Aesthetics

Rhinoplasty or Nasoplasty is one of the most frequently performed aesthetic operations. . It is the operation of correcting distortions which occurred in the nose depending on traumas or spontaneously. While performing this operation, the respiratory tract of the nose is absolutely required to make into optimum condition. Time of operation is approximately two hours.

It is preferable to go under a rhinoplasty operation after 18 years of age when the nose has reached adult size. Working on the digital image prior to the operation, the shape which shall be intended to obtain is tried to be determined. I believe that this has such benefits as that the surgeon shall understand the requirements of the patient and that the patient shall understand what kind of a nose the surgeon shall try to create.

It is preferable to stay overnight at hospital after the operation. Extremely light tampons to be inserted are removed a few hours before discharging from hospital. Plaster cast is removed in 7th to 10th day. Acceptable recovery and resumption of work starts after the 15th day.

Pre-Operation:
•    If you smoke, stop smoking 15 days prior to the operation if possible. This shall be useful for both the condition of your lungs and for the recovery of your scar.
•    Do not take such pills as Aspirin and its equivalent during 15 days prior to and 15 days after the operation. Take other painkillers if necessary. Taking Aspirin may cause excessive blood loss during the operation and spontaneous bleeding after the operation.
•    Stop eating and drinking within six hours prior to the operation.
•    Let your physician know if you have such a condition as influenza, cold, coughing, fever, exhaustion, etc. Your operation may have to be put off.
•    In case your are in your regular menstruation period, your operation may not have to be put off. However, you would better let your physician know.

Post-Operation:
•    Your painkiller for your pain shall be administered once you are resuscitated after the operation and continue in the subsequent period as well. One does not expect too much pain after this operation.
•    You must not stand up for a period of 6 hours after the operation. You may have staggers during the initial standing up. When you feel good, sit for a while and then stand up with the help of somebody who takes your arm.
•    There may be nausea and throw-up. The blood accumulating in the stomach basing upon the intentional or unintentional swallowing of the blood coming from the nasal cavity during and after the operation may go out by throwing up. Or it may come out in the form of a black diarrhoea in the same day or the next. These are normal conditions and there is nothing to fear.
•    If you do not have any nausea 6 hours after the operation, you may start to drink water and eat very little. In the initial days after the operation, liquid diet is recommended. Chewing hard food may damage your nose. You may shift to normal food 15 days afterwards.
•    The ligth tampon in your nose is usually removed the next day without causing any pain to you. Sutures and the plaster cast are removed on the 5th to 7th day. The plaster to be placed after the removal of the plaster cast shall stay for another 5-10 days.
•    Try to sleep on a high piloow if possible for a period of 15 days after the operation and do not bow your head down towards the floor. If possible, lie in bed on your back (face up) but not on your either side.
•    Do not move fast, climb the stairs slowly (so that your blodd pressure shall not rise and you shall not have nasal bleeding).
•    Avoid hot drinks (for a period of 15 days).
•    Avoid having an impact on your nose. After an unwanted impact or in case of spontaneous bleeding, stay calm. Lie down on your bed with your head at a higher level and wait. In this way, most of the bleeding shall stop. In case bleeding fails to stop 5 minutes afterwards, then call your physician.
•    Your are at liberty to inhale water into your nose and then blow it at 15 days after the operation. Do not attempt to open up your nose before that period, it is normal that it is clogged. Your nose will gradually open up over months.
•    Distention occurring in the non-nasal area shall be pronounced on eyelids. Such distention rapidly increases within 2-3 days and descneds towards the cheeks after the third day and starts to diminish and reduces to a great extent within 5-6 days.
•    Although the period during which you must avoid wearing eyeglasses varies by the technique applied, it is recommended not wear eyeglasses for a few months (ideally 6 months) for those who have gone under nose ridge bone operation.
•    Distention which is more pronounced on the nose tip and stem shall gradually reduce over months.

Breast Augmentation:

Breasts smaller than desired depend on an indeficiency of growth usually in breasts in young ladies but sometimes they are also seen after excessive reduction of breasts in the post-pregnancy period. In both cases, the condition is tried to be corrected by the application of silicone breast implant. In this case, the implant is usually inserted through an incision of 5-5,5 cm which shall be opened under the breast. In case where a sufficiently firm and uplifted breast cannot be obtained just by inserting an implant, excess skin must be removed as well as inserting an implant. Excess skin is removed from around the breast areola (ring of colour around the nipple) and in such a case, the implant may be inserted through here.

The physician must provide his/her patient with any necessary preliminary information about such issues as the content, shape, size of the breast implant and the cavity in which it shall be inserted, and then explain his/her decision with his/her reasons and associate his/her patient with his/her decision.

The operation is performed under general anaesthesia and takes approximately 1-1,5 hour. An overnight stay is recommended at hospital after the operation. The patient may start to perform light works and activities at the expiration of a period of 10-15 days.

Breast Reduction:

Breasts bigger than desired usually bring about their being saggy as well. In the reduction of big breasts, it is required to remove the excess glandular tissue and the adipose tissue in the breast, thus reducing the volume of the breasts. It is also tried to remove the excess skin at suitable places and to leave any scars at as small a number as possible and at such places where such scars shall be seen the least. As women who have not yet completed 18 years of age as well as those who have passed 60 years of age apply for breast reduction and as the breast volumes and skin qualities of the applicants vary by both age and person, it is unavoidable to have various operational techniques. The younger the patients are, the more important it is to choose a function-preserving (nipple sensitivity and milk production) method. Moreover, more attention is paid to leave as little scar as possible in young women. Although rare, it is possible in young women for the lightened breast which is only reduced by fat removal (liposuction) to stay without sagging thanks to good elasticity of the skin. In such a case, there will be no scars other than the tiny entry holes of the cannulas used for fat removal. In some cases where this operation shall cause the breast to sag, the excess skin is only tried to be removed with a scar around the breast areola (ring of colour around the nipple). In case where this is not sufficient, it may be required to add another scar perpendicular to the one around the breast areola. This is usually the type of operation with the maximum scar for young patients. And beyond this, addition of a horizontal scar which extends under the breast is a condition which shall be applied in patients of old age and in cases where the skin elasticity has been lost in extremely big breasts.


Briefly, it is essential to reduce the breats by preserving the veins, nerves and mammary ducts coming to the nipple and thus to give any desired shape and uplift and to do it with as minimum scar as possible.

Breast Lifting:

Lifting is sometimes ensured without using implants an sometimes by using implants in necessary cases. Use of implants is not required in those women with taut skin and firm mammary tissue in whom it is suitable to lift the mammary tissue with sutures by removing the excess skin of the breast. However, in women who have cracked skin and loose tissues but desire quite firm breasts, implants may be required. The operation is performed under general anaesthesia and takes 2-3 hours. An overnight stay is recommended at hospital after the operation. The patient may start to perform light works and activities at the expiration of a period of 10-15 days.


Pre-Operation:
•    If the breast operations only cover augmentation by inserting implants, the operational scar shall be quite small, but unlike this, operations may result in long scars in some cases in breast reduction operations. In breast reduction operations, you should know in detail beforehand what method you will require and where exactly and how long the scar shall stay.
•    In too big breasts, scars gradually reduce at varying degrees over months and years after reduction in many patients, usually depending on the person or rarely stay as distinctive and unrecoverable scars. This has nothing to do with taking utmost care in the operation or with the person who performs the operation, but it results from anatomical and unpredetermined reasons.
•    If you smoke, stop smoking 15 days prior to the operation if possible. This shall not make things hard for your lungs due to the general anaesthesia but shall be useful for the recovery of your scar.
•    Do not take such pills as Aspirin and its equivalent during 15 days prior to and 15 days after the operation. Take other painkillers if necessary. Taking Aspirin may cause excessive blood loss during the operation and spontaneous bleeding after the operation.
•    Stop eating and drinking within six hours prior to the operation.
•    Let your physician know if you have such a condition as influenza, cold, coughing, fever, exhaustion, etc. Your operation may have to be put off.
•    In case your are in your regular menstruation period, your operation may not have to be put off. However, you would better let your physician know. This is especially important for those patients whose breasts tighten to a great extent during menstrual terms.


Post-Operation:
•    Your painkiller for your pain shall be administered once you are resuscitated after the operation and continue in the subsequent period as well.
•    If you do not have any nausea six hours after the operation, you may start to drink a few sips of water and then eat and drink by gradually increasing at intervals.
•    You may have limited and painful use of your arms for a period of 15 days after the operation.

This is the operation of removing wxcess subcutaneous adipose tissues by inserting a thin metallic cannula under the skin through tiny holes. Cannula is chosen depending on the area to which liposuction shall be applied and on the amount of fat to be removed. Cannulas are connected to a device applying vacuum at varying degrees by mans of a transparent hose.

Prior to liposuction, the subcutaneous area is injected with a mixture which reduces bleeding and ensures easy removal of the tissue. Removal of adipose tissues from an area not only ensures the removal of excess fat in that area but also reduces the fat storage capacity of that area in the future. It is because the fat in that area is removed along with the chambers storing such fat, thus clearly reducing the number of the chambers (fatty cells) in that area. Number of cells does not increase over time. The areas where liposuction operation is frequently applied are shown in the animations. In case the skin is loose and slack in the front of the abdomen, "abdominoplasty" is also applied along with liposuction as the skin there may be more loose and slack after the operation.

Surgical operation is performed under general anaesthesia or spinal anaesthesia at a fully-equipped hospital. It is completed in a period of 1 hour to 2 hours.

Pre-Operation:
•    Do not take such pills as Aspirin and its equivalent during 15 days prior to and 15 days after the operation. Take other painkillers if necessary. Taking Aspirin may cause excessive blood loss during the operation and spontaneous bleeding after the operation.
•    Stop eating and drinking within six hours prior to the operation.
•    Let your physician know if you have such a condition as influenza, cold, coughing, fever, exhaustion, etc. Your operation may have to be put off.
•    In case your are in your regular menstruation period,, your operation may not have to be put off. However, you would better let your physician know.

Post-Operation:
•    You will have been put a corset on at the completion of the operation. Your corset has been designed to satisfy your toilet needs without taking it off. Do not ever take off your corset during the initial four post-operative days unless you have to.
•    Your painkiller for your pain shall be administered once you are resuscitated after the operation and continue in the subsequent period as well. One does not expect too much pain after this operation. Pain shall be usually felt while changing position or in case of contact. You will have no pain which requires taking painkillers a few days afterwards.
•    You may have nausea and throw-up. Ask for a container from the the healthcare personnel for this purpose. If it is disturbing, then medicine is administered to prevent it.
•    If you do not have any nausea six hours after the operation, you may start to drink a few sips of water and then eat and drink by gradually increasing at intervals.
•    You are recommended to urinate into a container to be provided by the healthcare personnel without leaving you bed during the initial six hours in the post-operative period. Your unchecked rise from your bed in the early period may cause you to fall due to sudden blackout.
•    Do never stand up suddenly during the initial days. You may have staggers. When you feel good, sit for a while and then stand up with the help of somebody who takes your arm.
•    Blood leakage may be expected from the tiny incisions through which the cannula is inserted to remove fat. And sometimes, the blood accumulated inside shall find a way out. Do not think that it is "a sudden bleeding" at that moment. It is normal and do not panic. There shall not definitely be any sudden and ample bleeding after this operation. In order to prevent the leakage which shall usually occur during the initial hours and gradually reduce and stop in a few days from making your corset and the environment dirty, the gauze bandages or pads placed over the tiny incisions in the corset shall be replaced as they get dirty. In the early period, this will be carried out by your physician or nurse and you yourself or a relative of yours will continue once you are home.
•    You are recommended to wash the corset and take shopwer standing after the fourth day. Put on the corset again after it has been washed in warm water and dried flat. You are recommended to wash the corset as necessary and wear it day and night for a period of one month. A big body, too much fat removal, existence of distention and hardness may further prolong the period of wearing the corset (15 days-one month).
•    Although the tiny incisions through which fat is removed are not sutured so that the leakage may be easy, sometimes there may be one suture on each. Such sutures shall be removed in 5-7 days.
•    Decay (cyanosis) is expected at varying degrees in the areas where fat is removed. Such purple spots shall fade out over time and disappear at the end of a period of 15 days.
•    Distention (edema) is expected in the areas where fat is removed. Widespread edema starting to reduce at the end of a week may be replaced by local indurations. It may take a few months for such indurations to recover and for the skin to restore its former natural softness. Wearing a corset is useful in speeding up the recovery of this condition.
•    Although there will be an apparent difference 15-20 days after the fat removal, at least 3 months are required for the disappearance of indurations and full recovery.
•    Although it varies by the extent of the operation performed, patients may resume their every day physical activities and works at the end of one week or two provided that they wear their corsets.
•    At the expiration of the 15-day period when the purple spots shall disappear, patients are at liberty to swim in the sea and have a sunbath for short pewriods of time.

This is the condition of the auricle which is larger or more projecting than desired when viewed from the front or the back. This condition is a reason for an important psychological trauma in young men and women. I perform the operation under local anaesthesia unless there is a special condition or state of sickness. It takes approximately 60-90 minutes for both ears. The scar which shall be left on the skin in the back of the auricle is not usually noticeable nor disturbing. Once the ear cartilages have been given the necessary folds and some catilage has been removed as necessary and the aurcile including the earlobe pulled over to the head folding backwards, the operation is completed by puncturing holes in the earlobe if so desired. The pateitn may leave hospital on foot in a short time.

The bandage covering the ears is retained for a period of 4-5 days and then a decision is made in the very first examination as to whether a second bandage should be applied for a similar period of time or to leave the ears exposed, depending on the technique used and on the condition of the ears.    

The patient is recommended to protect his/her ears for a period of 2 months and not to participate in any struggling sports and other unchecked activities which may cause trauma.

This is an operation basing upon the removal of excess skin and formation of a taut abdomen in cases where the abdominal skin is loose and slack.

As the removal of excess skin is an operation which leaves a scar, such scar is ensure to be in a place which shall remain under the bikini bottom where it shall be noticed as little as possible. In cases the section under the belly of the abdominal skin only displays some slackness to a limited extent, the belly button is left as it is and the section under the belly button is tightened and liposuction is applied to the section above the belly. This operation is called mini abdominoplasty.

However, as this will not be sufficient, we usually apply "full abdominoplasty" to most of our patients. What is done here is to disconnect the belly button from the abdominal skin and to draw the freed abdominal skin downwards from the rib cage in widespread manner.

Thus, while much more excess skin is removed from the bottom, all the cracks below the belly level are removed and a tauter abdomen may be obtained. During the operation, a firming operation (rectus muscle plication) is also applied to the abdominal muscles.

Pre-Operation:
•    Do not take such pills as Aspirin and its equivalent (ataspin, ecoprin, babyprin, dispril, coraspin) during 15 days prior to and 15 days after the operation. Taking Aspirin may cause excessive blood loss during the operation and spontaneous bleeding after the operation. Take other painkillers if necessary.
•    If you smoke, stop smoking 15 days prior to the operation if possible. This shall be useful for both the condition of your lungs and for the recovery of your scar.
•    Stop eating and drinking within six hours prior to the operation.
•    Let your physician know if you have such a condition as influenza, cold, coughing, fever, exhaustion, etc. Your operation may have to be put off.
•    In case your are in your regular menstruation period, your operation may not have to be put off. However, you would better let your physician know.

Post-Operation:
•    You will have been put a corset on at the completion of the operation. Your corset has been designed to satisfy your toilet needs without taking it off. Do not ever take off your corset during the initial four post-operative days unless you have to.
•    Your painkiller for your pain shall be administered once you are resuscitated after the operation and continue in the subsequent period as well. One does not expect too much pain after this operation. Pain shall be usually felt while changing position or in case of contact. You will have no pain which requires taking painkillers a few days afterwards.
•    You may have nausea and throw-up. Ask for a container from the the healthcare personnel for this purpose. If it is disturbing, then medicine is administered to prevent it.
•    If you do not have any nausea six hours after the operation, you may start to drink a few sips of water and then eat and drink by gradually increasing at intervals.
•    In abdomen tightening applications, especially in cases where the time or operation exceeds 3-4 hours depending on additional liposuction or other operations already performed, urinary catheter is fixed during the operation and kept in place until the next day.
•    Do never stand up suddenly during the initial days. You may have staggers. When you feel good, sit for a while and then stand up with the help of somebody who takes your arm.
•    Sutures in the belly button may be removed at 10th to 15th day and those below at the expiration of 2-3 weeks. In cases where it will be a problem for the patient to come for examination at the end of 3 weeks, such sutures may be removed somewhere else. And for those patients who do not want it, fusing sutures which do not require removing are used.
•    You are recommended to wash the corset if necessary and take shower standing after the first week. Put on the corset again after it has been washed in warm water and dried flat. You are recommended to wash the corset as necessary and wear it day and night for a period of one month. A big body, too much fat removal, existence of distention and hardness may further prolong the period of wearing the corset (15 days-one month).
•    Distention (edema) is expected in the tightened abdominal skin. Edema starts to reduce at the end of a week and your abdominal skin thins during the recovery period which takes a few months. In cases where additional liposuction is applied, distention and reduction of distention are more pronounced. Regular wearing of the corset is useful in speeding up the recovery of this condition.
•    Although it varies by the extent of the operation performed, patients may resume their every day physical activities and works at the end of two or three weeks provided that they wear their corsets. They are at liberty to swim in the sea and have a sunbath at the expiration of this period.

Lack of tissue usually in the inner side of the lower part of the knee may sometimes be disturbing. In such a case, a silicone implant inserted through a 4-5 cm incision in the back of the knee shall contribute to the distended appearance of this area.

The operation is usually performed under spinal anaesthesia and completed in approximately one hour.

Along with this problem, there may usually be fat accumulation in the inner sides of the knees. While inserting calf implant, we ususally apply liposuction to the inner sides of the knees.

In this way, the distance observed in the below-knee area seems to have reduced. As a matter of fact, no additional difference or difficulty is experienced other than the fact that the elastic socks which must be worn after the insertion of the implant shall reach above-knee level instead of below-knee level.

Pre-Operation:
•    Do not take such pills as Aspirin and its equivalent (ataspin, ecoprin, babyprin, dispril, coraspin) during 15 days prior to and 15 days after the operation. Taking Aspirin may cause excessive blood loss during the operation and spontaneous bleeding after the operation. Take other painkillers if necessary.
•    Stop eating and drinking within six hours prior to the operation.
•    Let your physician know if you have such a condition as influenza, cold, coughing, fever, exhaustion, etc. Your operation may have to be put off.
•    In case your are in your regular menstruation period, your operation may not have to be put off. However, you would better let your physician know.

Post-Operation:
•    You will have been put on a an elastic sock which apply pressure to the below-knee area at the end of the operation. If liposuction has been applied to the inner sides of the knee, then your elastic sock will be at above-knee level. You are recommended to wear these socks for a period of one month.
•    If spinal anaesthesia has been applied, your feet start to move and feel after a rest of some 4-5 hours. You may stand up after this period. Yet, do not ever stand up suddenly at the expiration of this period, you may have staggers. When you feel good, sit for a while and then stand up with the help of somebody who takes your arm.
•    Your painkiller for your pain shall be administered once you are resuscitated after the operation and continue in the subsequent period as well. Pain shall be usually felt when you stand up and gradually reduce and disappear over time. At least 2-3 weeks have to elapse for a painless walk. Wearing high-heel shoes reduces the pain as it reduces the stress in the implant area.
•    If you do not have any nausea six hours after the operation, you may start to drink a few sips of water and then eat and drink by gradually increasing at intervals.
•    Sutures in the back of the knees may be removed 2-3 weeks afterwards. In cases where it will be a problem to come for examination, such sutures may be removed somewhere else.