Rhinoplasty, or by its medical name rhinoplasty, is a complicated surgical intervention that, while allowing the person to capture the golden ratio in their face, also solves breathing problems. Although imagining the new reflection in the mirror is exciting, there are some functional concerns that occupy patients' minds. At the top of these concerns come the questions "Will I not be able to smell after surgery?" or "Will the taste of food change completely?" Especially for patients with a high enjoyment of eating and drinking and sensitivity to the sense of smell, this temporary situation can look quite stressful. Op. Dr. Ayşe Öznur Akidil, at her clinic in İzmir, prepares her patients mentally not only for the aesthetic results of the operation but also for such sensory changes during the recovery period.
011. Why Is the Sense of Smell Temporarily Lost?
After rhinoplasty surgery, a decrease in the sense of smell (hyposmia) or a temporary complete loss (anosmia) is an extremely normal and expected physiological process. This situation has nothing to do with a surgical error; it is entirely connected to the body's recovery mechanism.
The smell-perception area of our nose (the olfactory region) is located at the uppermost part of the nasal cavity, in a position very close to the brain. For us to be able to smell, the odour particles in the air we breathe need to be able to reach this roof area. However, after surgery the following factors prevent the air from reaching this area:
Tissue Oedema (Swelling): The interventions made on the bone and cartilage cause the mucous lining inside the nose to swell. The swollen tissues, by narrowing the airways, prevent the odour particles from rising up.
Silicone Tampons and Splints: The grooved silicone splints placed at the end of surgery to preserve the new shape of the nose and prevent bleeding/adhesion inside restrict the airflow.
Crusting and Secretion: The clots and dried secretions (mucus) that form inside the nose during the recovery process create a physical barrier in the airways.
022. The Inseparable Connection Between the Senses of Taste and Smell
Patients usually complain after surgery of losing not only their sense of smell but also their sense of taste. Expressions such as "Everything I eat is like cardboard" or "I can only feel the temperature of the food" are heard very frequently. So, how does nose surgery affect the taste buds on the tongue?
Actually, our tongue perceives only five basic tastes: sweet, salty, sour, bitter and umami. What allows us to understand that a strawberry we eat is a "strawberry" is the aromas that rise from the back of the mouth cavity toward the nasal cavity during chewing (retro-nasal olfaction). When the inside of the nose is closed due to swelling or tampons, this airflow cannot take place. Op. Dr. Ayşe Öznur Akidil, by explaining this anatomical connection to her patients in detail, emphasises that the loss of taste is actually entirely caused by the blockage of the smell passages and that there is no damage to the tongue.
033. The Return Timeline of the Senses During the Recovery Process
The return of the senses of taste and smell occurs gradually, in parallel with the speed at which the tissues shed oedema.
The First 1 Week (Tampon Period): In this phase the senses of smell and taste are usually at the level of 10 to 20 percent. Since the inside of the nose is full of silicone splints and the oedema is at its highest level, the sensory limitation is at its maximum.
2nd and 3rd Weeks: With the removal of the silicone splints, patients feel an instant relief. However, since the micro-swelling within the mucosa continues, the senses of smell and taste have not fully returned. During the day you may sometimes smell odours very clearly and sometimes feel that they have disappeared again. These fluctuations are extremely normal.
1st to 3rd Months: With the cleaning of the crusting inside the nose and the largely resolution of the internal oedema, the senses of taste and smell return completely to their old sharpness and normal function in 99% of patients.
044. Is There a Risk of Permanent Loss of Smell?
The darkest scenario in patients' minds is losing these senses forever. In a standard aesthetic and functional nose surgery, the risk of permanent loss of smell (permanent anosmia) is next to none.
The smell nerves (Nervus Olfactorius) are at the very top point of the nose, over the bony structure called the "cribriform plate" located at the base of the brain. In classic rhinoplasty operations the surgeon's working area is the nasal bridge, tip and septum (middle cartilage partition) areas; that is, the top point where the smell nerves are located is anatomically not approached too much. The use of current and safe technologies in aesthetic operations minimises the risk of harming the surrounding tissues.
055. Recommendations to Support the Senses During the Recovery Period
There are some steps that can be applied to get through this temporary period more comfortably and to regain the senses of taste/smell faster by speeding up the mucosal recovery:
Regular Nasal Rinsing: The isotonic seawater sprays or sinus-rinse kits prescribed by your doctor open the air channels by cleaning the dried blood and crusts inside. A clean mucosa is essential for the smell receptors to work.
Steam and Moisture: Humidifying the air of the room you are in (using a steam machine) prevents the inside of the nose from drying out and helps the oedema resolve.
Adequate Hydration: Drinking plenty of water makes the secretions in the body (nasal discharges) more fluid, which greatly reduces crusting.
Staying Away from Irritants: Cigarette smoke, harsh chemicals or very dusty environments prolong the recovery process by swelling the already-sensitive nasal mucosa even more.
066. The Effect of Anatomical Respect and Surgical Meticulousness on Recovery
The amount of oedema experienced after surgery in rhinoplasty is directly related to how respectfully the surgeon treats the tissue. Coarse surgical manoeuvres lead to the tissues being traumatised more than necessary and therefore to the internal mucosa swelling much more. This can prolong the return time of the senses of smell and taste by months.
Op. Dr. Ayşe Öznur Akidil, with the help of micro-surgical instruments and ultrasonic bone-shaping (Piezo, bur, etc.) devices, exhibits an approach that keeps soft-tissue damage at a minimum. Making the incisions and cartilage-filing procedures in a tissue-respecting way (with non-traumatic methods) does not only prevent the external bruises on the face; it also ensures that the airway inside the nose is rapidly repaired. Thus patients regain their sensory functions in a much shorter time after the operation.
077. The Psychological Process and the Management of Expectations
The rhinoplasty process is not only a physical change in which the bones and cartilage are reshaped; it is also an emotional journey in which the patient adapts to their body. Especially in the first two weeks after surgery, the loss of appetite caused by not being able to taste and the lack of smell can create a temporary "depressive" mood in the patient.
At this point the most important power is the belief that the process is temporary. Op. Dr. Ayşe Öznur Akidil and her expert team convey this biological process to their patients with all its transparency before and after surgery. A few weeks later, when you smell the familiar scent of your morning coffee for the first time again or feel the taste of a dish you love, you realise that all this difficulty is behind you and that you look at life much more confidently with a renewed profile. With correct surgical techniques and the patient's compliance with the recommendations, the perfect harmony of function and aesthetics is permanently provided.