Rhinoplasty through the eyelid
The procedure was created by Dr. Amar in Marbella, Malaga, Spain and is called a Transpalpebral Osteotomy – A rhinoplasty through the eyelid.
A rhinoplasty can be performed to alter nasal size or shape whether it is traumatic or genetically acquired. Unattractive nasal features such as a wide bulbous tip, wide nasal bridge, large dorsal hump, malformed/asymmetric tip, crooked nose, or a deviated septum causing breathing problems are readily correctable. Even in the case of prior surgery, the nose can most often be substantially softened and the overall shape vastly improved.
The objective of plastic surgery is to obtain the appearance of the nose that looks natural, while staying in harmony with the characteristics of the face. If you are unhappy with your nose it can also affect your personality and self-confidence.
The rhinoplasty surgery technique applied by Dr. Amar will be able to correct the nose and, where needed, the bony structure under the eye ring.
The objective of Dr. Roger Amar is to obtain the best possible result, smoothing out the expression of the face, to avoid haematomas and pain, and to shorten the post-operative period and possible problems and discomfort.
Am I suitable for it?
The best candidates for Rhinoplasty are people who are determined to improve their image and do not to have an ideal nose shape or size corresponding to their facial features. If you enjoy good health, are psychologically stable and have realistic expectations, you will be a good candidate.
It is preferable not to operate on adolescents until their cycle of growth has been completed because the face and the nose will have possible changes.
The recommended age is in men and women from the age of 18 years (once past puberty). It is not advised after the age of 40 (except for cases for total Face Rejuvenation – Lifting, or FAMI). According to the criteria of Dr. Roger Amar, “to change the appearance of the nose in an adult person can bring about upheavals for them in the psychological order when being recognized, since the image of the nasal appendix is determined deeply to the brain”.
Subtle refinement-not drastic alteration is key in most cases. This requires that the surgeon possesses artistic vision and sound aesthetic judgment.
FAMI Technique in Rhinoplasty
Dr. Roger Amar has been successfully applying the FAMI technique to remodel the nose for enhancement in selected cases. He will determine if your rhinoplasty case can be treated with FAMI, avoiding any incisions and the usual post-operative downtime and discomfort of a Nose Surgery (Rhinoplasty).
Before Rhinoplasty Surgery – Planning your surgery
The surgeon will provide specific instructions to you about how to prepare yourself for your rhinoplasty. These will likely include the norms on taking foods and liquids, tobacco, suppression of medicines and vitamins, as well as the cleaning of the face prior to the surgery.
Rhinoplasty Procedures are typically performed as outpatient day surgery.
Rhinoplasty procedures typically have minimal discomfort and swelling but this will vary with patient and surgeon. Dr. Amar has recommendations for medications and over the counter remedies to avoid in order to getting you ready for your rhinoplasty surgery.
It is important to stop smoking at least one or two weeks before the surgery. Following thoroughly our instructions will allow the surgery to be realized in better conditions.
Be sure to follow your doctor’s advice carefully and go to all post-operative visits.
The Surgery Procedure
Dr. Amar makes a mini incision (2mm) around the eyelid to gain access to the base of the nasal bones; this technique facilitates a clean fracture of the bone, if needed, without fracture with multiple fragments and resulting in a lighter, less discomforting recovery post operative time, while achieving most natural result.
The open or closed rhinoplasty surgery procedure is carried out through incisions disguised in the nasal base allowing the reshaping of the bone and cartilage, which are the solid infrastructure of the nose. The fracture or osteotomy of the bone can become unnatural in form with the risk of producing fracture with multiple fragments of the bone and, in the long term also, causing the appearance of ugly, round-shaped wrinkles.
Advantages of the Transpalpebral Osteotomy (Rhinoplasty through the Eyelid):
1. The breaking of the nasal bone is accomplished in perpendicular form, which guarantees precision and avoids the possible chance that the bone can chip or be broken.
2. It avoids bleeding, haematomas, also post-operative pain and possible problems
3. It often avoids the application of the splint.
4. It does not require sutures, avoiding scarring, the incision – of 2mm- disappears after a few days.
A rhinoplasty is always completed in an operating room, within a clinic or hospital. Normally, you will remain in the clinic on the evening and night after the surgery.
A rhinoplasty can be completed under local anesthesia and sedation, or what is more frequent, with general anesthesia; it all depends on the complexity of the surgery and the preferences of the surgeon.
When the surgery is completed, a cast or another material will support the new shape of the nose. Also nasal corks in both orifices are placed to avoid bleeding and to stabilize the nasal partition.
Rhinoplasty or Nose Reshape Procedures are vastly different from patient to patient as is swelling and post-surgical healing.
Recovery and Results
Immediately after the incisions have been closed, soft puffy material may be used inside the nose to maintain the structure along the nasal air passages. Also after surgery, an external splint is applied to help the nose maintain its new shape. The splint provides some additional protection for the nose during the healing process. The external splint is typically worn for six to eight days.
The nose area will be bruised and puffy after surgery. This bruising may extend to the eyes and all areas of the face. Common post-surgery instructions include a cold compress to reduce swelling, pain medication to reduce discomfort, and elevating your head for the first 24 hours.
Most of the swelling and bruising should disappear after seven days. You may experience limited bleeding the first few days. Normally after two weeks, all stuffing, splints, and other post-surgical dressings are removed. There will be some internal swelling within the nose for several months, but this will not be noticeable to anyone but you and the surgeon.
Perhaps the most important instruction: Do not bump your nose. We recommend that you stay in one of our exclusive accommodations for a period of 7-10 days to ensure that in the unlikely event of complications, they can be detected early by our Doctor and be managed at the earliest possible time.
During the first days after the surgery, when the face is swollen and with haematomas, it is easy to forget that your appearance is going to improve and many people can get depressed; it is a normal feeling.
You will improve gradually every day and the new and better look will be every day more visible. After 1 to 2 weeks, it will not be evident that you have been through surgery. The improvement is progressive and gradual, although a minimum swelling can stay, mainly in the early months. You should see a change within 6-8 weeks following surgery, with continued refinement for 6-12 months. Cartilage is a flexible and growing tissue; therefore results following surgery are not fully predictable.
The specific risks and the suitability of Nose Reshaping (Rhinoplasty) for a given individual can be determined only at the time of consultation. All surgical procedures have some degree of risk. Minor complications that do not affect the outcome occur occasionally. Major complications are unusual.
- Avoid physical exercise during the first 3 to 4 weeks after surgery
- We advise you to sleep keeping the head in an up-right position
- Avoid sun exposure during the first 1-2 weeks
- Avoid banging or rubbing the nose
- Take special care when washing your face or hair or when using cosmetics
- If you need glasses, please try to use contact lenses during, the use of glasses requires special consideration
Frequently Asked Questions about Rhinoplasty
What is the right age to undergo Rhinoplasty?
The ideal age to have a rhinoplasty is after the patient’s nose has completed growing. This occurs in females after the age of 16 and after the age of 19 for males.
Alternatives to Rhinoplasty:
Are there any alternatives? What are they? Currently there are no alternatives for cosmetic purposes. However, the FAMI technique applied by Dr. Amar has proven to improve essentially the look of the nose. We advise you to ask for a consultation to discuss your option and possibilities.
For purposes of improved breathing, you can try strips to open airways; however, they are not a permanent solution and often fall short of expectations.
How painful is the post-operative time?
Most people are amazed by how little pain there is after nasal surgery. The most uncomfortable part of the recovery is the inability to breathe through the nose for several days due to swelling. This usually improves within one or two weeks
When can I go back to normal life?
A few special precautions are required during your recovery. Bending or lifting can prolong swelling, so this is not recommended for three weeks after surgery. Running, cycling, or aerobics should not resume for three weeks. Contact sports should be avoided for six weeks, as it takes that long for the bones to fully heal. You can drive when the swelling subsides enough not to interfere with vision, and fly two to three weeks after surgery.
Avoid wearing your glasses for a period of 2 or 3 weeks after surgery until the nose is totally cured. You can use contact lenses as soon as you want to. If you use glasses its possible to use sticky tape to your forehead and the glasses and make sure they do not touch the nose.
What is Revision Rhinoplasty?
Revision Rhinoplasty is surgery that is meant to repair prior rhinoplasty surgery results. If done properly, it is possible to take results that were less than satisfactory and bring them up to your expectations.
In the first two weeks you will see you are bruised and have had some surgery. The healing is a gradual and slow process and there can be some internal scars during the early months. The final results of rhinoplasty will be appraised after 6 months to 1 year.
What are the possible Risks & Complications:
Bleeding, Infection, nasal obstruction, undesired result. Speak to your rhinoplasty surgeon specifically about these complications.