Rhinoplasty

What Tests Are Performed Before Rhinoplasty?

Posted on by Dr. Alev Camcıoğlu

Rhinoplasty is a surgical procedure that significantly affects our facial expression and can be performed for both aesthetic and functional purposes. Before this procedure, it is of great importance to comprehensively evaluate patients for the safety and success of the surgery. Just as we examine the ground, plan the construction process, and select the right materials before laying the foundation of a building, a similar approach is adopted in Rhinoplasty.

Why Is Evaluation Done Before Rhinoplasty?

Rhinoplasty might appear from the outside to be just a “procedure to change the shape of the nose,” but in reality, it affects many factors from breathing function to the overall aesthetics of the face. In order for the doctor to plan the surgery, they must know the current structure of your nose, the airways, and your general state of health in detail. No one likes surprises—especially not an unpleasant one on the operating table. Therefore, the preoperative evaluation both increases your surgical safety and helps align your expectations with the possible outcomes.

Which Tests Might Be Necessary Before Rhinoplasty?

Generally, the tests performed before Rhinoplasty fall under several main categories:

  • Blood tests (complete blood count, coagulation tests, biochemistry, etc.)
  • Imaging methods (X-ray, tomography, etc.)
  • Pregnancy test (for female patients)
  • Tests evaluating heart function (such as ECG)
  • Allergy tests (in suspicious cases)
  • Psychological evaluation (if deemed necessary)

Depending on your clinical situation and history, your doctor may request some of these tests or consider others unnecessary. In this section, we take a closer look at the most commonly requested tests and evaluations.

Why Do We Get Blood Tests?

Preoperative blood tests reveal the general health status of the body and possible risk factors. You can think of it like “checking the motor oil, brake fluid, and overall mechanism of a car before a long trip.” Blood tests provide a kind of “internal system check” before surgery.

  • Complete Blood Count (CBC): This test measures red blood cells (erythrocytes), white blood cells (leukocytes), and platelets. If conditions like anemia or infection exist, they can be detected early. For instance, a patient with a very low hemoglobin value carries a higher risk of bleeding during surgery.
  • Coagulation tests: Tests such as PT (Prothrombin Time) and aPTT (Activated Partial Thromboplastin Time) help determine whether the blood clotting mechanism is functioning properly. This is critical for controlling bleeding during surgery. If a clotting disorder is identified before surgery, additional precautions may be taken or the surgery might be postponed.
  • Biochemistry panel: This includes tests providing information about liver and kidney functions, electrolyte balance, and other aspects of the body’s metabolic processes. For patients who will receive anesthesia, having normal liver and kidney functions is crucial for the elimination of medications from the body.
  • Blood sugar: Conditions like diabetes or insulin resistance directly affect wound healing and infection risk. Keeping blood glucose under control makes the postoperative recovery process easier.

Are Imaging Methods Necessary?

There is no strict rule that an imaging method must be used before every Rhinoplasty. However, if needed—particularly in cases of severe internal nasal deviations, sinus problems, or complex anatomical structures—detailed imaging methods such as tomography (CT) may be used.

  • Tomography (CT): Helps examine both the bony and cartilaginous structure of the nose in three dimensions. If there is a hidden bony protrusion or a problem related to the sinuses, a CT scan can reveal it. This reduces the likelihood of encountering unwanted surprises during surgery.
  • Three-dimensional (3D) modeling: With advancing technology, some centers use low-dose CT data converted into 3D models for surgical planning. This is somewhat like a dress rehearsal for the surgery. The surgeon can plan the maneuvers they will perform beforehand, and patients can have a clearer idea of the possible outcomes.

If no clear internal nasal problem is anticipated or only a simple correction is planned, X-ray or CT scans may be optional. However, if a detailed procedure is planned, imaging makes the surgery safer and more predictable.

What Is the Importance of a Pregnancy Test?

For female patients, a pregnancy test may come into play before Rhinoplasty. Surgery and anesthesia during pregnancy, especially in the first trimester, can pose risks to the baby’s development. This test is a measure aimed at protecting both the baby’s and the mother’s health.

  • Beta-HCG (blood pregnancy test): Particularly for patients who have a delayed menstrual cycle or a possibility of pregnancy, doctors may request this test. If pregnancy is confirmed, the surgery is usually postponed or scheduled for a safer period.

Why Is It Important to Check the Heart (ECG)?

Just because your nose will be operated on does not mean your heart is irrelevant. Since you will be under anesthesia, your heart health also needs to be evaluated. The aim here is to detect any potential heart problems early and adjust the surgery plan accordingly.

  • ECG (Electrocardiogram): Examines the electrical activity of the heart. If there is an arrhythmia, past heart attack, or another abnormality, changes in the anesthesia plan or a joint evaluation with a cardiologist may be necessary.

Echocardiography or stress tests: Rhinoplasty is generally considered a medium- to low-risk procedure. Hence, not all patients require advanced cardiac tests. However, if risk factors such as hypertension or coronary artery disease exist, additional tests can be conducted to evaluate the heart’s performance more comprehensively.

Are Allergy Tests Necessary?

If you have allergic rhinitis or frequently recurring allergic reactions related to the nose, an allergy test (for example, a skin prick test) may be requested before surgery. You might wonder, “Could an allergic individual experience more intense swelling, nasal congestion, or other symptoms post-surgery?” Doctors largely clarify the answer to this question with allergy tests.

Allergy tests: If you react to certain pollens, house dust mites, pet dander, or other allergens, you may experience increased nasal swelling and congestion after surgery. In this case, your doctor can plan a medication regimen to control the allergy before surgery or, if necessary, make minor adjustments to the surgical technique.

What Is the Purpose of Psychological Evaluation?

Rhinoplasty is often performed to improve external appearance, but this change can also affect a person’s self-confidence and mental health. The most critical point here is whether your expectations from the surgery are realistic. Sometimes individuals who decide on Rhinoplasty may actually be hoping to escape deeper psychological issues. In such cases, the surgery may not deliver the expected effect, leading to disappointment.

  • Managing expectations: Your doctor will explain in detail what kind of nose shape you can expect after the surgery. If your expectations far exceed what the surgery can realistically achieve, this may lead to dissatisfaction post-surgery.
  • Identifying existing psychological issues: Depression, anxiety disorders, or obsessions about bodily appearance (such as body dysmorphic disorder) can negatively influence surgical outcomes. Some patients may continuously look for flaws or never feel satisfied with the results. Doctors might request input from a psychologist or psychiatrist if they anticipate such situations.

What Should We Change in Our Lifestyle Before Surgery?

Rhinoplasty does not succeed solely through the surgeon’s interventions in the operating room; the patient’s pre- and postoperative lifestyle also plays a significant role. Just as a plant needs regular watering and fertilizing after it’s planted in soil, proper body preparation and avoidance of harmful habits are essential before surgery.

  • Smoking and tobacco products: Smoking reduces the oxygen supply to tissues and negatively impacts wound healing. Quitting smoking before surgery can significantly speed up your postoperative recovery and also reduce the risk of bleeding during and after the procedure.
  • Alcohol consumption: Excessive alcohol weakens the immune system and can interfere with anesthesia medications during surgery. It’s beneficial to stop or minimize alcohol intake at least a week before surgery.
  • Nutrition: Your body needs protein, vitamins, and minerals during the healing process. Consuming protein-rich foods (such as fish, chicken, and legumes) supports tissue repair. Additionally, antioxidants like vitamin C can help reduce edema and inflammation.
  • Exercise: Regular exercise improves cardiovascular health and increases the body’s resilience to surgical stress. However, avoid intensive workouts in the last few days before surgery; do not excessively elevate your blood pressure. Light walks or mild exercises are preferable as the surgery date approaches.
  • Stress management: Mental and physical health are interwoven. Severe anxiety or stress can affect your sleep quality before surgery, weakening the body’s defense mechanisms. Activities like meditation, breathing exercises, or hobbies you enjoy can help reduce stress, contributing to a smoother surgical experience.

Medications and supplements: The medications or herbal supplements you use can increase bleeding risk or interact with anesthesia. Blood thinners, aspirin, and some herbal teas require particular caution. Before surgery, be sure to inform your doctor about all medications and supplements you are taking.

A Safer Experience with Preoperative Checkups

When done correctly, Rhinoplasty is a surgical procedure that can improve both appearance and breathing function. However, this success is not limited to what happens on the operating table. Tests, examinations, and preparations done in the preoperative period are integral parts of the process. Think of it like completing the missing pieces of a puzzle; each test and evaluation contributes to a smoother surgery and recovery.

If you have decided on Rhinoplasty, following the tests and recommendations your doctor deems appropriate will make your postoperative period more comfortable. Whether it’s allergies, heart health, or your psychological state, every detail can influence the success of the surgery. While “preoperative preparation” may sound like a tedious process, it actually serves as a guide that ensures you remain safe and healthy, fully preparing you for surgery.

Remember, preoperative tests for Rhinoplasty or any surgery are not just a “formality.” Every test acts as a safety belt for you and your doctor. All these precautions significantly reduce the likelihood of unexpected situations both during and after surgery. Thus, your transition to life with your new nose becomes much more comfortable and enjoyable.