I've been doing rhinoplasty for more than 35 years. I just arrived from the hospital where I finished a. And I do not get used to it. Because rhinoplasty , anyone, is always something very special.
Rhinoplasty, a surgery with history
And that the doctors are very trained: We have been fixing the nose for more than 5000 years (Papyrus of Edwin Smith, Egypt), reconstructing it for more than 3000 (Sushruta, India), complementing it with other techniques for more than 2000 ( Celsus, Rome) and perfecting it for more than 1500 (Oribasius, Byzantium). In the Middle Ages we treat them with herbs and prayers. And so on until the first "ad honorem" rhinoplasty , in the 15th century (Tagliacocci, Italy), published then not without risk, since don Gasparo (that was his name) almost ends up at the stake for modifying the divine work in a Homo Sapiens.
More history? Why not: In 1794, in the Gentleman's Magazine in London (there is nothing), the British doctors Cruso and Findlay, on their return from the Colonies (English, of course) publish a new nose reconstruction technique. As original, but Sushruta was doing it 23 centuries before (to treat the amputated noses of adulterers and thieves, who in India at that time did not walk with jokes on these criminals).
Let's finish the memory: It is a general practitioner named Dieffenbach who describes in 1845 (Leipzig, Germany) a true modern rhinoplasty with external incisions. But the first internally is attributed to an American, Roe (1887). Although I prefer it from a German teacher named Joseph, who in 1898 would begin to teach us the path of exquisitism in closed rhinoplasty. Like another American, Gunter, will train us since 1987 in the benefits of open rhinoplasty. I have both of the best jewels in my library; his original books.
I want to reveal now one of my best kept secrets: In a rhinoplasty I do not treat the nose. But I try to cure the person. Nobody is operated on the nasal appendix by removing a few grams or millimeters of it. I believe, and so I tell my patients, that the nose is not what others see, but what everyone feels. Intimately. Lonely. Each one. Because for the rest of the world "total, you're fine".
Rhinoplasty , make no mistake, is a complex intervention. Its indication is only given by the patient; you do not like it (they are not complex, it is something much deeper, less trivial). The surgeon indicates and performs the technique. And he must be an expert in it, very expert. You have to be well informed; know the curriculum, listen to the vox-populi. Because if the thing does not go, it has a bad arrangement. We all remember (and in glory is) Mr. Jackson (Don Miguel). True?
Internet does not work: In the previous era it took me about 15 minutes to explore my patient and explain his procedure. Today I take 45, of which 30 I use in the destruction of the "efes" of the Network: Forums, pomp, Photoshop.
In the consultation I have a magnificent toy for the patient to "see", in the preoperative, as it may be after. These artifices are interesting to reassure the patient, so that he knows what is in the mind of the surgeon. That he should be able to reproduce that virtual project in something real. With the art of your surgery. No bits. On an ever changing human being.
The nose should be operated in a regulated operating room and with general anesthesia. I started doing them with local (thanks doctor Planas, doctor Converse). But today this is not going. Because my patients are basically from here, where our conscious can make us dirty tricks. Sedation. That is like general, but with a very fast recovery .
The postoperative period is not painful. For real. Annoyed yes, because to take a protection on the outside (splint) and some plugs inside, even for a few days, do not like anyone.
There may be bruises (bruises) the first few days. That about a week, when removing the nose protector may have disappeared. Then its shape will be better than before, although not defined at all. It will take months, up to a year for your discreet inflammation to go down.
In this time of evolution do not have to take excessive care. But keep in mind that the Sun and the blows are bad companions .
Cheer up. Rhinoplasty is magical : Change the life. It's creative : We surgeons love to do it (aesthetic and / or functional). In about an hour. And to patients, enjoy it for a lifetime.