I'm writing in real time :)

Preparation:

There is a week and a half left before the operation. Ironically, I was scheduled for February 14th. And before the New Year, I broke up with my loved one, and I still miss him, but this is already offtopic :)))

During consultations with the surgeon, they decided to slightly raise the corner of my nose, make the tip narrower and correct the septum so that I could somehow breathe.

We will do everything under local anesthesia plus medicated sleep.

Already now there is panic, what if something goes wrong with the tests, and they won’t allow me to go to surgery, it’s winter and we all have a slight cold :) And I’ve never checked my heart, you never know. In short, panic is growing :)

In addition to standard tests, I was sent for permission to undergo surgery from a general practitioner. I’ll go to her with all the data ready.

Within a day: tests showed an allergy in the body (you shouldn’t overeat chemical crackers, well, all normal girls love chocolate/sweets/cakes, and I love salty crackers :)) But the operation was still allowed. I'm happy. There is no fear yet, rather joy and anticipation. I’ll go to the clinic right after work, because sitting at home on this day is going crazy :)

I am corresponding with two girls who did the same thing 3-5 days ago. They say it doesn't hurt, there's nothing to be afraid of. One was operated on under general anesthesia, the other, like me, was operated on without. One surgeon. Somehow we feel better together mentally. I am several days behind them, conveniently, I know what awaits in real time from real people. I advise everyone to find “plastic surgery friends.”

In the hospital:

Before sedation (medicated sleep), you should not drink 2-3 hours before, eat 6-8 hours before...

Before she had time to understand anything, she fell asleep. It was almost not scary (I was surprised, because I usually panic).

I woke up with turundas being shoved into my nose, it hurt a little, but I could endure it.

I got up from the table with difficulty, everything was floating, as if from a big binge. They brought me hand in hand to the room where I lay for about 30 minutes with ice on my face. Then, still with difficulty, I got dressed, walked to the taxi and home. Even though they met me, I tried to do everything myself, so the dizziness went away faster, in motion.

Already at home I drank some tea (they told me to drink more so that the sedation would go away faster) and ate a cake. I fell asleep.

At night a terrible sneeze began, the blood flowing onto the bandage tickled madly. I was afraid to sneeze, so as not to injure my nose, I opened my mouth as much as possible.

Morning after plastic surgery:

It’s difficult to drink, everything in the nose is squishy, ​​stuffy, and makes it difficult to swallow normally. But I still managed to cope with a cup of coffee. I had difficulty eating ice cream, now I will drink tea with amino acids, as it will be almost impossible to eat meat, fish or hard cottage cheese for now.

Still sneezing, brrrr. But it doesn’t hurt anywhere; I haven’t taken Ketonal even once. But everything inside itches. The feeling is disgusting.

It is almost impossible to speak, this makes the squelching and itching increase. But no one understands my speech anyway.

Day two:

I woke up with a terrible pain in my throat. The tongue is wooden. I drank a liter and a half of water and had difficulty eating cottage cheese. I took off the bandage to let the skin on the patch “breathe.” It hurts to touch the tip of the nose.

second day, no diaper.

In the evening we pulled out the turundas. The feeling is disgusting. It’s painful, disgusting, they’re wet and bloody. Thankfully it's fast.

I took a breath, it's awesome! I haven’t breathed so freely for 10 years!

But after a couple of minutes, my nose began to bleed on one side. They stuffed the bandage back in. At home, I pulled it out myself and washed the coin with peroxide (using cotton swabs). There doesn't seem to be much bleeding. But the smell in the nose is hellish!!! Medical and medicinal. Rinse, blow nose, etc. The doctor forbade it. But you can lubricate it with peach malo, I couldn’t find it, I took sea buckthorn.

I’m not attaching a photo of the bloody nose :))

Day three:

There is almost no bleeding, I clean it with chlorhexidine. I haven’t touched the oil yet, because it’s still bleeding instead of crusts. The first swelling and bruises under the eyes appeared.

I apply Lyoton + iontophoresis (a home electroplating device). I read that physical therapy helps to get rid of post-operative bruises faster, we’ll see.

There is almost no pain. Itching too. The squelching remained, but it was now quite possible to breathe through the nose and relieve the strain on the mouth and throat (and the latter was beginning to seriously hurt from drying out).

By the way!!! If you have a wooden tongue with a brown coating in the morning, do not be alarmed, this is dehydration from mouth breathing all night.

Day four:

The nose is stuffy and it’s hard to breathe. In the depths of my soul, I was waiting for miracles - that I would breathe immediately and forever. It didn't work out. On the one hand, sometimes 30 percent of the air gets in, then the nostril is completely blocked. I rinse with cotton swabs and peroxide with chlorhexidine. Clots of blood and medicine (or something else) come out.

The bruise has turned yellow, the swelling is subsiding.

The photo is still not very different from yesterday, I’m not attaching it :)

PS - there is still no pain, the itching has stopped, except for congestion and the interfering plaster, there are no problems.

The plaster has become subjectively 50 times heavier and is pressing on the nose. Before that, I didn't notice him at all.

Day five:

I have a temperature of 37, tomorrow at my scheduled consultation I will check if everything is normal. The psycho mode has already turned on :(

A pale bluish bruise (barely noticeable) appeared on the tip of the nose, and the plaster became leaden. Apparently tissue sensitivity is returning. Previously, I almost didn’t notice this noose on my nose.

The seams are clean (t-t-t), swelling and inflammation are not visible. I hope everything is as planned.

Day six:

They removed the plaster and taught him to fix the tip and bridge of the nose until the skin “settles” so that there is no beak. I also learned that temperature fluctuations after plastic surgery are the norm, there is nothing to be afraid of :) But my maximum was 37.2. Today everything has been normal all day.

Oh, and one more thing: removing stitches is painful :(

Day eight:

The strips cut into the skin terribly. I bandage my nose with a breathable bandage. I found a transparent one, “on the way out”. For the first time in my life, I liked a photo taken with the front camera.

The crusts began to dry out and come off - it became painful to squeeze the nose, and to touch it in general (tissue sensitivity is actively returning).

Day 12:

I continue to “live” in plasters and sleep in a cast. Sometimes I take it all off to feel a little freedom. It's -20 outside, so it's completely impossible to walk. The cold makes your nose ache mercilessly, and clear liquid pours out of it mercilessly.

The suture on the columella is still swollen, but the tubercles are gradually subsiding. I'm thinking about a silicone patch.

Day 13:

There is almost no swelling, the nostrils are only slightly asymmetrical. Nodules fall off from the absorbable sutures; when I clean with cotton swabs, sometimes I remove them and see them :) The shape of the nose is becoming more and more clear.

But I “live” in patches, changing them once a day. When removing the old one, I carefully hold the skin so as not to stretch or damage it.

The bumps on the columella, near the suture, have almost smoothed out. The redness subsides.

The bruises have completely disappeared, no new ones appear.

Day 15:

My nose periodically gets stuffy, I continue to clean it with chlorhexidine sticks. The swelling continues to subside. The only thing that worries me is the columella, I’ve attached a photo. I’ve already bought a cream for sutures (at the same time there will be a new experiment for review), but it’s too early to use it. We must wait for the wound to heal completely.

Day 20:

The skin on my forehead began to become very oily (I read that this is a common occurrence, but still not pleasant), and rashes appeared.

Now I will only apply the patches at night and at home; I can go out without them.

Yesterday I allowed myself alcohol (dry red wine, no soda), there was almost no swelling in the morning, I was afraid. that will blow to the floor of your face :)

I walked along the street (-10 degrees now) - I was all exhausted!!! The nose aches terribly, even if you breathe through your mouth. The nostrils (already soft in the warmth) became wooden, impossible to touch. And it started pouring again, but it was almost impossible to wipe it off: you couldn’t blow your nose, your nostrils wouldn’t close, so you had to put a handkerchief under your heel and move around like that. I barely crawled home and cleaned it with cotton swabs.

In terms of breathing: periodically stuffy, apparently there is swelling inside. Although, as you can see in the photo, there is still a little of it on the outside.

I smear the columella (suture) with imoferase.

In general, all the changes are happening much slower now than in the first two weeks. Therefore, I will update the review less now :)

PS - maybe it’s spring vitamin deficiency, maybe it’s stress, but I don’t yet have the same effect that many people have after rhino - COSMIC self-confidence, the desire to constantly take pictures and walk a new face :) I still don’t like myself in the photo. It’s time to give up staying at home and force yourself to go out in public; it won’t take long to become an introvert.

Another point - there is post-operative weakness, and I’m not eating much yet, as I hardly move. I haven’t gotten close to the barbell yet, the gym misses me.

The tip of the nose is still very hard, “not native”, almost not sensitive.

I'll take a good quality photo soon, as soon as I come to my senses more :)

Day 23:

Alcohol slightly increases swelling. But outwardly this is almost invisible, it just makes breathing more difficult. The tip of the nose is still “plastic”, hard. It’s still difficult to go outside; my nose hurts and runs.

Day 28:

I had a scheduled consultation. Everything is healing well. They allowed me to put my nose earring back on.

I don’t drink alcohol because it’s hard to breathe afterwards and the swelling increases.

The rest of the time I breathe great. You have to clear your nose much less often :) It became easier outside (but it just got warmer to -5).

The tip of the nose is still swollen, but has become more elegant.

Day 33:

Depression began. Either against the background of PMS, or postoperative depression. Feeling tired from everything, from sleeping in bandages, from swelling under the eyes, which is why you still look tired. And it seems that before I was better :))) And now I’m kind of a freak.

I don’t want to appear in front of people, I also categorically don’t want to be photographed yet:(((

I hope this is a temporary fix.

Day 42:

I found out that mood swings after surgery, from “what a horror, I want an old nose” to “how beautiful it has become” are quite a common occurrence :)) Only in reviews they write little about this, I found it on forums and from personal communication with “friends from operations "

The nose swells, sometimes more, sometimes less, and its appearance changes accordingly (and with it the general appearance of the face). Sometimes she looks like a pug, sometimes like a pig, sometimes like a beautiful girl (it’s already funny).

Advice - be patient and nerve-wracking, you are guaranteed six months of “fun”.

Well, a couple of fresh photos (I used to post all the photos without erasing, but after some comments “what a horror” it became somehow unpleasant, so now I have to post a little worse photo content. I apologize to all adequate readers)

Day 70 (or almost 2.5 months):

There are still crusts inside the nose, but they hardly interfere. The seam on the columella was approximately 80% flush with the skin and disappeared. There is no pain at all. The tip became soft and normal (also 80-90 percent). There is no point in gluing the patches anymore, and I gave up on it already in the second month. I breathe great :)

I got sick with bronchitis, before that I had a cold with a runny nose - it didn’t cause any problems for my nose. I don’t use drops, the runny nose “goes away” easily with regular nose blowing (though very carefully). They say that the appearance will hardly change anymore, so here is the final photo from the filming :)

PS - I'm happy, all doubts - whether the new nose works / doesn't work - have disappeared!!! It fits, looks beautiful, breathes:)) I don’t regret it one bit, two months of discomfort and psychosis (subjective) were worth it.

Modern plastic surgery in many countries around the world places a clear emphasis on minimally invasive methods of correcting a person’s appearance: minimal labor and time costs, achieving maximum results, reducing possible pain to a minimum.

Rhinoplasty is quite difficult to imagine without the use of local or general anesthesia. It is quite difficult to compare the advantages and disadvantages of local and general anesthesia because these types of pain relief are used in different cases. Local anesthesia is necessary if a minor surgical intervention is planned, short in time, and also if there are certain contraindications to general anesthesia. In any case, the choice of anesthesia will depend on the complexity of rhinoplasty and the individual characteristics and wishes of the patient.

In this video you will see how anesthesia works. The video contains footage of a real operation (open rhinoplasty): Anesthesiologist: Konstantin Nikolaevich Donets, Surgeon: Edgar Kaminsky.

Features of performing rhinoplasty under local anesthesia

Local anesthesia has been widely used in pain management for many years. It can be isolated (i.e., the only one), or act as a part in a combined version. With this type of anesthesia, a small area of ​​the face (the nose and adjacent tissues) is anesthetized, which is achieved due to the fact that the anesthesiologist scalds this area with a solution of a special anesthetic (or a combination of several drugs).

The anesthetic is quickly injected into the tissues, skin and other anatomical structures of the nasal cavity. Injections of anesthetic drugs of this type are very superficial, although in some cases rhinoplasty requires a deeper injection of anesthetic. Taking into account the fact that the drug is administered with long and thin needles, the process of administering the drug itself is completely painless for the patient.

It is immediately worth noting that at the injection site the drug will cause a sensation of tissue growth and an increase in temperature in the nasal cavity, but such feelings will not last long, so by the beginning of the operation they usually subside completely and the person simply ceases to feel half of his face. In some cases, oddly enough, the patient may well retain the ability to have some deep sensitivity, so during the operation it will seem to him that something is happening in the nasal cavity, but there is no talk of any pain - he will feel it impossible.

Sometimes, in order to normalize the patient’s psycho-emotional state, reduce his feeling of anxiety before surgery, and also eliminate anxiety, local anesthesia during rhinoplasty is combined with sedation (putting a person into a state of drowsiness).

It is impossible not to note some of the disadvantages of local anesthesia during rhinoplasty:

• The patient will see and feel everything the doctors do. This negatively affects his psycho-emotional state;
• The quality of rhinoplasty decreases and its duration increases. When a person is conscious, doctors need to systematically monitor his behavior and position. In addition, seeing, for example, blood and sharp instruments, the patient may simply become frightened and disrupt the operation;
• Local anesthesia for rhinoplasty is not recommended by most foreign and domestic anesthesiologists and plastic surgeons.

At the same time, general anesthesia, despite the fact that it is more preferable when performing nasal surgeries, can cause certain complications after the doctors complete their work.

What drugs are used?

Rhinoplasty under local anesthesia is performed using special anesthetic drugs, which can be divided into two large groups:

• Esters (Tetracaine, Novocaine, Dicaine, Chloroprocaine);
• Amides (Etidocaine, Ropivacaine, Lidocaine, Bupivacaine, etc.).

Novocaine is usually used to perform infiltration anesthesia according to Vishnevsky. Seriously inferior in effect to modern anesthetic drugs. The same Dicain is approximately 15-20 times stronger than Novocain in terms of its main anesthetic characteristics. Lidocaine is considered a rather toxic drug, but at the same time it is a potent and universal anesthetic, because it can be used for epidural, conduction, infiltration, and terminal anesthesia.

Bupivacaine is the most powerful and long-lasting anesthetic drug. Can be used for various types of local anesthesia for rhinoplasty. The potency of Bupivacaine is slightly inferior to Naropin, but it is also an incredibly strong and powerful anesthetic used in infiltration and epidural anesthesia.

I created this project to tell you in simple language about anesthesia and anesthesia. If you received an answer to your question and the site was useful to you, I will be glad to receive support; it will help further develop the project and compensate for the costs of its maintenance.

Rhinoplasty– This is one of the most popular plastic surgeries. Rhinoplasty is a serious surgical intervention that takes quite a long time to perform, since it involves the correction of pronounced aesthetic And reconstructive problems. At the preliminary consultation, the plastic surgeon and the patient discuss all aspects of the planned operation. The patient expresses expectations and requirements, the doctor coordinates them with the surgical intervention and informs the patient about the possibilities of rhinoplasty.

The doctor devotes a lot of time to convincing his patient of the renunciation of general fear anesthesia. Many patients have a lot of prejudices and fears about this, and some perceive anesthesia simply as a dangerous factor, knowing nothing about it, while other patients believe that they know even more about anesthesia than the surgeon, and are still afraid of it.

It is obvious that patients are not behind the decision on the choice of method of surgical anesthesia, and the final word remains with anesthesiologist-resuscitator.

However, there are general rules that all plastic surgery establishments follow. First of all, the use of anesthesia during rhinoplasty should make excuses according to the method of surgical intervention, safety and according to the patient’s health indications.

Many patients are very worried about the upcoming operation, but they are especially afraid of anesthesia. Some people even persuade the surgeon to perform the operation under local anesthesia. Numerous fears associated with anesthesia are largely associated with past times, when the operation was performed without anesthesia or with the use of chloroform or ether.

People fear that anesthesia can cause irreversible situations. Many people have contraindications for its use, and in general, some people tend to think that the purpose of anesthesia is to render the patient unconscious without risking his life. After all, there were times when a certain amount of vodka was used as an anesthesia for oral administration. But it cannot be said that surgical procedures after this were painless.

Before and after rhinoplasty

Advantages of anesthesia over modern anesthesia

These days anesthetic anesthesia is a precisely calibrated and safe part of almost any surgical intervention, capable of making correct calculations of one’s own capabilities in the fight against the patient’s pain. One of the newest achievements of modern anesthesia is medical sleep, which, without harm to the patient’s body, immerses him in unconscious state.

However, if the clinic you choose lists its advantages as performing rhinoplasty under local anesthesia, this indicates the following problems:

• the clinic most likely does not have modern anesthesiological equipment and equipment capable of monitoring the state of the body during the operation;
• Perhaps it does not have an experienced anesthesiologist-resuscitator capable of providing anesthesia.

Rhinoplasty under local anesthesia involves pain relief small by volume of the patient’s tissue and skin area. During the operation, a person does not feel anything, but all medical procedures reach his ears and eyes, especially rhinoplasty.

Among other things, the noise of the surgical instrument, the metal clamps used during the operation, and the flap of skin that appears after the incision is a huge stress. Here the main thing becomes obvious advantage anesthesia before local anesthesia - performing an operation with preservation health And spiritual balance of the patient, avoiding any demonstrations to the patient of the progress of the surgical intervention that could cause shock to the person.

Remember that during rhinoplasty, general anesthesia should be a priority over local anesthesia, especially if we are talking about the extensive scope of the surgeon’s intervention. Of course, superficial problems can be solved with local anesthesia.

Use of anesthesia and additional anesthesia during surgery

The list of necessary equipment needed for a plastic surgery clinic includes many items that can occupy a large room. The anesthesia machine requires a separate room, which must be available with all the equipment for each licensed plastic surgery clinics. Among other things, the clinic must have an anesthesiologist and his nurse. This is necessary to ensure joint implementation of the correct submissions anesthesia, because without these people the surgical manipulations of the operating team are not able to give an adequate result.

During rhinoplasty, the nose, of course, not capable to independent breathing. Therefore, the doctor inserts a special phone, which ensures the flow of air into the lungs and prevents mucous and blood secretions from entering the esophagus and lungs.

Due to the fact that the operation lasts from 2 to 4 hours (the operation time depends on the complexity of the situation and the volume of intervention), the constant presence of an anesthesiologist-resuscitator during the operation ensures control over condition patient. The oxygen content in the blood is continuously measured, breathing rate, blood pressure, body temperature are measured, and an electrocardiogram is taken.

Thus, it becomes clear that general anesthesia allows you to control the patient’s condition, preventing any unforeseen problems during the surgeon’s intervention. To relieve pain in the surgical area, the doctor also administers local anesthesia as an additional pain reliever. Obviously, anesthesia cannot replace the effect of anesthesia, but it can perfectly accompany it during rhinoplasty.

Features of the postoperative period

After the patient awakens, he is under the supervision of an anesthesiologist-resuscitator, who makes sure that the operation went well and the patient’s well-being is normal.

Choosing the right place for rhinoplasty

When deciding on rhinoplasty for aesthetic or reconstructive reasons, remember that any intervention by a plastic surgeon, including rhinoplasty, is not an express procedure carried out in a few minutes, although at least one plastic surgeon out of several will try to assure you of this. If you are faced with choosing a suitable institution for rhinoplasty, choose not a place where you are promised the elimination of any aesthetic defects under local anesthesia, but one where the medical team is aware of the full painstakingness and the seriousness of the intervention and complies with absolutely all measures security.

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Septoplasty is a surgical intervention that is aimed at correcting the nasal septum to improve respiratory functions. During surgery, the surgeon can correct the deformed structures of the septum (bone and cartilage) that separates the two nasal passages.

Rhinoplasty is a plastic surgery in which the shape of the nose is changed aesthetically or its reconstruction is performed, either partial or complete.

Plastic surgery - rhinoplasty

These operations are one of the complex plastic surgery interventions that are performed to eliminate difficulty breathing through the nose after an injury that has caused asymmetry or a shift in the position of the bridge of the nose. For any surgical intervention, pain relief is required: local anesthesia or general anesthesia.

What anesthesia is used for rhinoplasty? This is the main question that concerns all patients.

Anesthesia of the nasal area with local anesthetics in plastic surgery allows you to block pain in a specific area for manipulation. The patient remains conscious throughout the entire surgical procedure, feels all the manipulations being performed, is fully aware of everything that is happening around him, but does not feel pain. Local anesthesia in plastic surgery is used for rhinoplasty and septoplasty.

This method of pain relief is mainly used by those undergoing surgery who are not suitable for general anesthesia for nose correction surgery or minor surgery. For example, patients with acute neurological abnormalities who had an acute myocardial infarction less than six months ago, suffering from uncompensated heart failure, with stable or unstable angina, with hypertension and other diseases.

Local anesthesia is used when general anesthesia is contraindicated for the patient

The main positive side of local anesthesia is the absence of post-anesthesia complications. The rehabilitation period takes less time than when using medicated sleep during septoplasty or rhinoplasty.

The main negative factor is that the patient fully controls the course of the surgical intervention and is aware of all the actions performed by the surgeon.

If your doctor does not recommend using local anesthesia, it is best not to panic, but to listen to the advice. This method of pain relief cannot always be used in plastic surgery to perform surgery on the septum or to correct the shape of the nose.

Medication-induced sleep during rhinoplasty

Many patients are afraid of general anesthesia due to the high risk of complications after the operation. This surgical intervention to correct the nose is quite difficult in plastic surgery, and the use of medicated sleep for all manipulations is more relevant. The operated patient is completely immobilized and calm, which has a beneficial effect on the course of the surgical intervention.

General anesthesia is preferred for rhinoplasty

During the operation, the patient is unconscious, so there is no pain or awareness of the manipulations being performed. The surgeon and anesthesiologist carefully monitor the condition of the patient during surgery, and the medical staff monitors the operated patient until he fully awakens.

After waking up, it is not recommended to drink a lot for a couple of hours and you should not eat food, as nausea and vomiting may occur. Follow all the recommendations of the anesthesiologist, and when recovering from plastic surgery, stop smoking and drinking alcoholic beverages. If you experience negative feelings, immediately notify the medical staff so that the observing doctor can provide timely assistance.

Feeling after anesthesia

When the local anesthesia completely wears off and the patient regains sensitivity in the nasal area, pain gradually appears, up to severe pain. In such a situation, it is important to immediately tell the medical staff about such pain sensations in order to promptly relieve the condition with painkillers.

After the operation, the patient may experience severe pain, so it is necessary to be under observation

After surgery, under the influence of medicated sleep, the patient is monitored by an anesthesiologist until he fully awakens. When the operated patient wakes up, the doctor will ask a couple of simple questions to assess his well-being. In the first hours after anesthesia, you may experience dry mouth, dizziness, nausea, as well as chills and pain in the nose. Most often, the patient experiences drowsiness, which goes away within 24 hours.

Postoperative complications in surgery can develop both after medicinal sleep and local anesthesia. It all depends on the general condition, the individual characteristics of the patient’s body, and compliance with the recommendations of the surgeon and anesthesiologist.