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Nose Health and Aesthetics Clinic
You And Your Congested Nose

Nasal congestion, difficulty in breathing, is one of the oldest complaints of humanity. Even if this is not very important for some, some people have difficulty because of these complaints.

Doctors examine the causes of nasal congestion in four categories, and sometimes there may be similar points between these. These common points are increasing, especially in patients whose complaints are caused by more than one factor.

STRUCTURAL CAUSES

This category examines the disorders of the nose and nasal septum, which consists of thin cartilage and divides the nose into two separate parts. These disorders usually result from an accident in the life of the individual. The accident may have occurred in childhood or even be forgotten. Seven percent of newborns may have nasal injuries during birth. It is a fact that a person gets a hit on the nose at least once in a lifetime. For these reasons, nasal deformities and septal deviations are very common causes. If these make breathing difficult, they can be surgically corrected. The most common cause of nasal congestion in children is the growth of adenoid. This is a tissue that resembles tonsils and is located behind the nose at the back the palate. Children with this problem breathe loudly at night, even snore. In addition, these children constantly breathe through their mouths, with an expression of unhappiness on their faces. There may even be deformities in their teeth. Surgical procedures may be recommended to remove adenoid. Other causes included in this category are nasal tumors and foreign bodies. Children tend to put small objects in their noses. These can be buttons, safety pins, toy parts, peas and chickpeas. Be careful when you notice unilateral odorous discharge. Because this may be the sign of a nose obstructed by a foreign body. In such a case, a doctor should certainly be consulted.

INFECTION

A normal individual may have a common cold once or twice a year on average. This is more common in young people and less in elderly people with a developed immune system. Cold is a disease caused by viruses. Some viruses spread by airborne transmission and are mostly transmitted through the nose and hand. Once the virus settles in the nose, it causes the secretion of a chemical in the body, called histamine. As a result of this agent, a significant increase is observed in the amount of blood supply to the nose. In conclusion, the nasal membranes swell. On the other hand, the secretion of fluid from the nasal membranes increases. Antihistamines and decongestants can be used to alleviate these complaints. But a common cold spontaneously heals over time. During virus infections, the resistance of the nose and sinuses to bacterial infections decreases. This explains why nasal and sinus infections are common during a common cold. If the color of nasal discharge turns into yellow or green from its transparent appearance, it indicates a bacterial infection, and a doctor should certainly be consulted. Sudden sinus infections present with congestion in the nose, dark discharge, pain and tenderness in the cheeks and upper teeth, between and behind or above the eyes depending on which sinus is affected. Chronic sinus infections may or may not cause pain. But nasal congestion and nasal discharge are constantly present. Some patients develop polyps from the sinuses. The disease can also spread down the airways, causing chronic cough, bronchitis and asthma. Acute sinusitis usually responds to antibiotherapy, and surgical treatment is usually recommended for chronic sinusitis.

ALLERGY

Hay fever is the name given to allergic rhinitis. Allergy is an excessive inflammation response to a foreign body, pollen, house dust mite, animal wastes or some particles in house dust. Sometimes foods also play a role. Pollen causes problems in spring or autumn. In addition, house dust may disturb all year round. The ideal treatment of this is to avoid the things that cause the complaints. But this is often not practical. In allergic patients, as in the common cold, nasal congestion and discharge occur as a result of particles that cause the secretion of histamine in the body. Antihistaminic drugs can eliminate the complaints by inhibiting the effect of histamine. Decongestants open the nose by contracting the enlarged blood vessels. While the majority of antihistamines increase sleep tendency, in contrast, decongestants have a stimulating effect. Therefore, it would be best to use these drugs together.

WARNING

It is unfavorable to drive and work in dangerous jobs for those who tend to sleep while using antihistamines. Decongestants should not be used in patients with hypertension, arrhythmia, glaucoma, and difficulty in urinating since they increase heart rate and blood pressure. Pregnant women should absolutely consult their doctor for any medicine they will take. Corticosteroids (Cortisone) are significantly effective in many allergic patients, but should be used under the supervision of doctor due to its known side effects. In addition, these drugs are also effective when used as a nasal spray and this type of use is safer. Allergy shots are the most specific treatment method and have a high rate of success. Sometimes blood and skin prick tests are performed to determine which substances the patient is allergic to. The doctor will determine the initial schedule of the treatment. These will generally be in the form of injections. This treatment acts by blocking human antibodies, inhibiting the allergic reaction. Many patients prefer injection because of the side effects of drugs. Allergic patients have an increased tendency to have sinus infections.

VASOMOTOR RHINITIS

Rhinitis refers to inflammation of the nose and nasal membranes. Vasomotor means relating to blood vessels. Nasal membranes have arteries, veins and capillaries capable of enlarging and contracting to a large extent. Under normal conditions, half of these vessels are open and the other half is closed. But if the individual does heavy exercise, the secretion of stimulating hormones (adrenaline) increases. Adrenaline causes the vessels to contract. As a result, the membranes contract, the airway opens and the individual breathes more easily. The exact opposite of this occurs in an allergic attack or when the individual is exposed to cold. Blood vessels dilate and the nose is congested. In addition to allergies and infections, some other causes also lead to vasomotor rhinitis by causing dilation of the nasal vessels. These may include stress, insufficient thyroid functions, pregnancy, some blood pressure medications, birth control pills, and excessive or prolonged use of decongestant medications. At the beginning of all these causes, nasal congestion is temporary and recurrent. So if the cause is eliminated, the disease will improve. In addition, if it persists long enough, this time the blood vessels will lose their elasticity and the condition becomes irreversible. They look like varicose veins. When the patient lies on back or turns to one side, the lower parts are filled with blood.

Rhinoplasty

In this surgical procedure, called rhinoplasty, the goal is to correct the nasal deformity. It is possible to perform with the surgery for deviation, which prevents breathing in the nose. In rhinoplasty, commonly known as nose reduction, it is sometimes aimed to augment the nose.

WHO SHOULD PERFORM MY SURGERY?

Should this surgery be performed by an otorhinolaryngologist or plastic surgeon? Rhinoplasty is a surgery of facial aesthetics (facial plastic) branch. Sixty percent of the members of the American Academy of Facial Plastic and Reconstructive Surgery consists of otorhinolaryngologists (ENT specialists). An otorhinolaryngologist is a head and neck surgeon. The only branch that has nose surgery in its basic training is ENT (otolaryngology). Facial plastic surgery is rapidly becoming popular all over the world as a side branch of otorhinolaryngology. An otorhinolaryngologist who is interested in facial plastic surgery will ideally solve your problem. Yet, you will still make the right decision about choosing your physician.

PREOPERATIVE INTERVIEW

It will be helpful to identify all problems with your nose before you interview with your doctor. Determination of breathing status, whether there is nasal discharge, postnasal drip and headache will make it possible to solve this problems with this surgery. Certainly discuss your nasal shape problems and what can and cannot be corrected with your doctor.

The possibility of your postoperative expectations will be stated by your doctor. The best way to avoid frustration after the surgery is to evaluate this period well. In this surgery, your cooperation with your doctor will both comfort you and your doctor. Helping each other will turn your entire surgery period into an enjoyable endeavor. Different expectations will bring you up against your doctor at the beginning of the road. While very large deformities for you can be corrected surgically by a simple procedure, a very small detail can sometimes be corrected by a challenging surgery. The best should be remembered as the enemy of the good.

WHAT IS THE GOAL OF THE SURGERY?

The goal of rhinoplasty is to create the most suitable nose for your face. This surgical procedure will undoubtedly be performed with the existing fabric. So the thickness of your skin, the thinness and form of the existing cartilage determines your wound healing and the success rate of previous nose surgeries. The goal is not to create an irrelevant nose with your face. Therefore, creating the most beautiful nose alone will not solve the problems. Creating the most suitable nose for your face is considered the most successful result. While some parts of the nose are reduced, some parts are augmented to make the nose look good. It is important that the nostrils do not look too large, the bone roof is not lost and the impression that it is operated is hidden.

In other words, THERE IS NO BEAUTIFUL NOSE, THERE IS NICE LOOKING NOSE!

OPERATION AND POST-OPERATION

Cosmetic nose surgeries are the most commonly performed cosmetic operations in the world.

The operative time does not exceed 1-1.5 hours. However, this may be longer in specific cases.

Postoperative bruising and swelling are much less common compared to previous surgical techniques. A nasal packing that will remain for a day in your nose or a special sponge that will not prevent your breathing will be placed and a tiny plaster surrounding the nose will be applied.

The postoperative period is not as painful as it is usually feared. This period will be quite comfortable with simple painkillers. After a day, inside the nose will be emptied and your breathing will return to normal.

It is recommended that you rest with your head slightly up or in the sitting position in a not too hot environment. After rhinoplasty surgeries, every person you encounter will make different comments. This is related to the different tastes, as well as the fact that your old nose is not well known.

Even experts on this subject can only comment on your nose by considering the old nose. It is best to follow the changes in your nose with your doctor over time.

POINTS TO CONSIDER AFTER RHINOPLASTY

The plaster on the nose will remain between 7-10 days. It should not get wet. You should not be excessively hot places considering that this plaster will get loose with sweating. You must brush your teeth very carefully in the first 10 days. Especially when brushing your front teeth, you will need to pay attention. It is important that your brush is soft. Avoid excess physical activity after the surgery. Do not take bath or be in a steamy environment until the bandages on your nose are removed. Avoid excessive facial movements and laughter for a week. Do not wear a turtleneck sweater or tight necked clothes for 20 days after the surgery. Do not touch your face and nose harshly for 3 weeks. Avoid excessive sunlight for 6 weeks following the operation. Excessive heat will cause swelling in your nose. Swelling may occur under the eyes and in the face after nose surgeries. This is less common compared to the previous surgical techniques. These swellings will disappear within 1-2 weeks. Do not take any medicines other than those prescribed by your doctor. Contact lenses should not be used for 5 days postoperatively.Do not wear glasses of any kind for 16 weeks, then use a light frame in the later period. After the bandages are removed from the nose, clean your nose skin with liquid soap or special lotions. You can make up after your bandages are removed. Contact us for more information.

Sinus – Pain, Pressure, Discharge

Help me, my sinuses are killing me! Have you ever said that before? If your answer is no, you are very lucky. Because every year millions of liras are spent for sinus problems (nasal fullness, headache, and nasal discharge).

DOES EVERYONE HAVE SINUS?

Yes, even a newborn baby has sinuses, even they are very small. These cavities, beginning as pea-sized pouches, expand outward from the inside of the nose to the bones of the face and skull. They continue to expand and grow throughout childhood and young adulthood. They are air pouches. They are covered by the same membrane that covers the inner surface of the nose and are connected to the nasal cavity with openings as large as a pencil head.

WHAT DO SINUSES DO?

Sinuses are a part of the system of the nose which produces normal secretion (mucus). Normally, the nose and sinuses secrete about half a liter of mucus per day. The produced mucus moves on the mucosa, sweeping and washing dust particles, bacteria and other airborne particles. This mucus is then is swept into the back of the throat and swallowed. Particles and bacteria in it are broken down by gastric acid. Many people are not aware of this because it is a normal body function.

WHAT DOES POSTNASAL DRIP MEAN?

Inside the nose produces too much mucus than normal when disturbed by air pollution, allergy-causing substances, smoke or viruses. This is a transparent, water-like secretion that is produced plentifully to wash and remove the allergic substance from the nasal membranes. A water-like secretion forms towards the back of the nose. This is the most important cause of postnasal drip. Another type of mucus is sticky and thick. This occurs when the airways are too dry and the membranes cannot secrete enough fluid. In cases of infections caused by bacteria, a sticky and thick mucus is also observed, meanwhile the color of the mucus may be yellow or green due to pus.

WHAT IS SINUS?

The suffix “-itis” refers to infection or inflammation in medicine. Therefore, sinusitis is an infection or inflammation of the sinuses. A typical case of acute sinusitis is manifested by plenty of mucus secretion as a result of cold or an allergic attack. The membranes can swell so much that the small openings of the sinuses are blocked. If the air and mucus cannot move freely between the nose and sinuses, the mucus accumulates in the sinuses and causes increased pressure. Depending on the affected sinus, pain arises by compression on the face or forehead, between or behind the eyes, on the cheeks and upper teeth. A blocked and mucus-filled sinus is a suitable environment for the growth of bacteria. If the cold lasts longer than normal and the color of the mucus turns green-yellow or a strange taste arises, a bacterial infection has possibly developed. Facial and forehead pain can be very severe in cases of acute sinusitis. In cases where the sinus opening is blocked for a long time, chronic sinusitis develops. Headache is rare but discharge and malodor persist. As a result of excessive inflammation, formations, called polyps, develop. Some cases of sinusitis occur as a result of passing of infection in the upper tooth into the sinus.

IS SINUSITIS DANGEROUS?

The majority of sinusitis cases respond to medical treatment and are not dangerous. However, an infection within the sinus is very close to both the eye and the brain. The spread of the infection to the eye or brain is very rare. Mucus draining from infected sinuses is not healthy for the lungs. Thus, sinusitis exacerbates bronchitis, chronic cough, or asthma, or causes them to occur.

WHAT IS SINUS HEADACHE?

During the cold or when the nasal membrane swells and the nose drains, or when the nose is full of mucus, a headache arising in the face, cheeks, forehead or around the eyes is probably sinusitis pain. Sinus infection causes this. Another kind of sinus headache occurs when the plane descends to land. This especially becomes significant if you have a cold or active allergy (this is called a “vacuum headache”). Unfortunately, there are many other causes of headaches that can be confused with sinusitis. For example, migraine and other vascular or “tension” headaches can be confused with sinusitis since they both cause pain in the forehead and around the eyes and cause nasal discharge. But such headaches are more likely to come and go away in a short time without a doctor’s intervention. They are different from sinusitis that persists for a long time without a doctor’s intervention and can be treated with antibiotherapy. Furthermore, intermittent headaches that cause nausea and vomiting are more likely a migraine-type headache. For the diagnosis of severe, frequent, or prolonged headaches, the patient should certainly visit a doctor.

WHO FACES WITH THE SINUS PROBLEM?

In fact, everyone can have a sinus infection, but some groups are more sensitive.

Allergic individuals: Just like a cold, an allergy attack causes swelling of the mucosa, blocking of sinus canals, prevention of mucous discharge and bacterial infection. Those with structural nasal deformities to prevent good breathing and mucous discharge: For example, a fractured nose or septum deviation (septum is a cartilage structure that divides the nose into the right and left between the nostrils. The deviation of this structure to one side is called deviation.) Those frequently exposed to infection: School teachers and healtcare staff are sensitive. Smokers: Tobacco smoke, nicotine disrupt the natural resistance mechanism.

WHAT WILL THE DOCTOR DO FOR MY SINUSES?

Your doctor will ask you questions about your breathing, the color and smell of your nasal discharge, and what events (at what time of day or what season) cause these symptoms. Be prepared to describe your headache, when and how often it occurs, how long it lasts, whether it is associated with nausea, vomiting, visual impairment, or nasal congestion. The otorhinolaryngologist will examine your ear, nose, mouth, teeth and throat, paying particular attention to the appearance of the mucosa and the nature of the secretion. S/he will examine the sensitivity of your nose. In some cases, x-rays of your sinuses may be necessary. The treatment will be related to your doctor’s diagnosis. Antibiotherapy or surgical intervention or both may sometimes be required for infections. Acute sinusitis usually responds to antibiotherapy, whereas chronic sinusitis usually requires surgical intervention. Functional Endoscopic Sinus Surgery (FESS) that has recently been used is a simple technique used for the treatment of these diseases. The results are quite successful. If the symptoms are caused by allergy, migraine or sinusitis, your doctor will utilize an alternative treatment plan.

WHAT CAN I DO FOR MY SINUSES?

If you are allergic, check this. Use a steam humidifier when you have a cold. Sleep with the head of your bed elevated. Decongestants can be used, but the chemicals in them can act as adrenaline, which can be risky for hypertensive individuals. They are also stimulants that cause insomnia. Consult your doctor before use. Avoid contaminants that irritate your nose, especially cigarette smoke. Follow a balanced diet, exercise regularly. Try to limit your relationship with people you know to be infected, and if that doesn’t happen, take some precautions (washing hands, not using common towels and aprons). Many over-the-counter sinus medicines are sold, but it is not correct to use them without a definitive diagnosis. It is best to use the medicines prescribed by your doctor who will examine you and know your complaints.

Sinusitis Treatment And Surgery

Sinuses

Sinuses are air-filled spaces located in the facial bones around the nasal cavity. They help the nose physiology. Although some of these sinuses exist at birth, some of them become prominent in childhood. These sinuses are divided into groups such as maxillary, ethmoid, frontal and sphenoid sinuses.

Sinusitis

Sinusitis is the infection of the air spaces around the nasal cavity, called the sinus. Short-term infections are called acute sinusitis, while recurrent infections lasting more than 3 months are called chronic sinusitis. Acute sinusitis acts as an upper respiratory tract infection and treated in a similar way, while surgical treatments in addition to medical treatments are also used for chronic sinusitis.

Diagnosis: The diagnosis is made by the history of the disease, nasal endoscopic examination, and radiological studies. Computed tomography (CT) is the most useful technique in radiological examination.

Findings: Symptoms similar to that of a severe common cold such as headache, nasal congestion, cough, malaise, and nasal discharge are present.

Medical Treatment: In acute and some chronic sinusitis, an appropriate antibiotherapy for 10-14 days and some medications to eliminate intranasal swelling are used. In the treatment of chronic sinusitis, surgical treatment for the causative factor is the most appropriate treatment. Medical treatment alone will not be beneficial.

Surgical Treatment

The experience and knowledge of the surgeon is very important in these techniques, called Functional Endoscopic Sinus Surgery (FESS). Although previous techniques, which do more harm than good, have been still used, they should be abandoned. In this surgical procedure, the sinuses are accessed by operating intranasally with the help of an endoscope. Without damaging the surrounding tissue, the sinuses are cleared and their natural canals are opened to ensure that the physiology regularly functions after the operation.