THE FIRST CONSULTATION
It will assess:
- skin texture: its thickness, its elasticity. A thin and clear skin will show the slightest blemish.
A thick skin will tend to mask the details of the nose cartilaginous architecture and make its volume reductions more difficult for the skin retraction capacities are more limited.
As for a nose formerly operated on, the fibrous cicatricial tissue also alters this retraction capacity. The result will then be harder and longer to obtain.
- The consistency of the' cartilages at the tip of the nose: their resistance to pressure. leur résistance à la pression.
- The proper bones of the nose: differences in incline, after-effects of fractures.
It is of paramount importance: Such an examination will enable us to explore the nasal fossae entrance painlessly and detect a nasal septum curvature, turbinate bones hypertrophy or a nasal vestibule chronic infection, which the patient often did not know about. In certain cases, a scan will be asked and carried out in order to know the sinus after-effect of those pathologies to contemplate an associate gesture if necessary: Nasal septum surgery ( septoplasty ) and / or, sinis surgery ( meatotomy, ethmoidectomy ) Therefore it is only after such a full examination that the surgeon can determine whether the operation to plan is strictly cosmetic or both functional and cosmetic.
ANALYSIS OF THE PHOTOGRAPHS AND COMPUTER MORPHING
Computer morphing is carried out with the patient's help. The very sophisticated used software enables to create a draft in profile but also a full-face one ( more difficult to make ) Caution: the images we get are virtual images made with a computer mouse; the results of the operation cannot be superposed onto the computer morphing results in every respect. Once the photo draft has been materialized, two situations can appear.
It is what is usually meant by rhinoplasty, i.e. a surgical operation carried out at the clinic under anaesthetic. We will be able to act on all the parts of the nose (bones, cartilages and sometimes thickness of the skin), change them, reduce them or increase them thanks to cartilaginous grafts(taken from the cartilage of the nasal septum or the ear). The results are final. A description is made of the nose anatomy and techniques specifically chosen for your project. The potential operating risks and best ways to avoid them are also mentioned. You will be given a summary document as well as an enlightened consent form. An estimate is made out with all the details about the expenses inherent to this surgery: The surgeon's fees The anaesthetist's fees The clinic expenses A two weeks' time to think will of course be allowed. Cosmetic surgery of the nose does not entitle to any reimbursement by the mutual insurance company or the health insurance.
THE SECOND CONSULTATION
It takes place fifteen days after the first consultation and lasts half an hour. The patient has already been informed on the risks inherent to such a surgery and possible complications published in medical literature. We go back over each one of them in detail and on the way to avoid them. The enlightened consent form is then filled in and signed. The morphing photos are validated and become the final project. The hospital file is filled in and the appointment with the anaesthetist is made at St François Clinic. The latter must take place 48 hours before the operation at the latest. The pre-operative blood check-up will be carried out during this consultation. No antiaggregating platelet medicine (aspirin, Plavix Ticlid) nor anticoagulant one (Sintron, Coumadine, Préviscan) should be taken within the 10 days preceding the operation. Let us remind you that it is necessary to be on an empty stomach (no drinking, no eating, no smoking) during the 6 hours preceding the operation. The estimate is to be accepted, signed in triplicate (patient, doctor, clinic).