overall size of the nose
Correction of any defects in the appearance of the nose (For example, ridges or bumps on the bridge)
Minimizing and aligning nostrils
Fixing some respiratory problems related to the structure of the nose (Nasal polyps)

The shape of the nose is compared with other structures of the face, that is why any changes in the structure of the nose should be considered the effect that these changes will have on the overall appearance of the face.. For this reason, it is very important that rhinoplasty is performed only by a skilled plastic surgeon with facial surgery skills.

جراحی بینی ترمیمی :

Rhinoplasty may also be used in reconstructive rhinoplasty to relieve respiratory problems. Reconstructive rhinoplasty is much more complicated than primary surgery, so choosing a plastic surgeon with artistic skills and insight is essential to achieve the desired result..

Choosing a rhinoplasty surgeon :

Rhinoplasty is a delicate and complex operation and choosing a qualified and capable plastic surgeon to perform this operation is an important part in achieving the desired result.. Several rhinoplasty procedures are available, including "open" and "closed" procedures. The open surgical procedure involves making an incision in the columella, which is the skin that separates the two nostrils. This surgical method provides more direct access to the internal structures and tissues of the nose.

In some cases, due to the size of the nose blades, incisions may be made on the sides of the nose. The closed method usually has no external incisions and can cause less swelling.. However, closed surgery is not suitable for every disease. After examining the patient's condition, the plastic surgeon determines which treatment method can have the best results.

Recovery after surgery :

After rhinoplasty, you will have some bruising and swelling that will subside within two to three weeks. Patients are usually ready to return to work after one to two weeks and can resume all normal activities after four to six weeks..

اسکار (جای زخم) Nose surgery :

As with any surgery, scars are formed at the incision sites.
In open rhinoplasty, a scar is created between the nostrils, although there is also a scar in the nasal passages..
However, these sores are small and usually go away over time.

What are the advantages and disadvantages of rhinoplasty?

Rhinoplasty is one of the most common cosmetic procedures. This technique is designed to enhance the beauty of the nose. And it can also be used to improve respiratory function. Rhinoplasty can change the size and shape of the nose in many ways, including changing the width of the bridge, removing ridges or protrusions, changing the angle of the tip, correcting the size of the nostrils, etc. During your initial consultation, our doctors They will discuss and assess your needs to create a customized treatment plan.

Can rhinoplasty improve breathing problems?

بله. Rhinoplasty is sometimes performed with the aim of solving breathing problems and nasal congestion problems. which may be caused by the anatomy of the patient's nose.
This procedure is also called septoplasty. because it often needs to correct the wall separating the two nostrils, which is called the septum.
A deviated septum can block one or both nasal passages and lead to breathing problems.

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Correction of nasal dysfunction simultaneously with rhinoplasty

Complications and benefits of rhinoplasty

02OctJune 9, 2022

Investigating the complications and benefits of rhinoplasty surgery

Who is rhinoplasty suitable for?

If there is a significant deformity in your nose, and if correcting the deformity makes you feel better about yourself, you may be a good candidate for rhinoplasty..

If your nose is too big or too small
If the tip of your nose is crooked or drooping
If your nose is wide from the front
If there is a curve on the bridge of the nose
In case of asymmetry between the two sides of the nose
If there is a problem with the nostrils
If the tip of your nose moves too much when you laugh or talk
If you have breathing problems, you are probably a candidate for rhinoplasty.

If you have one or more of the above problems, it is better to consult a skilled plastic surgeon before making a decision. You can make a decision after visiting in person, examination and opinion of the surgeon.

The result is actually a psychological improvement, so it is important how the beautician feels before the surgery. It should be noted that the factors affecting the results of rhinoplasty include the thickness of the nasal skin, the shape of the nose itself, previous rhinoplasty and….

What are the benefits of rhinoplasty?

Rhinoplasty is often performed for specific purposes. In some people, it is done with the aim of improving breathing and also improves the appearance of the face. During rhinoplasty, the surgeon may make your nose look more pleasing to you:

Removing the hump on the nose
Correction of the bridge of the nose
Deformation of the tip of the nose
Deformation or resizing of nostrils
Nasal repair after injury or trauma
Increase or decrease the size of the nose

What are the complications of rhinoplasty?

Complications from rhinoplasty are rare, and if they do occur, they are usually minor. These may include::

Hematoma or infection
Bleeding after surgery, and rarely need blood transfusion.
Reaction to anesthesia
Loss of sense of smell in very rare cases
Perforation of the septum (The hole between the two sides of the nose)
Some patients may experience nosebleeds or numbness in or around the nose.
Adverse functional or aesthetic outcome in rare cases

In general, rhinoplasty is considered a very safe operation.

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Unsuccessful nasal cosmetic surgery repair strategies

Correction of nasal dysfunction simultaneously with rhinoplasty

Unsuccessful nasal cosmetic surgery repair strategies

29SepJune 9, 2022

Investigating strategies for repairing failed nose surgery

Unsuccessful nose surgery has certain characteristics. The most common feature is that the tip of the nose and the blade of the bridge of the nose appear to be separate pieces. This is often because too much of the bones behind the nose have been removed. Another characteristic of unsuccessful rhinoplasty surgery is the thin and small tip of the nose. This is again the result of excessive destruction of the cartilage of the tip of the nose. However, the cartilage with a very important reference point at the tip of the nose must remain intact in a certain dimension. In this article, together with the nose surgeon of Isfahan, we will discuss the solutions for the repair of failed nose surgery.

Sometimes I see that all these cartilages have been removed and the nose is apparently compressed. Another bad feature of the nose is that sometimes the tip of the nose is too upturned so that when you look at it from the front, the inside of the nostrils is visible.. In women, the nose should have a maximum angle of 100-110 degrees with the lips. In men, this angle can be 90-100 degrees. In male patients, the bridge of the nose should not be curved.

If people are not satisfied with the result of the previous surgery, secondary nose surgery or reconstructive surgery is recommended. In fact, nose reconstruction surgery is an opportunity for patients to reshape the nose, and the skill and expertise of the surgeon is very important. As the number of reconstructive surgeries increases, the correction becomes technically more difficult and the probability of success decreases. Therefore, it is recommended to make sure of the skill of the surgeon before deciding to perform nose surgery in order to save the cost of nose surgery.

Why is secondary rhinoplasty more difficult than primary rhinoplasty?

Reconstructive nose surgery is a secondary procedure to correct the unfavorable results of the original surgery (primary) The nose is done. Patients may seek secondary rhinoplasty if they are not satisfied with the initial results, or if the appearance of the nose appears abnormal due to trauma, or if the internal structure of the nose needs to be repaired due to breathing problems after the primary surgery. have.

Some surgeons do not perform reconstructive rhinoplasty because the factors associated with the initial rhinoplasty are important to the outcome of the subsequent surgery and not every doctor's expertise. These factors may include scar tissue from the primary surgery, or secondary surgery requiring reinforcement of the nasal structure with cartilage grafting.. It should be noted that the cost of reconstructive rhinoplasty is often higher than primary rhinoplasty. The duration of surgery is also longer and has a higher risk.

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Long nose tip surgery