Rhinoplasty consultation with Dr. Khalili (nose job in IRAN)
A rhinoplasty consultation with plastic surgeon “Dr. Nafiseh Khalili” about Rhinoplasty in Iran , facial plastic surgery, nose plastic surgery, nose cosmetic surgery, cares , issues, postoperative treatment and some tips in cosmetic surgery in IRAN.
This article covers the following topics :
- Introduction of Dr. Nafiseh Khalili
- Open and closed methods in rhinoplasty.
- Possibility of returning the fleshy nose to the previous state
- The effect of nose lift on fleshy noses
- Duration of postoperative rhinitis
- Causes of unilateral swelling after rhinoplasty
- Swelling of the tip of the nose after nose reshaping
- Comparison of thin, normal and thick skin
- Return of dorsal hump after surgery
- Scraping to remove the hump after surgery
- When and under what conditions is Corton prescribed?
- The reason for the bad smell inside the nose after rhinoplasty
- Loss of sense of smell after nose cosmetic surgery
- Solution to restore the sense of smell after rhinoplasty & facial surgery
- Things to consider before nose surgery
- Suitable age for surgery, minimum age and maximum age
- Postoperative nasal depression, causes and solutions
- Taping after rhinoplasty
- Nose blowing after surgery
- Taking birth control pills before and after facial plastic surgery
- When can nasal congestion occur?
- The effect of Anahil tablets after nose lift surgery
- The effect of Accutane after surgery and side effects
- Sensitive postoperative care
Introduction of Dr. Nafiseh Khalili
Hello, please introduce yourself first of all
Greetings to all my dear friends and companions. I am Dr. Nafiseh Khalili, an ear, nose and throat specialist, Rhinoplasty Focus, Sinus and Skull Base Fellow. I’m at your service.
Dr. Khalili, please tell me, is your main activity in Tehran or do you work in other cities as well? And the fact that you only do nose surgery or do other operations as well?
Most of my activity is in the Tehran office, and of course I go to Ahvaz from time to time for our friends in Khuzestan. The main operation I perform is rhinoplasty, but I also perform blepharoplasty, eyelid surgery, gel and Botox, as well as treatment activities separately.
Rhinoplasty open vs closed procedure
Very good. Dr. Khalili A question that arises for many people is whether the doctor who chooses for cosmetic surgery chooses the closed method or the open method? And in general, what is the difference between these two methods and whether there is a difference as a result of the operation or not?
We have two surgical methods, the open method and the closed method. In the past, when open methods were not very advanced, the closed method was used. But over time, as cartilage and grafting issues were used, the results of open procedures were better, and many of my colleagues and I preferred to use the open method, especially in people with more flawed noses. Like people with crooked noses or fleshy noses. These people need to have cartilage implanted, that is, they need to be trapped, and traps can be placed much more accurately in the open method. In fact, the surgeon’s hand is more open on the nose, and as a result, surgery in the open method is better and more satisfactory than the closed method.
Dr. Khalili Friends of Ahvaz ask if you only work in Ahvaz or do you visit nearby cities like Abadan?
Free rhinoplasty consultation with Dr. Khalili by Direct link and number +989305234218 on WhatsApp.
I worked in Abadan for several years, but after I got my specialty, I came to Tehran and now I am in Tehran. Due to my busy schedule in Tehran, I can not go to Ahvaz on regular days. I mostly visit Ahvaz friends online on Insta and WhatsApp, and sometimes I go for surgery for one to two days.
Do African / fat noses get back to their prior form after a nose job? (Fleashy Nose)
Thank you very much, we tag the doctor’s Instagram page for friends who are visiting Ahvaz and take the time to consult. Ms. Doctor, I want to ask a little more about the fleshy nose that you talked about, because those who have a fleshy nose, one of the arguments that worries them is that the fleshy nose will come back after a while. And do noses that are fleshy and do nose lift have an apparent effect and change or not? If you are kind enough to explain these, thank you.
Yes, I heard that term a lot, by the way. They say that meaty noses may bring extra meat or return to the previous shape.
I always give an example to all audiences. We have three skin types: very thin skin, normal skin and thick skin. The best skin for surgery is skin that has a normal thickness. Because in very thin skin, when we get it, we put it down or weave threads from the skin, it may become clear after the operation, and this is the biggest problem that the skin They are very thin. Thick skins are the opposite of thin skins.
For example, when we put a silk fabric on a textured design, this silk fabric shows the texture under itself, but when we use a leather fabric, this texture does not show under the fabric.
Rhinoplasty on fat nose
In other words, the following structure that we use for the patient’s nose and the cartilage that we do in fleshy noses, this form of the following structure may not be completely absorbed. Meanwhile, the fleshy nose never returns, only the skin tissue that we lifted and put back, the fat of the subcutaneous tissue, and when that fat goes, it may not show this structure as much as the bony nose, but in any case, it is not the case that the nose returns to its original days. This is a mistake they often make and say that it’s like the first day when it is not.
I had a fleshy nose myself. Many friends say why your nose is not smaller? I say you do not have expertise. Anyway, the doctor who is doing this will certainly reshape the nose as much as possible, but the skin must allow this to happen.
Many people even have fleshy noses, then their friends or those around them keep telling them that if you do it again or three times, your nose may get smaller. It is a common mistake that the nose is not supposed to shrink with 10 cosmetic procedures because the underlying structure is damaged and nothing new can be done. Of course, there are methods that make the skin thinner, but we can not completely change the skin type.
How Long Does Swelling Last After Rhinoplasty?
Dr. Khalili, I want to ask a more general question about rhinitis that many people have this question. A group of friends think that when they do rhinoplasty, a miracle is going to happen and as soon as the nose comes out from under the plaster, it should have a final shape. Let’s talk a bit about swelling and how long it may take to get rid of it. Another point is that there is a new phrase that patients keep saying “one-sided swelling” when they turn their nose. Explain the term unilateral swelling or swelling of the tip of the nose. And they also ask about taping, how often do you usually tell your client to tape?
Regarding rhinitis, I have to say that several factors play a role in this. One of these factors is the thickness of the skin, and people whose skin is thinner therefore have less swelling after surgery, although not at all without swelling. Not! There is no person who does not have swelling at all after cosmetic surgery.
But they are less swollen than people with more fleshy noses. Fleshy noses take longer to swell because of their thickness than people with bony noses.
The second factor that affects rhinitis is the surgeon’s method. Noses that are more complex and more manipulative, or in cases where there is more cartilage, usually last longer after surgery.
The next factor is the postoperative care that they must follow. For example, in the first few months, do not lift heavy loads, do not smoke or any other heavy activity. Failure to comply with these factors will increase their swelling.
Uneven swelling after rhinoplasty
But in the case of asymmetry rhinitis. Yes, this is the case. In general, any part of the nose that is more manipulated is naturally more swollen. It is not the case that we swell symmetrically when we remove the plaster. Not! This is a misconception. Often one side of the nose may be more manipulated or more cartilage may be placed.
Well, that side of the swelling gets worse. Even some people after surgery expect two nostrils to be perfectly symmetrical and similar. Note that most of us doctors check the nostrils several times from the bottom of the bed to make them symmetrical.
Of course, we never delivered asymmetric nostrils to patients, but still after surgery, because one side is always more swollen than the other, the nostrils may show themselves asymmetrically early on. But over time, as the swelling progresses, these holes begin to show themselves and become more symmetrical in size.
How long does this swelling last? It normally takes up to 18 months. That is, 12 to 18 months is the time when the nose is swollen and the swelling gradually disappears and takes shape. The amount of swelling in the first three months is much higher than the next month. Of course, every doctor may have a different opinion, because surgical methods differ and the patient differs from patient to patient. We may advise a patient with very thin skin not to stick for more than a month.
But most people who have thicker skin, at least two to three months, say that there is tape on their nose. Of course, depending on the amount of swelling that the patient has after three months, sometimes I tell my patients to use U-shaped tape only at night when sleeping between one Use for up to two months.
Excellent, we recommend this talk to our friends, but we do not know why they do not accept it. As you speak, friends ask questions about the swelling of the tip of the nose as well as the swelling of the upper lip. Friends, in general, we should not worry about the appearance of the nose until a year later. Let’s comment on that later.
Return of dorsal hump after nose job ( nose plastic surgery )
A friend has a question about nasal hump, and for those who have a nasal hump and are having nose surgery, they are worried that the hump will come back. Does this hump grow like a mushroom again or not?
It was an interesting question. In some people, it may occur infrequently after shaving the nasal bone and removing the hump, and in some limited people the dorsal hump may grow back a bit.
This is a possible condition, and the second condition is when during surgery, depending on the tissue of the nose and the swelling of the nose, the surgeon may not be able to accurately estimate whether the bone has been removed enough. Because if the hump remains, it is better to remove it completely.
But the third case, which is also the most common option, is that in some cases, a series of cartilages, spreaders or dorsals are left for the patient due to the structure of the nose. In these cases, in the first six months when the nose is numb, it may be hit by the baby while sleeping or for any other reason. Because these cartilages are only attached with a thin thread, a knot may be untied and the cartilage may move a bit, but it does not show itself because of the swelling it has. But when the swelling goes away, the displaced cartilage appears as a bony hump.
Scraping dorsal hump after surgery rhinoplasty
Thank you very much. If someone has this happen to him, he must perform a repair operation or not, can these problems be solved by scraping?
Not. If nasal hump occurs, we must first see what was the cause? Of course, it is better for them to see their own surgeon. Because if they guess it is a bone, they should do a scraping and there is no need for re-surgery. But if the nasal hump is due to the displacement of the graft or cartilage, then the problem will be solved in the same way, that is, outpatient and simple, and there is no need for open surgery.
That is, nothing important will happen and do not worry?
No, there is no problem and these problems can be solved even on an outpatient basis
How many steroid injections after rhinoplasty?
When and under what circumstances is it determined that corticosteroids should be given?
There are people who become addicted to corticosteroids and say that we should take corticosteroids several times. Corticosteroids also have their own conditions, meaning that not everyone has the conditions to take corticosteroids. To insist that the surgeon give me corticosteroids, first depending on the thickness of the skin, and then the surgeon must determine that the person really needs it.
Because there are so many people with fleshy noses that I operated on, for those people who also have thick skin, their swollen noses may not go away with what they expect. Or we know we’ve done a lot of cartilage and the swelling remains a bit too normal for these people. For these people, I inject corticosteroids, which are mostly triamcinolone.
Because the nasal bone usually forms quickly, we inject more corticosteroids around the tip of the nose to remove the swelling. Of course, it has to do with the surgeon, because I often do it between one and three months, but we also had cases where we did it for up to a year and got good results. But in general, noses that do not have swelling or noses that have thin skin do not need to inject corticosteroids.
Thanks, the explanation I have to give to friends who ask about the pain of scraping or corticosteroids. Friends in general, every cosmetic procedure you do has some pain. You need to see if you need to do this or not. If you need to inject corticosteroids and your doctor prescribes it, you should do it. Now you have to endure the pain. But there is no pain that he could not bear. My surgeon also gave me Corton, it was like a dental anesthetic injection.
Why Nose smells bad after rhinoplasty?
Dr. Khalili, friends ask what is the reason for the bad smell inside their nose and how long this bad smell continues and something can be done to eliminate it or not?
Yes, many times we use a series of long-term absorbable sutures for the cartilage that we want to attach to each other or to connect the septum of the nose. The reason for using these yarns is that because synthetic yarns are not absorbable and absorbent yarns are made of natural tissue, these yarns are not stretchable and must fall naturally. In these cases, these absorbable threads are impregnated with nasal secretions, and now you can imagine a living tissue clinging to these threads naturally smelling bad.
This bad smell is usually for people who have had surgery for about three weeks. Our recommendation is to rinse their nose with a washing solution. There are people who think that if they pour the solution on the palm of their hand and pull it up with their nose, this is the right method, while this method of washing is not correct.
These people think that this rinse eliminates nasal secretions. I usually recommend for sinusitis patients who go for surgery to rinse their noses with either a syringe or a nasal wash bottle.
Nasal wash bottles can be obtained from pharmacies or medical equipment, which is easier to use. Otherwise, use a 10 cc syringe and after removing the needle, spray the rinse solution with pressure inside the nose. To remove nasal discharge from the back of the mouth or from the other side of the nose.
In cases where this bad odor persists, we recommend pouring a series of antibiotics into the washing solution to get rid of that bad odor. But this foul-smelling odor may persist for about six months when the sutures fall off or are absorbed.
Losing sense of smell after rhinoplasty
Dr. Khalili Friends ask about the sense of smell. People who have surgery do not have a normal sense of smell and are worried that if something goes wrong or not, they may have a coronavirus. The next question is how long is the nasal congestion and what should be done to get rid of it. Please explain. .
Note that the sense of smell should not be eliminated forever and in general in nasal surgery because it does not affect the base of the skull much, so it should not eliminate the sense of smell. However, in the early postoperative period, the sense of smell of people who use tampons may be affected by a bite. Or because of the secretions that have accumulated inside the nose and the fact that the olfactory cells are located on the surface of the nose and if the olfactory cells do not hit the air, as a result, they do not feel the smell.
In these cases, people who cross the nose and concentrate secretions inside the nose, these people may have a weaker sense of smell, but it does not disappear completely. For these people, we recommend using sodium chloride washing solution. The salt in this solution improves the sense of smell.
But because we have unfortunately been infected with the corona virus for the last two years, some people have thought that the cause of the weakened sense of smell is nasal surgery, while unfortunately they may have gotten the corona virus like the Omicron that was common for a while. This is a different matter because the corona affects the olfactory cells and disrupts the sense of smell.
Solution for losing sense of smell after rhinoplasty
For these people, we also recommend using a nasal wash solution, along with a series of physiotherapies that I put in one of my Instagram highlights. We suggest sniffing and smelling a number of ingredients, such as eucalyptus, mint and vanilla, to restore the sense of smell. If they inhale these substances daily or use their incense, it helps them to regain their smell.
Friends be careful. Dr. Khalili telling you to smell these substances. Some people pour these substances like vanilla into their noses and say why it got worse. Do not do this.
No, no, not at all, nothing should be poured into the nose, they just need to inhale and smell them.
do’s and don’ts before rhinoplasty
Well, let’s talk a little bit about preoperative topics. Doctor, please talk about the things that need to be done before the operation and if they are not followed, the operation will be canceled.
Well, there are several factors to consider. First of all, I ask all people who want to have cosmetic surgery to be honest with their doctor about their diseases. That is, tell their doctor about any illness they have. For example, we had a case of lupus, but because he was afraid that his doctor would not operate on him, he did not tell his doctor. Or we had a case where he did not have a kidney and did not tell his doctor. Or prolactinoma, which is more common in women and happens to be at the same age, and they were bleeding profusely and did not tell their doctor.
True, we do tests before the operation, but we can not include all the factors. That is, we perform routine factors that are necessary for the surgery. For example, we ask for red blood cells, white blood cells, coagulation factors, or a series of kidney factors, so that the medications they take later do not cause any problems. For example, there was a case when we asked him if he had a specific disease? Said no. Then I said, for example, do you not have hypothyroidism? He said yes, I have hypothyroidism. Well, hypothyroidism is exactly the disease. Hypothyroidism is very important for anesthesia, and a person’s thyroid hormone must be normal so that we can give him anesthesia.
The next case is the use of Accutane capsules. They must tell their doctor about this, because we can not perform surgery immediately after taking this drug, and we must also have the approval of an anesthesiologist. There are different opinions about stopping the use of this drug, but I say that for rhinoplasty, the use should have been stopped at least 3 months ago.
The next point is smoking and alcohol consumption. Most of my anesthesia colleagues say that you should stop smoking 48 hours before the operation. Of course, not smoking is much more important after the operation.
There are a number of tests that we routinely request, and based on these symptoms that the patient has, such as a stuffy nose or a suspicious sign of sinusitis, we ask the patient for a CT scan of the sinus, and these are some of the things that happen before surgery. We ask the patient to do it.
I just want to tell the audience that any medicine they take must tell their doctor because, for example, medications that dilute the blood can be dangerous for nose lift surgery. Another point is that many patients say that we do not know, for example, that we may have a problem or disease, such as coronavirus, which has just been introduced and may not yet be active in the body and does not show itself. Or, for example, we may have anemia or hypothyroidism and not realize it ourselves. What should we do in these cases? Please explain about these issues
Yes, we order tests for anemia, we check the hemoglobin and RBC test results for the patient to make sure there is no problem. We also have tests for hypothyroidism. Of course, if they have been tested before and the result is normal, we will not ask for it anymore, but if they have not had any tests at all and the patient has suspicious symptoms (both hypothyroidism and hyperthyroidism are separate symptoms) Based on these symptoms, if in doubt, I request a test.
Rhinoplasty surgery age limit 2022
The question that is often asked is what is the approximate age for nose surgery for both men and women and is there a limit?
If we want to discuss the issue of age academically, they consider bone growth based on age, for example, around 15 or 16 years old, but I do surgery for people 18 years and older (17 full years). This is the first case I consider because we prefer the facial skeleton to be fully developed. The second issue is the issue of intellectual maturity. Usually, people under the age of 18 may not have the vision they should have towards the nose. You know, rhinoplasty should actually be done for people who are mentally and emotionally prepared for the procedure and accept a lot of issues and do not deal with it emotionally.
For example, a 15- or 16-year-old patient with a fleshy nose who comes to me for rhinoplasty, regardless of age physics, may not have a good view compared to a 20-year-old, and I prefer that for 18-year-olds Above to perform surgery.
The maximum age at which we perform nose reshaping is 55 years. Of course, it can be done for older people, but due to underlying diseases such as cardiovascular diseases that they may have, it is not an emergency operation that we want to do for them, but usually there is no problem until 55 years old.
Swelling tip of nose after rhinoplasty
Dr. Khalili, please explain more about the tip of the nose separately because many people ask this question.
When we break the bone above the nose, the skin is thinner than the skin at the tip of the nose. In fact, the thickest part of the skin is the tip of the nose. When we put plaster, it is related to the bony part, not to the tip of the nose. Because we can not plaster the tip of the nose. So usually when we remove this plaster or splitter, the most common place where there is swelling is the tip of the nose. Because there is nothing on it and it is the thickest part of the skin. As a result, it is the last place where the swelling disappears, and on the other hand, the nose, which is called flesh, is based on this tip of the nose.
There are generally two modes. If it is in the first 18 months after surgery, we should give it time. Of course, sometimes we help to make the tip of the nose narrower by injecting corticosteroids. But if it is after 18 months or 2 years, it is the thickness of the skin and we may not do much for the thickness of their skin. And I have to tell them this before the operation and let them know how many percent of their noses change so that they do not have unrealistic expectations. For example, some people who have nose plastic surgery(rhinoplasty), even though they have a thick fleshy nose and skin, expect their tip to be sharp.
Well, this expectation is wrong and the tip of the nose will never be sharp. Yes, it gets smaller than the first case, but it is not sharp. It depends on the amount of swelling. Is this the end result of the surgeon or not in the first 18 months and we may be able to make the tip of their nose smaller with the help of corticosteroid injection.
Pinching after rhinoplasty , cause and solution
Dr. Khalili, if you can give an explanation about nasal pinch and why it may occur, and if it occurs, that person should have a repair operation or not. Also, can that nasal pinch be removed inside the office?
This nasal pinch depends on which part of the nose it belongs to. There is a point I always make: “50% of the outcome depends on the type of skin and the surgeon, and 50% is the result of the care that the person does.” There are many people, for example, the neighbor next to them tells them that after my nose job, I massaged my nose firmly with two fingers and the patient does it on his own without a doctor’s prescription. It is clear when you Massage the nose in this way. This bone, which takes 6 months to heal, may lead to a sunken nose.
Or when you massage the nose with a lot of pressure, a pinch will occur in the part where the cartilage is placed. So, one of the reasons for the pinch is these irregular and unprincipled massages. The second factor that I have to say in the massage and how to apply the tape and I saw that many people do not pay attention to this issue is that some people think that the tighter the tape is, the sooner they will get results and the sooner the nasal swelling will disappear.
Note that the weakest point we have in the nose is the keystone. The nasal keystone is the junction of bone and cartilage at the junction of the upper and middle thirds of the nose. In this area where the bone and cartilage are connected and there is a weak part, people who apply the tape on the nose very tightly, this part subconsciously goes in a little and a nasal pinch is created. This is another reason that due to improper taping, the nose becomes sunken.
But the third reason for the pinch of the nose is due to the blows that a person gets after the operation and thinks that it is too small and it is said that a child’s hand or a pillow hit the nose. Because at that time the nose was numb and the person did not feel any pain, it is probably not something special. But unaware that this is what caused one of the cartilage to move and create a depression in the nose.
What should be done now? First of all, I advise you not to insist so much on your doctor to reconstruct your nose. For example, there are some who have 2 or 3 months after the operation and tell their doctor to correct my nose soon. Note that at least a year must pass from the nose operation to show its original form. If cartilage is needed to repair the nose, it is much easier for the surgeon to decide to do it after a year. Of course, it also depends on which part has the problem. Sometimes, with an outpatient surgery, cartilage can be placed on them and the problem can be solved. Sometimes not, when the spreader is down or the nose is hit hard and the spreader is displaced, then surgery is needed, although surgery is not as complicated as the initial surgery.
Could the pinch be due to the same rhinitis? That is, for example, the swelling of one part is more and the other part is sunken? In my case, the nasal septum was swollen earlier and the tip is still swollen and there is a pinch between the tip of the nose and the nasal septum. The doctor told me to tape the tip of my nose for a month or two to form. Of course, I myself see the changes that this is for swelling and it is going away. Patients are usually frightened to see the depression. Please give an explanation
No, do not worry, you should not think about it at all for 18 months. The nose takes shape and when one side is swollen, the other side shows itself sunken, or when the tip of the nose is still swollen, it shows its sunken top of the nose. This is for a time when it is past time, not early after the operation, now for example, six months have passed and one side is swollen and the other side is not swollen, not in these cases. This is for pathological depressions that I say not for the nasal congestion that exists. It must be swollen, which is why I always say do not insist on early corrective surgery. Let 18 months pass and your nose takes shape, and then we will do whatever is necessary.
Nose scraping surgery after rhinoplasty
Dr. Khalili, please give a brief explanation about scraping and whether after scraping there is a need to re-tape in a period or not and whether scraping is done in the office or should it be done in the clinic?
In scraping, these cases depend on the patient and the surgeon. If the facilities of the office are complete, it is possible that the scraping was performed in the office, but it is better that an anesthesiologist be present in the office. However, the most reliable way is to do this in a clinic. Note that the process is not very complicated and the problem is solved with an incision inside the nose and a scraper. Of course, I emphasize again, it also depends on the facilities of that office. I always tell people who want to have cosmetic surgery, as well as my colleagues, to do the safest possible procedure, because finally, due to the fact that anesthesia is used and there may be side effects, an anesthesiologist should be present.
Please talk about taping after scraping
It is better to apply the tape for at least a few weeks because it is swollen
Taping after nose beauty surgery
Regarding taping, there are many patients whose doctor says they do not need to taping now and stop taping. Then they see their cousin or a friend tell her why they stopped taping so soon? I taped for six months. Why did your doctor tell you not to stick for more than three months? And recommend that you continue taping. We see that these friends are addicted to taping and we see for years that they are still taping after rhinoplasty. What happens to the nose if this happens?
Be careful, too much taping will weaken the cartilage. Let me give you an example, I had a client who did not have facial plastic surgery(rhinoplasty) and because he was dissatisfied with the appearance of his nose and was bothered by it, he used nasal tape continuously for two years. Note that this is why I say age is so important. The day she came in for a cosmetic procedure, there was a horrible cut line under her nose that I first thought had been cut or accidentally cut, and this caused a very horrible cut line under her nose.
Unfortunately, this incision line does not disappear even after cosmetic surgery. Because even a small incision that we make under the nose remains a small line, and in the case of this person, the scalp that he put under the nose was very awful and the cartilage was inside. It was broken.
Try to listen to your doctor. Every patient’s doctor knows what cartilage he has placed and what he has done for the nose and how much the nose needs to be taped. Excessive taping can damage cartilage.
Again, some people think that the tape they take off makes their nose swell. Well, this is always the case, and normally even those who do not have surgery, wake up in the morning, their face is swollen and it is not possible for anyone to tell me I got up in the morning and see that there is no swelling or my eyelid is not swollen. Such a thing is not possible at all, but those who have nose reduction surgery( rhinoplasty) think that when they get up in the morning, it is an artificial nose and it should be stylish and elegant on the face. No, not at all.
Be careful because the nose is manipulated, people who do cosmetic surgery like everyone else and even more sometimes have rhinitis in the morning. And by not observing some cases such as using pepper, spicy and salty foods, garlic and onion or smoking cigarettes and hookah, this swelling will increase. It is not the case that the skin sticks to the nose and stays like this for the rest of its life. They have to adapt their lifestyle to their new circumstances. I tell them to take the tape off and let the nose fit. Do not try to tape so much that we keep the nose beautiful, this way even people’s self-confidence will go down.
Can blowing nose ruin rhinoplasty?
Dr. Khalili, friends ask about nose blowing. When do you usually advise your patients to do this easily?
In general, any surgery that is performed inside the nose, whether it is a nose lift(rhinoplasty), endoscopy or septoplasty, they should not do this for a month, they should not force or lift a heavy load. Because the roof of our nose is the base of the skull anyway, and that hurts. Another problem is that this causes strong wind and air pressure to enter the skin and the amount of swelling increases. For the first month, we strongly recommend that they do not do this, and even if they sneeze, their mouths should be open.
Regarding the nasal arch, the doctor asks, when will this arch be determined?
Well, whenever the swelling of the nose disappears, that is, usually about 18 months after the operation (nose job).
Note, the reason we keep asking this question is that some people, even though we tell them to conclude after 18 months, still have questions about the details of the nose and ask when the nasal arch will be known? When is the shape of the nose blades determined? So we have to ask this in detail to ease the minds of these people.
Well, I even have a series of referrals that say when they get pregnant, it’s over. Every day we see it swell, we tell them pregnancy is different and when we get pregnant it is normal for the nose to swell. Well, during pregnancy, the nose swells and nothing can be done about it. Anyway, the pregnancy that can not be terminated.
Do need to stop taking birth control before & after surgery
Another question they ask is about the use of contraceptive pills before surgery and pregnancy after rhinoplasty. They have questions if you can give a general explanation.
I can not tell people not to use birth control pills, but we must have the approval of an anesthesiologist. It does not cause a particular problem. Of course, it may cause a vascular problem in women, but if the tests are normal, no special measures are needed. But in the case of pregnancy after cosmetic surgery, sometimes it is unwanted and nothing can be done and we have no choice. Usually these people get very stressed and ask what should we do if we become pregnant?
Well, nothing special can be done and we have to admit that pregnancy is swollen. But do not worry too much, I even had a case where a month after the nose beauty surgery, she became pregnant and her nose became swollen, and after she gave birth, and after the swollen nose disappeared, her nose took a very good shape and no particular problem arose. Of course, my advice is that we do not get pregnant until the nose is formed, that is, the first year to 18 months. But getting pregnant does not damage the shape of my nose enough to say that I am stressed and say that our nose is damaged. No, it is not like that. But we recommend that they wait for the nose to take shape and then try to get pregnant.
Nose congestion after rhinoplasty
The question my friends have is when nasal adhesions may occur because as soon as a week or a month has passed since their operation and they can not breathe, they say that I have adhesions and it is over. The question is, when can nasal congestion occur and what is the solution?
Two terms are wrong. One is premature adhesion and the other is turbinate after nasal surgery. This term “turbinate” is not justified at all. Note that we make incisions inside the nose and fix them with stitches, sometimes when they are cleaning or rinsing the inside of the nose or any other manipulation, these stitches stretch and become a little inflamed. Well, this also has its own solution and is not a particular problem. The second reason that is a wrong term is nasal congestion. Note that the internal adhesion of the nose is not such that it occurs immediately after surgery. First, adhesions are unavoidable, meaning that anyone who has surgery may develop nasal adhesions, and the most common cause is internal nasal manipulations.
In fact, we have three slang terms that say extra meat, which we call extra meat in Iran, of course, its scientific term is “turbinite”. We have three turbines, for people who do septoplasty, that is, we manipulate their nasal septum, and at the same time, their turbines are large and we make them small, there is a possibility that it will cause adhesions. It is not the case that this theorem does not exist at all, but it is not the case that it shows itself now in the first, second or third month. It is a long process that must take time to happen.
Small adhesions that do not require special treatment at all and many people have them naturally. Of course, the most common cause is internal manipulations, because they want to remove its secretions and damage the nasal septum, and this causes the mucus to stick together, and in cases that are very severe, it is not very heavy work and even easier than scraping. This problem is solved after a while with an incision and placing a splint inside the nose, and it is easier to treat than a nasal hump.
The effect of “Anahil” tablets after Nose job in IRAN
Dr. Khalili Do you believe in Anahil pills and do you prescribe them for the audience or not? And in general, if you prescribe, how long will it be effective?
Well, at the beginning I do not prescribe it routinely. Anahil pill is the same as pineapple and the person who eats pineapple does not need to take this medicine and I do not prescribe it routinely. But people who have a lot of swelling and bruising, Anahil works well in some people and not all people. Finally, every 12 hours, ie two a day, can be used for 10 days and not for a long time. The purpose of Anahil is to eliminate “swelling of the face” and not “swelling of the nose”. Because after surgery, sometimes there is swelling around the eyes and swelling of the cheeks and lips, and Anahil is for these cases, not rhinitis.
The effect of Accutane after rhinoplasty and side effects
Thanks, there are questions about taking Accutane or Isotretinoin or Accutane after rhinoplasty, whether it has an effect on reducing rhinitis or not, and whether you prescribe it to patients or not.
There is one interesting thing about Accutane that I rarely tell anyone to use. First of all, I do not prescribe it myself and I do not prescribe it directly, but Accutane has a number of liver side effects that anyone who uses it should have regular liver tests. There are some of my colleagues who routinely prescribe low-dose Accutane for people who need it and have fleshy noses or thick skin, or who have a lot of pimples.
Of course, I do not do this, and I only recommend, or in other words, I prefer those who need to use dermatologists, especially those who are more likely to have swelling due to the thickness of the skin or those who have pimples on their face. And they have bad acne.
I recommend these people to my specialist friends to use Accutane under the supervision of a specialist doctor and along with routine tests. This medicine is not to say that it has 100% side effects, but I say it should be checked, which means that we should not endanger our health because of this nasal structure.
Sensitive postoperative care
Dr. Khalili, let’s talk a bit about the complications of nose job. The audience often asks what should we do in the first few days after the operation that will have a good effect? Please give key points about this issue.
Yes, after rhinoplasty, the first advice I have is about nose blowing, which I mentioned earlier. Another important point that many people ask is about smoking and hookah, which they ask what should we do? Many of my colleagues say that you should not smoke or smoke hookah for six months, but I say that you should not use these items for a year when your nose takes shape. Because it takes time for the inner tissues of the nose to heal, and in fact the inside of the nose may be more prone to congestion, I recommend that they do not do this.
The second point is to exercise. Note that light exercise should not be done for the first three months, but after the first three months, they can do light exercise, but heavy exercise, going to the club and working with equipment should not be done for 6 months, ie before six months. Do not do this at all. For example, do not lift heavy children because there have been many such cases when they called me. In general, such things should not be done until six months.
As for the glasses that many ask questions, if we want to talk very practically, we still should not use glasses in the first six months that the bone is boiling. But according to what I said at the beginning of the article about the weakest part of the nose or the keystone, for those who use heavy glasses, considering the pressure that these glasses put on this area, I suggest that up to a year after Rhinoplasty Do not use glasses.
Note that the first month in general is the most important month in rhinoplasty. In the first month, I recommend that they do not sleep too much on their sides and try to sleep on their backs and their head is a little higher so that they do not swell and their head does not hang too much. Because these things eventually affect the nose. The most important thing is not to hit the nose and also don’t tape the nose too bad, which means that these are very important, especially in the first month. As I said, do not use spicy foods and salt, which increase inflammation.
Nose job consultation with Dr.Khalili In IRAN
Dr. Khalili, once again, tell us some information about yourself. For friends who have just joined us, they ask questions about which city do you work in? What surgeries do you perform? And that if someone is in another city, he can get advice through WhatsApp and take action?
My main activity is in Tehran because my office is in Tehran. As for the operations that I perform, well, in addition to the usual surgical surgeries that I perform, the most cosmetic surgeries that I perform are rhinoplasty and upper eyelid blepharoplasty, and a series of cosmetic surgeries that are mostly on the head and neck area. LT is.
Regarding the audience that is in the city, I would like to say that there are many cases in Khuzestan at the moment. Because I was there for several years, they either send their photos on WhatsApp with the number 0930 or on Instagram and tell their details so that we can consult and if we need to see them in person, we will inform them. In the case of surgery, if necessary, we specify the time of the operation there and only visit once for examination and surgery.
Doctor, if there is anything you would like the audience to know, please let me know.
I do not have a special point and almost everything has been said. I want to thank your page because I looked at your posts and I can almost say that you are the only page that looks very logically and realistically at rhinoplasty. Because many people have a dream vision of rhinoplasty, not just rhinoplasty but all cosmetic procedures in general. That is, they show a photo of an actor, regardless of whether the actor has make-up or it may be Photoshop, and they tell us that we want our nose to look like this.
Unfortunately, this perspective is more in Iran, and if you check on cosmetic surgeries abroad, because I follow these foreign cases a lot. The result of the surgery that foreigners publish after the operation, when we compare it with Iranian surgeries, we see a catastrophe in those cases. That is, if you show the result of cosmetic surgery to someone who is in Iran, the patient will not accept it at all.
Friends, be careful. A very important point that we should consider before the rhinoplasty operation is to pay attention to what the surgeon says and compare it with our expectations and see if this talk that the doctor can meet our expectations or not?
Because sometimes the doctor refers to an issue or restriction before the operation, but unfortunately we see that the person says to himself that it may not be like this and it should be like that. The important thing is to accept the doctor’s opinion and go to the nose operation realistically. If this point is taken into account, the person’s satisfaction after the operation will be much better and he will face much less problems after the operation. Unfortunately, some pages and media show a very ideal form with a very short distance from the surgery, which is not really the case. For example, the process that takes 12 months to reach the proper form is shown shortly after the removal of the nasal plaster that such a thing is not possible at all.
We had cases where a person, even though he was constantly moaning after the rhinoplasty and was not satisfied with the result and said why my nose is not small and we told him to wait, is very satisfied now after 4 years that the nose has formed.
Exactly, now we are not talking about the doctors themselves, but unfortunately a number of people who are responsible for producing the doctors’ content or the media that only seek to collect the sick are sometimes viewed, editing the photos and using yellow headlines like “Miracle after 15 days” try to attract people with unrealistic expectations. We also say that we should look at the operation of the nose logically and not just pay attention to the edited photos and advertising videos.
Yes, exactly. I also say that most of my colleagues do not do this, but in some cases this image editing is done by intermediaries. I think this will ultimately hurt everyone, both our beauties and the doctors themselves. So it is better to look more realistically at the nose job.
Note: This conversation was conducted by the “Tajrobe amal bini” collection and this article is only the text of this conversation. If you want to watch the video of the conversation, you can refer to the experience page of nasal surgery
Free rhinoplasty consultation with Dr. Khalili by Direct link and number +989305234218 on WhatsApp.