Rhinoplasty
& Facial Plastic Surgery

Rhinoplasty is a surgical procedure which aims to correct and reconstruct the shape of the nose. Its main goal is to aesthetically enhance the nose and restore its function.

With the nose localized in the center of the face and being its most prominent feature, small deformities are easily noticed and the patients complain the aesthetic deformity. Besides its aesthetic part, the nose serves as an organ of the respiratory system, having important functions: cleaning, heating and humidifying the inhaled air. Thus, patients with nasal problems often suffer from ear, pharynx and larynx dysfunction.     

Frequently, patients come to my private practice office bringing with them photographs of actors and models asking for a nose that would like the one on the photos. A beautiful nose is the one that looks good aesthetically but also harmonizes with the rest face features. Rhinoplasty is an extremely personalized procedure that must be performed in accordance with the rest face features without disrupting the anatomy and the physiology of the nose.

There is no such thing as the best age to undergo a rhinoplasty, but there is an age limit prior to which the procedure should not be performed. This age limit is estimated at 15-16 years for the female and 17-18 for the male patients. Until that age the nose is not fully developed and has not gained its final form.

Any change on the external appearance of the nose can result in tampering the nasal breathing. One must know how any modifications of the shape of the nose will affect the breathing. The nasal septum provides support to the dorsum of the nose and plays an important role in defining the shape of it. Thus, a septoplasty is essential to ensure good nasal breathing postoperatively and serves as the keystone of nasal reconstruction.

A preoperative consultation is necessary to fully address the specific requests of each patient and perform a clinical evaluation of the aesthetic and the functional part of the nose in order to define the surgical plan. This part of the consultation allows the surgeon and patient to reach a mutually agreeable set of expectations by demonstrating the planned outcome of rhinoplasty and describing the objectives of surgery. Only by applying this rule, one can expect that both the patient and the surgeon are satisfied by the outcome of the surgery.

Rhinoplasty can be performed under local or general anesthesia depending on the extent of surgical manipulations. It requires a few hours up to one day of hospitalization.

The patient wakes up with a splint placed over his/her nose. A nose tampon may be placed in each nostril, if a septoplasty has also been performed. The patient may feel nasal blockage, as well as a minor discomfort. The nasal packing will be removed the day after and the nasal splint will be removed on the 6^th postoperative day. During the postoperative period the nasal rinsing is recommended and antibiotics are applied locally. Edema and bruising of the lower eye lid is normally expected on the first days after surgery and resolves gradually during the healing period.  

The patients can return to their work and their every-day activity 6 days after surgery, when the nasal splint is removed and the edema is almost completely eliminated. They are advised not to wear glasses for six weeks as well as to avoid minor trauma by not engaging in sports and other physical activities.    

The success rate depends on a variety of factors such as the healing ability of each patient, prior surgeries as well as the expertise of the surgeon. Our estimated success rate is 92-95%.

Yes, it is called revision rhinoplasty. However, it is preferable to meet the patient’s expectations during the primary surgery, as the surgical field is optimal and the healing is not disrupted by the formation of post-operative scars. Approximately 30% of my rhinoplasty cases are revision cases. I realize that the main cause of failure is the inadequacy of the first surgeon to address the patient’s expectation and I strongly believe that the surgeon-patient relationship must be based on trust and mutual understanding. If one does not feel ready to undergo the consultation session, this should be rescheduled. The revision rhinoplasty is far more difficult and demanding due to the scaring resulting from the primary surgery. 

Prof Constantinidis Jannis is a certified ENT since 1996 after completing his specialty training at the Department of ENT Diseases, Head, Neck and Facial Plastic Surgery, Communication Disorders of the Municipal Hospital of Fulda. From 1996-2000 he served first as an attending ENT specialist in the ENT-Department of Saarland University, Homburg/Saar and  afterwards as an Assistant Professor in the Ear, Nose and Throat Clinic, Head and Throat Surgery of the Erlangen- Nurnberg University Hospital, specializing in facial plastic surgery and mainly in rhinoplasty. In 2000 he was certified as a Facial Plastic Surgeon by the German Medical Association in Munich after completing his training and successfully passing the essential exams. He was in charge of the Facial Plastic Surgery cases of the ENT departments he served during his stay in Germany and he organized on an annual basis surgical courses on this subject with international participation. Up to now, he is an invited speaker in a great number of national and international conferences as well as in Facial Plastic Surgery courses. Since 2008 Prof Constantinidis is the Greek Delegate in the European Academy of Facial Plastic Surgery (EAFPS).