The aesthetic and functional-aesthetic correction of the nose, i.e. restoring respiratory function, is one of the oldest and most complex plastic surgery procedures and has been performed for around 2000 years, first described in the Middle East.
The nose forms the centre of the face and therefore - whether we like it or not - shapes the first impression we get of someone. The decisive factor here is the extent to which a face is perceived as harmonious. The nose can dominate a face in any shape and size or make it appear disharmonious. Individual harmony is important here.
If you don't like your own nose, the result is often a long period of suffering. For this reason, successful rhinoplasty surgery brings great psychological relief and an increase in self-esteem to all those affected.
The final result of a rhinoplasty (Rhinoplasty) depends as much on the individual anatomy of the patient as on the Skills of the surgeon determined. No two noses are completely alike. As a result, there is no standard procedure for achieving a perfect result in the course of rhinoplasty.
Many years of extensive surgical experience in both functional and aesthetic surgery determine the aims of this procedure at the Goethe10 Clinic:
Our aim is to reconcile a harmoniously aesthetic nose shape with perfect breathing. As several different, interrelated types of tissue are involved in the structure of the nose, nose corrections to one structure always have an effect on others.
There are limits to the desired external shape of the nose to ensure good breathing, taking these relationships into account.
A natural appearance of the nose after surgery is the aim of our practice clinic in Frankfurt. The ideal result of an aesthetic and functional rhinoplasty is a beautiful, natural-looking nose with normal function that blends harmoniously into the proportions of the face.
Nose surgery is usually performed under general anaesthetic. Depending on your personal preference, this can be done on an outpatient or inpatient basis.
Depending on individual requirements, all modern surgical procedures are used. It is decided on a case-by-case basis whether the so-called "closed" or "open" technique is more promising for solving the problem.
The difference between the aforementioned procedures lies in the choice of incision, which is either made invisibly in the nose ("closed" technique) or via a small, barely visible incision on the nasal bridge ("open" technique). We almost exclusively use the body's own tissue (e.g. ear or nasal septum cartilage) as a grafting material to avoid intolerance reactions. Internal silicone splints (see nasal septum surgery) and an external Thermasplint are used to support the surgical result. The Thermasplint replaces the traditional plaster cast and remains on the newly reconstructed nose for 12 days.
In the pre-operative consultation, the surgeon will explain to you in detail the techniques required for your needs and the associated post-operative requirements.
The inserted tamponade is removed on the first day after the nose operation, the silicone splints remain in the nose for approx. 3-4 days. Removal in our practice in Frankfurt is largely painless, as the coating means that they do not adhere to the inner nasal walls. The healing phase of the nasal mucous membranes is supported by nourishing oils and sprays.
Thanks to the use of tissue-sparing procedures, post-operative swelling is significantly reduced, although not eliminated. After approx. 14 days, the external signs of the nose operation are no longer visible.
Physical exertion should not be started until at least three weeks after the operation. Sports where there is a risk of injury to the nose should only be practised after 6 weeks. Wearing glasses should be avoided for approx. 4 months, as this can lead to changes in the shape of the nose. During this time, wearing contact lenses is a good alternative. Sunbathing or tanning beds are also not possible for a period of around three months, as this can lead to permanent pigment changes in the skin around the nose.
The final result of a rhinoplasty can be expected after approximately one year, as only then is the complete scarring of the tissue types involved completed and therefore no longer affects the external shape. After approx. 6 months, however, these changes are only slight and can usually only be noticed by the patient themselves or by the surgeon.
Due to the different healing processes of the structures involved in building the nose (bone, cartilage, skin, mucous membrane, connective and supporting tissue), unpredictable undesirable changes in the shape of the nose may occur after the operation, even if the surgical technique is optimised. If these changes in shape, which are perceived as disturbing, persist for longer than 9 months, they can be "reworked" in a second operation.
Even many years of extensive surgical experience do not protect against such undesirable complications. Overall, however, our rate is low compared to the figures published on this topic.
If the proportions of the face and body appear temporarily inharmonious during puberty, many adolescents wish to have a nose correction. From a cosmetic point of view, a rhinoplasty does not make sense at a young age as the body is still growing. The result of the operation would therefore not be final.
Nasal growth is usually completed in women from the age of 16 and in men from the age of 17. We recommend an age of 18 years. If surgery is performed too early, this can result in growth disorders that make another nose job necessary.
These recommendations relate to cosmetic-aesthetic procedures. The situation is different in the case of severe functional complaints (e.g. difficulty breathing) or the condition following an accident.
Every person feels pain differently. In addition, pain after an operation is heavily dependent on the findings and the procedure performed.
In most cases, there is little or no pain after rhinoplasty. Patients often experience a feeling of tightness caused by swelling, which is similar to the feeling of sunburn on the skin. If the feeling is too unpleasant, nobody has to put up with it. Pain can be alleviated with medication.
Yes, there are medications that are "incompatible with surgery". These include, for example, tablets that thin the blood or inhibit its clotting (e.g. ASA, aspirin, Marcumar, vitamins K and E). These should be discontinued several days before the procedure.
During the preliminary consultation for rhinoplasty, please tell us whether you are currently taking any medication and if so, which medication. We can then - in consultation with your family doctor or treating specialist - clarify whether the medication can be suspended for a short time. It may also be possible to switch to a different dosage or a different preparation.
Please also inform us if you have recently taken any medication.
Minor corrections can be carried out under local anaesthetic or in "twilight sleep" (a deep sedation that does not require intubation).
However, a classic nose operation is preferably performed under general anaesthetic. And for good reason: during the procedure, blood or nasal secretions can enter the throat and from there into the airways. Intubation during anaesthesia means that the airways are well protected against this.
You do not need to worry about the general anaesthetic itself: We have experienced anaesthetists at our side who will take good care of you and administer the anaesthetic perfectly.
If there is a mild cold, the nose operation can take place. In some cases, however, an antibiotic should be prescribed prophylactically.
If the cold gets worse and develops into a cold, it is better to postpone the procedure.
Rhinoplasty is a surgical procedure. This will result in swelling and possibly bruising of the nose and soft tissues of the face, which may affect your ability to socialise. The extent of these after-effects is not always predictable and varies from person to person.
An external nasal splint must be worn for protection for the first two weeks after the operation, and a tape bandage may be worn for a further week. Once the splint or bandage has been removed, experience has shown that the skin needs one to two days until it is no longer irritated. All in all, it can be expected to take two to three weeks until the patient is fit for socialising. However, this does not mean that the final healing is already complete. This will continue for several months.
During the first 24 hours after rhinoplasty, you should stay in bed as much as possible. Make sure you keep your head elevated. This works best with an elevated upper body and an additional pillow.
In the first one to two weeks after the operation, we recommend that you sleep on your back. Sleeping on your side or stomach can lead to unwanted reshaping of the nose.
After about three weeks you can sleep on your side again as usual.
It is precisely because the nose is swollen after the operation and the patient has difficulty breathing that they often have the feeling of wanting to blow their nose. But as understandable as this is, it can also be harmful.
The patient should touch their nose as little as possible in the first few days after the surgical procedure. The surgical wounds are held together by only thin sutures. There is a risk that the newly built-up structures of the nose may shift if touched.
If you have a "runny nose", the secretion can be gently dabbed away with a tissue. The patient should refrain from blowing their nose for four to six weeks.
It takes several months for the corrected nose to heal completely. The nose has already stabilised in the first few weeks. However, the permanent pressure from glasses could have a negative effect on the patient's well-being and the final result of the operation. For this reason, the patient should refrain from wearing glasses (including sunglasses!) for the first eight weeks after the operation and switch to contact lenses if necessary. After this time, the glasses should be refitted by an optician.
Most incisions are made inside the nose during the procedure. This means that no scars are visible.
However, depending on the surgical technique or type of rhinoplasty, external incisions may also be required. When narrowing the bridge of the nose, for example, small scars may appear on the sides, but these fade over time and become almost invisible. An incision in the skin (in the base of the nostrils) is also necessary if the nostrils are to be reduced in size and their shape changed. Here too, the scar fades over time.
Direct sunlight should be avoided for three to six months. If the patient exposes the freshly operated nose to sunlight, they risk painful swelling and bleeding. Wound healing is also impaired. UV rays can darken scars, making them more visible. This condition can hardly be reversed.
Not only direct sunlight, but also heat can slow down the healing process after rhinoplasty. Patients should therefore refrain from taking a sauna for six months.
Not only does the nose swell in the course of the nose operation, but in most cases the connection to the middle ear also swells. The swelling can cause considerable problems during take-off and landing, as air equalisation is restricted. Active pressure equalisation on the part of the patient is not recommended, as this could cause the pressure in the newly operated nose to become too high.
We therefore recommend using a nasal gel or cortisone preparation before take-off and landing shortly after a rhinoplasty - if travelling by plane is unavoidable. This causes the mucous membranes to swell and pressure equalisation is easier.
Two to three weeks after the nose operation, there should normally be no more problems when flying.
Like any surgical procedure, rhinoplasty can also be associated with complications. Firstly, there are the general risks associated with surgery, e.g. thrombosis, embolisms or circulatory problems.
Bruising and swelling on the nose, eyelids and cheeks are very common and heal within two to three weeks after the operation. Postoperative haemorrhaging is possible, but is rare and easy to treat.
After the operation, a tamponade of the nose is necessary, which impairs nasal breathing for the remainder of the operation. During this time, the patient must breathe through the mouth. This can temporarily cause a sore throat. If the paranasal sinuses are not sufficiently ventilated, this can lead to inflammation. In individual cases, localised infections may occur which must be treated.
Nasal tamponade can cause a feeling of pressure in the ears (due to the anatomical connection between the nose and ear).
If the nasal septum is corrected, it is possible that it will become curved again. In this case, further correction will be necessary.
In rare cases, extensive corrections (especially to the bone on which the nasal septum rests) can cause tooth damage.
Furthermore, a hole can form in the nasal septum after surgery. This may lead to nosebleeds, bark formation or even a whistling sound when breathing. In this rare case, a follow-up operation may be necessary.
After a nose operation, a furry feeling may occur on the tip of the nose, which usually disappears completely during the healing process. It is extremely rare for the furry feeling to persist.
If there is a medical indication, there is a very good chance that the health insurance company will cover the costs of the operation. This is the case, for example, with malpositions of the nasal septum that cause breathing problems and with disfiguring changes caused by accidents or tumours. In such cases, an application must be submitted to the health insurance company, including written confirmation of the medical indication from the ENT specialist.
Purely aesthetic treatments or aesthetic components are not covered by health insurance. The costs must be borne by the patient.
In a humped nose, the bones and cartilage along the bridge of the nose are excessively pronounced. This creates the impression of a hump. In addition, the tip of the nose may be slightly curved downwards and lack support.
With a rhinoplasty, we can reduce the hump on the nose and make the nose appear straighter. For an optimal result, we mobilise the bony bridge of the nose and push the side walls together. We also support the downturned tip of the nose and rotate it upwards. This creates a natural-looking nose profile. In addition, the nose appears smaller overall.
A broad nose is a nose shape that appears proportionally too broad for the rest of the face. It can affect the tip of the nose, but also the entire bony area, the base of the nose or the cartilaginous part of the bridge of the nose. The broad nose appears barrel-shaped overall. In addition, the nostrils are often not clearly visible.
A broad nose can be congenital. However, it is also often the result of injuries, such as trauma to the face.
There are various approaches to correcting a wide nose: we can reduce the bony bridge of the nose if it is too wide. If the tip of the nose is too wide, we can use a special suture and incision technique. With a nose correction, we can narrow a nose base that is too wide overall.
You can also find more information in our blog post: Narrowing the nose: Rhinoplasty for a broad nose
A hooked nose is a rather conspicuous nose shape that is often perceived as particularly unattractive. It is characterised by a curved nasal bridge and a nose tip that curves downwards. It is not uncommon for the tip of the nose to be tilted so far downwards that it forms the lowest point of the nose.
We can compensate for a hooked nose by surgically removing cartilage and bone tissue and reattaching it where it is needed to support the nose. By changing the position of the tip of the nose, we can also achieve an attractive result.
The short nose is also known as a snub nose. It has an upturned nasal tip. This makes the nose appear relatively short.
We can compensate for the short nose by surgically lowering the tip of the nose.
As its axis is uneven and clearly tilts to the left or right, the crooked nose appears crooked. This is often caused by a curvature of the nasal septum. In this case, breathing is often also impaired. However, it is also possible that the crooked nose is caused by accidents or injuries - for example, if the bony bridge of the nose has not healed straight after a fracture.
We can surgically straighten a crooked nose in various ways. It is possible to correct the bony bridge of the nose. This is the case if the crooked nose is only caused by the bone. If the Nasal septum If the nose is affected by crookedness, it must be straightened. The positive effect of this operation is not only a straighter nose, but also improved breathing.
If there is insufficient cartilage tissue on the bridge of the nose, this can cause a visible depression. This often makes the nose look broad and plump. The bridge of the nose is too short, the tip protrudes. In profile, the nose resembles a saddle. A saddle nose is usually caused by an accident, but previous surgery or inflammation can also cause this nasal deformity.
To correct the saddle nose, we perform a so-called reconstructive nose operation. This involves filling the indentation on the bridge of the nose with the body's own material (cartilage). We take this from the nasal septum or the back wall of your ear, for example.
In many cases, the saddle nose also hinders breathing. A correction can help you to breathe freely again.
A blocked nose can have a considerable impact on everyday life. Many people then turn to nasal sprays, which can provide quick relief. But what happens if the medication doesn't work? There can be various reasons for this.
Recurrent sinusitis can have a significant impact on quality of life and is often associated with persistent symptoms such as a feeling of pressure in the centre of the face, headaches and a blocked nose.
Free, undisturbed nasal breathing contributes significantly to quality of life and well-being. However, anyone who suffers from restricted nasal breathing knows the effects on sleep, concentration and general fitness only too well. In the following, we will show you effective options and modern treatment methods that will allow you to breathe freely again.
Some people suffer repeatedly or even permanently from the feeling of a blocked nose. In this case, you may have enlarged turbinates. During a laser conchotomy, we can laser the inside of your nose and allow you to breathe freely.
Loud snoring can turn sleep into torture. In some cases, snoring surgery can be the solution so that you can sleep peacefully again. We offer this form of snoring therapy at our ENT clinic in Frankfurt.
Many people are unhappy with the size and/or shape of their nose. Anyone who suffers from their appearance may consider a nose job. In some situations, health insurance will even cover the costs of rhinoplasty or subsidise the procedure. You can find out when this is the case below.
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As the central feature of the face, the nose is a real eye-catcher. If the nose is crooked, it is not only this unit of attractiveness that can be disturbed. A crooked nose can also lead to functional disorders such as breathing problems. In this article, we explain how we can help you here.
Epistaxis - that's the medical term for something you've probably had before: A nosebleed. In most cases, it looks worse than it is. In this article, we explain when nosebleeds can be a sign of a (serious) illness and when you need to see a doctor.
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Almost everyone has a vice, big or small: some people love to eat but don't exercise enough, others smoke and others drink too much alcohol. There are also people who are addicted to medication. Tens of thousands of Germans resort to nasal sprays because they are addicted.
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Nowadays, nobody has to put up with a "chunky tip", as aesthetic plastic surgery offers all kinds of possibilities to give everyone a harmonious nose. This is also shown by the global trend: rhinoplasty is the fourth most popular cosmetic surgery worldwide.
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