ASS. PROF. DR. ÖMER FAİK SAĞUN
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ULTRASONIC RHINOPLASTY(CUSA®)

Ultrasonic Rhinoplasty (CUSA®)

Seeking a beautiful and natural-looking nose.
Beauty is a relative and subjective concept therefore its meaning varies from person to person.
Something liked by one person may not be liked by another person. Then which one is true? Both of them are true. There is a Turkish proverb says ‘‘pleasures in life and choice of colors are indisputable aspects’’.

‘What kind of a nose you would like to have’ is a question we ask to all our patients.

The common answer by our patient is ‘a beautiful and natural-looking result.’

This is where the problem starts. What does a beautiful and natural-looking nose mean?
Each patient customise a non-exaggerated, better nose design based on their overall features. We call this ‘‘A Natural-Looking Nose’’.

We show post-operation photos to our patients underwent rhinoplasty surgery and ask them which nose they find more natural.
Their reactions and responses varies. One says, ‘Looks so natural!’ while other one says ‘Looks too exaggerated’ because concept of natural and beauty vary from person to person.


Scoring Technique

My priority is to understand how my patients perceive and measure the concept of beauty. By applying a scoring technique that I learned at Harvard University, patients can review and analyze what their nose will look like.

 

Is it possible to determine what my nose would look like by using Photoshop?

Sometimes our patients visit us with someone else’s photo on their hand and let us know that they would like to have a similar nose and whether or not
that would be possible.

Unfortunately, it is not possible to have that exact nose because lines that provide facial aesthetics (between eye-brows, cheek, eye-brow to tip of nose
etc.) create the face analysis. Everyone have unique lines therefore we can not just cut the nose on the photo and paste it to someone else’s face. If we
do that, we would end-up having a totally different / not likeable nose.
Another common mistake is to tell patient’s that they would have the exact same nose as 2D or 3D imaging system generates. It is NOT possible to
reach the 100% exact pre-surgery designed nose because there are many critical factors affecting the final result. Nasal skin type, subcutaneous fat
texture, nasal cartilage structure, amount of curvature of the cartilage that forms the nasal roof, angle between bone structure of cartilage, etc. are
different for each patient. These factors affect the final result and look of the patient’s new nose. Unfortunately, it is not possible to determine these
mentioned factors prior to the surgery.
 
Is it totally wrong to correct a nose via Photoshop?
No, it is not totally wrong. The photo that is shown to us will give an idea of what our patient desires to have (it will not be the same). It is critical for us to understand what type of nose is desired (they need to define beautiful nose and what it means to them).
 

Is it important to have a Pre-operation Consultation?
Pre-surgery consultation is the most important part of the Rhinoplasty. It is critical to understand the need of our patients, analyze their face and explain them post-operation possibilities and determine if there is any breathing problems.

First, we ask our patients what is it that they do not like about their nose and what bothers them.

Often, our patients complain about the followings when looked from profile:

  • Nasal Hump
  • Droopy Nose
  • Long Nose

And they complain about the followings from the frontal view:

  • Wide and thick nose
  • Crook nose

All these deformations corrected and refined to match patients’ face proportionally. We make sure patient’s final result matches with their concept of beauty (no pig-like-nose).

What is the difference in surgery performed with Ultrasonic (CUSA®)?
Local or general anesthesia used in our surgeries. We use two techniques during rhinoplasty surgery:Open and closed one but mainly open technique. Despite the common knowledge about the open technique, the incisions are mainly inside and only one small cut is made underneath the nose. Since the incisions are from inside, nothing can be seen from outside.


Generally, nasal bridge &bones are shaved and rasped to shape the nose. The ultrasonic waves and sharp tools are used for bones during the Piezeoelectric surgeries (mostly used by dentists).
Being the first one to use ultrasonic (CUSA®) bone and cartilage aspirator in Turkey, we also use sharp and flat based tools.
These pieces are stronger than piezoelectric. Nose and cartilage are vacuumed to remove the nasal hump. Even the tiny bulge gets corrected by using the ultrasonic device. This process helps the overall surgery especially on areas where chisel or rasp cannot reach through.
Another advantage of Ultrasonic (CUSA®) is that breathing problem caused by cartilage or uneven bone can be easily fixed (normal surgery corrects it via hammer). Our patients have less pain, less swallowing and less bruising compared to surgeries done with chisel and rasp. We use silicone tampons which is easier to breath with and does not hurt when removed and helps breathing.


 

How much does Rhinoplasty cost?
The most frequently asked question is the cost of surgery.

The cost of surgery depends on the hospital and whether it is patients’ first nose surgery or not.
 

If the cost of surgery is too much, this doesn’t mean that doctor is good. Also, if the bill is too low, this doesn’t mean that doctor is bad.
It is possible for a social media phenomena doctor who charges a lot to operate a poor surgery than a surgeon who does not charge at the government hospital.

Plus rhinoplasty surgeries performed by doctors do not necessarily have to be beautiful. No surgeon expose their poor operations on media.

Most of our patients come to us through a reference. Most patients examine our previous operation images, like them and come to us through recommendations. All patients searching doctors via internet must feel the trust when face-to-face consulting with the doctor. Being sincere and being an expert should be the reason for our patients to choose us.

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