Rhinoplasty (Nose Surgery)

The nose is one of the most prominent features of a person's face. Men and women who are dissatisfied with the shape or size of their noses can improve their appearance through a procedure called rhinoplasty. Nasal reconstruction or rhinoplasty was one of the first cosmetic procedures ever developed and is among those most frequently performed today. Rhinoplasty is a surgical procedure in which deformities of the nose are corrected by removing, rearranging or reshaping bone or cartilage.

Typical reasons for nose surgery are to improve the angle, reduce the size of the nose or remove a bump. These conditions may be the result of natural causes or external trauma to the face. Both profile and frontal face views can be altered through rhinoplasty. The surgery can be performed in conjunction with procedures designed to relieve nasal obstructions. it is not usually performed however, until a person has reached the mid-teenage years when growth is nearly complete.

Before Rhinoplasty

Prior to rhinoplasty, a medical history is taken in order to evaluate the general health of the patient. A careful examination is also conducted. The cosmetic surgeon and patient discuss together how the nose should look in relation to the patient's other facial features. it is important for the patient to understand that the goal of the surgery is not to achieve perfection but rather to improve the appearance. Photographs of the nose allow the cosmetic surgeon to evaluate the appropriate procedure to achieve the desired results. The type of anesthesia to be used, the procedure and possible risks and complications are also discussed. Preoperative instructions may include the elimination of certain drugs which contain aspirin in order to minimize the possibility of excess bleeding. Antibiotics may be prescribed before Surgery to prevent infection.

The Rhinoplasty Procedure

Rhinoplasty can be performed in a cosmetic surgeon's office, an outpatient surgical facility or a hospital, depending upon the cosmetic surgeon's and patient's preference. it can be done under general anesthesia with the patient asleep or local anesthesia in which the area is numbed and the patient remains awake. Premedication may be administered to relax the patient.

The procedure is determined by the type of correction to be made. in most cases involving a reduction in size or shape of the nose, the removal of a hump or the improvement of an angle, incisions are made inside the nose. Working through these incisions, the cosmetic surgeon is able to cut bone and cartilage, the soft, movable tissue inside the nose, to reshape it.

To remove a nasal hump, a special file or chisel is used. A narrower nasal bridge is then formed by bringing together the bones on either side of the face. In patients in whom the size of the nasal tip is too large, cartilage is removed through the inside incision. The angle between the nose and the upper lip can be improved by elevating and trimming the septum, the dividing wall between the two chambers of the nose.

In some cases, it is necessary to narrow the base of the nose. This procedure involves removal of skin from both sides of the nostrils at the center. In order to improve the contour of the noses of some patients, it is sometimes necessary to add tissue. These procedures can last from one and a half to two hours or more depending upon the extent of surgery.

Following Rhinoplasty

Following rhinoplasty, a lightweight splint is applied to maintain the new shape of the nose. The splint is usually removed within a week. Nasal pads may be inserted at the time of surgery to protect the septum. This packing is removed within a day or two. Before and even after the packing is removed, there is frequently some stuffiness of the nose, particularly when work has been done in the nasal septum. The cosmetic surgeon advises when it is permissible to gently blow the nose.

Pain connected with the surgery is minimal to moderate and is controlled with oral medication. Bruising around the eyes occurs but begins to fade within a few days. Discoloration usually disappears in two to three weeks. Swelling around the treated areas slowly diminishes and can be reduced by keeping the head in a slightly elevated position when reclining. Cold compresses may be recommended. Some slight swelling may be present for as long as two to four months.

During the healing process, great care must be taken to protect the nose from injury. Eyeglasses should be adjusted in order to minimize pressure on the nose. The cosmetic surgeon advises if contact lenses can be worn. Although patients are usually up and around a day or two after the procedure, strenuous exercises, particularly those which might elevate blood pressure, must be avoided for several weeks. The cosmetic surgeon determines when normal activities can be resumed.

How Much Improvement can be Expected?

The amount of improvement is individual and depends upon the extent of surgery. In some cases, as when a badly misshapen nose is reconstructed, dramatic results may be obtained. On the other hand, the removal of a slight bump may produce very subtle yet satisfying results. Final results may not be apparent for up to one year.

Each year thousands of rhinoplasties are successfully performed on people who want to change the size or shape of their noses. Complications connected with rhinoplasty are rare: however, there are some inherent risks connected with every surgical procedure. Possible risks and complications should be thoroughly discussed with the cosmetic surgeon. Patients can minimize complications by carefully following directions given by the cosmetic surgeon.

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