What is Nose Smoothing Surgery?
Nose filing surgery is one of the many surgical methods performed under the name of rhinoplasty or rhinoplasty surgery. The deformation that needs to be corrected in every nose is not the same. For this reason, the tip of the nose, the dorsum of the nose, the bone and cartilage roof of the nose, the wings of the nose, the nostrils, the forehead-nose angle, the nose-lip angle and the relationship of the nose with other structures of the face are evaluated for each patient, the existing problems are determined and an operation plan is made accordingly.
Nose filing surgery is the process of rasping the excess bone and cartilage tissue on the back of the nose in arched noses and making the nasal ridge between the nasal root and the tip of the nose flatter.
Arched Nose Types and Treatment Options
In the profile view of the nose, when a line segment connecting the nasal root (nose-forehead junction area) and the tip of the nose is drawn, if the dorsum of the nose is in front of this line rather than in line with or behind it, there is an arched nose deformity.
There are different anatomical reasons and different treatment methods that lead to the appearance of an arched nose. For this reason, the reason why the nose looks arched should be analyzed well before surgery and the surgical plan should be made correctly. The aim of the treatment is to bring the back of the nose 1-2 mm behind the nasal root-nasal tip line in women and in line with this line in men.
Arched Nose Types and Treatment Approaches:
- Normal nasal root and nasal tip projection and nasal arch
In the treatment of this type of nose, excess bone and cartilage tissue is rasped.
- Increased nasal tip projection and nasal arch
In this type of nose, the nasal tip projection is first lowered and then the nasal arch is filed.
- There is a false arch appearance due to low nasal tip projection
Since the nasal tip projection is less than it should be, the line drawn between the tip of the nose and the root of the nose passes through the background and the nose appears arched. Raising the tip of the nose is the correct approach in this type of nose. If the nose is filed with reference to the low nasal tip, aesthetic and functional problems are seen.
In such a nose, if the low nasal tip is taken as a reference, the nose appears to be arched, whereas the correct treatment is not to file the nasal arch, but to increase the nasal tip projection, as was done in this patient.
- Nasal root is more hollow than it should be
The root of the nose is lower than it should be and the nose appears arched because the root of the nose is sunken; in the treatment, it is necessary to fill and elevate the nasal root area. For this purpose, cartilage tissue, fat tissue or ready-made filling materials (permanent or temporary) can be applied under the skin of this area.
- Mixed type arched nose
There is an arch in the nose, the nasal tip height is not in the ideal position and there may be pitting at the root of the nose. It is the most common type of arched nose I encounter in practice. In the treatment, the nasal tip height is first brought to the point where it should be (the nasal tip projection is reduced or increased) and then the nasal arch is filed.
How to Determine the Ideal Nasal Tip Projection (Height)?
After the nose – lip angle is brought to the required angle, the ratio between the length of the nasal dorsum between the nasal root and the tip of the nose and the nasal tip projection is 1:0.67.
As can be understood from the above information, in an arched nose, first of all, a very good analysis should be made before surgery and the relationship of the nasal root, nasal dorsum and nasal tip with each other and the face type should be revealed. The factors causing the arched appearance should be determined and a surgical plan should be created accordingly. All these preoperative analysis, planning and surgical application processes require considerable knowledge and experience.
How is Nose Smoothing Surgery Performed?
In the vast majority of noses that require nasal filing, the tip of the nose, nostrils, nasal angles and nasal bones also require intervention, all of which are called rhinoplasty, aesthetic nose surgery or rhinoplasty. In other words, nose filing is one of a series of procedures performed in aesthetic nose surgery and is performed under general anesthesia.
Using a closed or open technique, the skin on the back of the nose is separated from the bone and cartilage tissues underneath, the root of the nose and the tip of the nose are brought to the required height, and the back of the nose is filed with reference to these two points. The filing process is performed using chisels, rasps or ultrasonic instruments. After filing, the nasal bones are made mobile and the bone and cartilage framework of the nose is reconstructed.
How Much Should the Arch of the Nose Be Trimmed?
After the root of the nose and the tip of the nose are brought to the correct height, when the line connecting these two points is taken as a reference, the back of the nose should be 1-2 mm behind this line in women and tangent to this line in men. Especially in female noses, the entire face should be examined and the nose-lip angle and nose profile should be determined according to the face type. In some face types, more curved and upturned noses are compatible with the face, while in some face types, flatter and sharper angled noses are compatible with the face.
Do the nasal bones also need to be intervened in the nose filing procedure?
When the excess bone and cartilage tissue on the back of the nose is rasped, the triangular prism-shaped nasal roof is removed and the roof formed by the nasal bones with each other on the back of the nose is disrupted. For this reason, the right and left nasal bones are mobilized using different techniques and brought closer to each other to form a roof again and molded in that way. If this procedure is not performed, the nasal bones do not merge with each other to form a roof, they stand apart and a deformity called “open roof deformity” occurs on the back of the nose.
Our patients frequently ask, “Can’t you just file the back of the nose without touching the nasal bones?”. If the nasal arch is not caused by the nasal bones but only by excessive nasal cartilage, only filing can be performed.
However, most of the time, the cause of the arch is the excess of both cartilage and bone structures, and when the bone roof is filed, the nasal bones must be mobilized and the roof must be reconstructed. Your aesthetic plastic surgeon will explain to you what kind of procedure is required in your nose during the preoperative examination.
Are other parts of the nose also intervened in nose filing surgery?
In practice, nasal filing is rarely done alone, mostly the tip of the nose, the septum part of the nose, the nostrils and the wings are also intervened in the nose and a 3-D shaping of the entire nose is made, the whole of these procedures are called rhinoplasty, aesthetic nose surgery or rhinoplasty surgery.
Is there a risk of nose filing surgery?
As with any surgery, nasal filing surgery has some risks in terms of anesthesia and surgery. If the bone and cartilage structures are filed more than necessary during the nasal filing process, a collapse of the nasal roof develops.
This will cause an aesthetically bad appearance as well as impair the nasal breathing function. For this reason, the nasal filing procedure should be performed with extreme care and the distances and angles (internal valves) required for respiratory function in the nose should be preserved with additional cartilage supports.
Who is nose filing suitable for?
People who have completed 18 years of age, do not have any physical and mental health problems, have an arched nose and are uncomfortable with this appearance, and have realistic expectations from the surgery are suitable candidates.
Is nose filing a plastic surgery?
Yes, nose filing surgery is a plastic surgery and is not covered by insurance companies.
Is nose filing done with local anesthesia?
Very limited applications such as filing only the cartilage parts can be performed under intravenous sedation and local anesthesia, but in my own practice, I perform all my nose filing operations under general anesthesia because it is often necessary to intervene in the nasal bones and other parts of the nose during filing.
Is revision necessary after nose filing?
After the nasal filing procedure, if the nasal ridge is filed more or less than necessary, or if the bone roof reconstructed with the nasal bones remains open, or if the desired straight line cannot be obtained on the nasal ridge, revision may be required to be performed at least 1 year after the nasal filing procedure.
Swelling and edema after nose surgery
There will be more or less some swelling and edema after aesthetic nose surgery. This swelling will start on the night of surgery and will reach its maximum on the night of the next day. In the following days, it will start to shift from the top, that is, from the eye circles downwards, first to the cheeks, then to the upper lip, then to the lower jaw and neck, and will disappear completely over time.
The degree of swelling that develops in the nose and surrounding structures such as the eyes, cheeks and upper lip after nose surgery depends on many factors. One of them depends on the size of the correction procedure to be performed in the nose. Swelling will be less after operations in which the nasal bones are not intervened except for slight filing or only the tip of the nose is intervened.
On the other hand, swelling and edema will be seen more after surgeries in which the nasal bones are intervened and the nasal roof is reshaped and in addition, structures such as concha and septum deviation in the nose are intervened. On the other hand, although surgery is performed in the same way, edema does not occur in the same way in every person because the tissues of each individual do not have the same characteristics.
Some people are more prone to edema and swelling. On the other hand, some other factors such as whether the patient remains in a semi-sitting position after surgery, whether cold application is applied after surgery, excessive straining after surgery, frequent sneezing, high blood pressure also play a role in the degree of swelling.
After nose filing surgery
There are some practices that are applied in all surgeries for rhinoplasty and are generally accepted among surgeons. Some of these include being in a semi-sitting position in bed within hours following the surgery, applying cold around the nose and staying as calm as possible. Oral nutrition is started 2 hours after the operation and after a few hours, you can stand up with the help of a nurse and take a short walk. Some blood leakage from the nose is normal.
Excessive straining and bending forward should be avoided when going to the toilet. In the days following the nose filing surgery, the nose should be kept clean as described by the doctor and the recommendations should be strictly followed. In the postoperative period, blood thinners, food and nutritional supplements, herbal products such as green tea should be avoided for at least 2 weeks. Sufficient fluid and protein-rich food should be consumed.
When the bands on the nose are removed after the nose filing surgery, the first nose shape you will see is not the final shape of your nose, it is more edematous and swollen compared to its actual appearance. In this process, you should not rush to comment on the aesthetic appearance and wait patiently for the edema to disappear. Especially in the first 6 weeks following the surgery, trauma to the nose should be avoided.
Nose bridge filing prices 2022
Nasal arch filing prices vary according to the hospital where the surgery will be performed, the degree of difficulty of the surgery and the initiative of the aesthetic plastic surgery specialist who will perform the surgery. You can contact our office to find out the surgery price to be determined for you.