What are Rhinoplasty?
Known as a rhinoplasty, it is a plastic surgery procedure to modify and reconstruct the nose. There are two types of plastic surgery used - reconstructive surgery that restores the shape and functions of the nose and plastic surgery that changes the appearance of the nose. Reconstructive surgery seeks to resolve nose injuries caused by various injuries including blunt trauma, closures, and blast trauma. Reconstructive surgery also treats birth defects, breathing problems and failed primary rhinoplasty. Rhinoplasty may remove a bump or narrow width of the nostril, change the angle between the nose and the mouth, or treat injuries, birth defects, or other problems that affect breathing, such as a deviated septum or a sinus condition.
In closed rhinoplasty and open rhinoplasty surgeries - an otolaryngologist (an ear, nose and throat specialist), an oral and maxillofacial surgeon (a jaw, face and neck specialist), or a plastic surgeon creates a functional, aesthetic and facial-proportionate nose by separating the skin of the nose and soft tissues from Frame the nose, adjusting as needed for shape and function, suturing incisions, using tissue glue and applying either a bundle or stent, or both, to immobilize the altered nose to ensure the incision heals.
Fortunately, for the right candidate, a rhinoplasty performed by an experienced and qualified facial plastic surgeon can correct most of these concerns. A rhinoplasty can greatly increase a person's self-esteem and self-confidence, giving them a better quality of life.
Why is this done?
Rhinoplasty can change the size, shape, or proportions of your nose. This can be done to repair deformities from an injury, correct a birth defect, or improve some breathing difficulties.
How to Prepare
Before scheduling a rhinoplasty appointment, you should meet with your surgeon to discuss important factors that determine whether the surgery will work well for you. This meeting generally includes:
• Your medical history. The most important question your doctor will ask you is your motivation for the surgery and your goals. Your doctor will also ask questions about:
Medical history - including a history of stuffy nose, surgeries, and any medications you're taking. If you suffer from a bleeding disorder, such as hemophilia, you may not be a candidate for rhinoplasty.
• A physical examination. Your doctor will perform a complete physical examination, including any laboratory tests, such as blood tests. He or she will also examine the features of your face and the inside and outside of the nose.
The physical exam helps your doctor determine what changes to make and how your physical features, such as the thickness of the skin or the strength of the cartilage at the end of your nose, might affect your results. A physical examination is also critical to determine the effect of rhinoplasty on your breathing.
• Photographs. Someone from your doctor's office will take pictures of your nose from different angles. Your surgeon may use computer software to manipulate the images to show you the types of possible results. Your doctor will use these images for before and after evaluations, for reference during surgery and for long-term reviews.
• Discuss your expectations. You and your doctor should talk about your motivations and expectations. He will explain to you what rhinoplasty can and cannot do and what your results could be. It is normal to feel a little shy when discussing your appearance, but it is very important to be open with your surgeon about your desires and goals for the surgery.
If you have a small chin, your surgeon may talk to you about having surgery to enlarge your chin. This is because a small chin will create the illusion of a bigger nose. Chin surgery is not required in these circumstances, but this may result in a better facial profile.
Once your surgery is scheduled, you will need to arrange for someone to drive you home if you are going to have the surgery on an outpatient basis.
In the first few days after anesthesia, you may have memory lapses, a slow reaction time, and impaired judgment. So arrange for a family member or friend to stay with you for a night or two to help with personal care tasks while recovering from surgery.
Food and Medicine
Avoid medications containing aspirin or ibuprofen (Advil, Motrin IB, others) for the two weeks before and after surgery. These medications may increase bleeding. Only take those medications that have been approved or prescribed by your surgeon. Also avoid herbal remedies and over-the-counter supplements.
If you smoke, stop smoking. Smoking slows the healing process after surgery and may increase your risk of infection.
What are you Expecting
Rhinoplasty does not have a series of arranged steps. Each surgery is unique to the anatomy and specific goals of the person undergoing the surgery.
During Surgery
Rhinoplasty requires local anesthesia with sedation or general anesthesia, depending on the complexity of the surgery and your surgeon's preference. Discuss with your doctor before surgery which type of anesthesia is best for you.
• Local anesthesia with sedation. This type of anesthesia is usually used on an outpatient basis. It is limited to a specific area of your body. Your doctor injects a numbing pain medicine into the tissues of your nose and calms you with one that is injected through an intravenous (IV) line. This makes you groggy but not completely sleepy.
• General anesthesia. You receive the medication (anesthetic) by inhaling it or through a small tube (IV line) placed into a vein in your hand, neck, or chest. General anesthesia affects your entire body and causes you to lose consciousness during surgery. General anesthesia requires a breathing tube.
Rhinoplasty can be performed inside your nose or through a small external incision (incision) at the base of your nose, between the two nostrils. The surgeon will likely reset the bone and cartilage under the skin.
A surgeon can change the shape of the nasal bones or cartilage in a number of ways, depending on how much they need to be removed or added, the structure of your nose and the materials available. To make minor changes, the surgeon may use cartilage taken from inside your nose or from your ear. To make larger changes, the surgeon can use cartilage from your rib or implants or bones from other parts of your body. After making these changes, the surgeon places the skin and tissue of the nose back and sutures the incisions in your nose.
If the wall between the sides of the nose (septum) is bent or twisted (oblique), the surgeon can also correct it to improve breathing.
After surgery, you will be in the recovery room, with staff monitoring your return to wakefulness. You may leave later that day, or if you have other health problems, you may stay overnight.
After Surgery
After surgery, you need to rest in bed with your head elevated above your chest to reduce bleeding and swelling. Your nose may be congested due to swelling or from splints placed inside your nose during surgery.
In most cases, internal dressings remain in place for one to seven days after surgery. Your doctor also places a splint on your nose for protection and support. It will usually be in place for about a week.
Slight bleeding and drainage of old mucus and blood are common for a few days after surgery or after removing the dressing. Your doctor may place a "drip pad" - a small piece of gauze held in place with duct tape - under your nose to absorb the drainage. Change the gauze as directed by your doctor. Do not place the drip pad tightly over your nose.
To reduce the chances of bleeding and swelling, your doctor may ask you to follow precautions for several weeks after surgery. Your doctor may ask you to:
• Avoid strenuous activities such as aerobic exercise and jogging.
• Take a shower instead of showering while you apply bandages to your nose.
• Don't blow your nose.
• Eat foods rich in fiber, such as fruits and vegetables, to avoid constipation. Constipation can cause you to strain, putting pressure on the surgical site.
• Avoid excessive facial expressions, such as smiling or laughing.
• Gently brush your teeth to limit movement of your upper lip.
• Wear clothes that fasten the front. Do not pull clothing, such as T-shirts or sweaters, over your head.
In addition, do not put glasses or sunglasses on your nose for at least four weeks after surgery, to prevent pressure on your nose. You can use the cheek pads or stick glasses to your forehead until your nose is healed.
Use sunscreen SPF 30 when you are out, especially on your nose. Excessive sun exposure can cause permanent and irregular change in the color of the skin of your nose.
Some temporary swelling or black-and-blue discolouration can occur in your eyelids for two to three weeks after nose surgery. Nose swelling takes longer to resolve. Reducing the sodium in your diet will help get rid of swelling faster. Do not put anything like a cold compress on your nose after surgery.
Your nose changes throughout your life whether you have had surgery or not. For this reason, it is difficult to determine when you got the "end result". However, most of the swelling goes away within a year.
Results
Very slight changes in the structure of your nose - often measured in millimeters - can make a big difference to the shape of your nose. Most of the time, an experienced surgeon can get the results that satisfy both of you. In some cases, however, minor changes are not enough, and you and your surgeon may decide to have a second surgery to make more changes. If this is the case, you must wait at least a year for a follow-up surgery, as your nose can go through changes during this time.
How is Rhinoplasty Different from Septoplasty?
Rhinoplasty is a surgical procedure to change the shape of the nose. Since both breathing and the shape of the nose are interrelated, rhinoplasty can sometimes be performed not only to change the shape of the nose but also to improve breathing through the nose.
Septoplasty is a surgery to improve breathing by straightening the wall inside the nose that divides the nasal passages into the left and right side (nasal septum). When the septum is crooked, it can make breathing through the nose more difficult. Septoplasty is often combined with rhinoplasty.
Is Rhinoplasty a Simple Procedure?
No, rhinoplasty is a difficult procedure. This is due to several factors. First, the nose is a complex three-dimensional shape located in the middle of the face. Often the changes that are made during rhinoplasty are very small. But these changes can make a big difference to the shape and function of the nose. Because these changes are small, so is the margin for error.
Swelling and application of local anesthetic in the skin distort the nose during surgery and mask many of the minor changes that have been made. Rhinoplasty also does not have a standard plan or a specific order of steps. Doctors design each procedure according to the patient's needs.
Will I Need to Stay in the Hospital?
Almost everyone who has had a rhinoplasty can safely leave the hospital the same day after surgery. In rare cases, you may stay in the hospital for one night if you suffer from nausea or have other health problems that need monitoring.
How Long is the Recovery Time?
Plan to take a week off from work, school, or other commitments. You will feel a gradual improvement every day during the first week. A week after surgery, people usually feel they are back to normal.
After surgery, there will be some swelling. The swelling can take several months to resolve, although most people stop noticing it after two months. People usually return to performing most activities after a week and resume all activities after two to four weeks.
Can I see the Shape of my Nose After Surgery?
Yeah. Before your consultation, your doctor will take standard photographs of multiple views of your face. These pictures can be manipulated to give you an idea of what your nose might look like after surgery.
Is Rhinoplasty Painful?
Not for most people. One day after surgery, most people rate their pain between 0 and 4 out of 10.
Will you Strap my Nose?
No, packing can be very uncomfortable. But you will likely have some soft splints in your nose. These splints have an opening inside to allow you to breathe through, for at least a few days. Doctors easily remove these splints at the week-long visit
.
How Long will I be Bruised?
Bruising is uncommon. If you have some minor bruising, it usually lasts for a week or so.
What Should I Look for in a Surgeon?
Plastic surgeons, facial plastic surgeons, or otolaryngologists perform most rhinoplasty procedures. Training and board certification in one of these disciplines is a good starting point. You will likely need a surgeon who will often perform rhinoplasty.
You will likely need a surgeon who has a good reputation among other patients and doctors. If your surgeon has published many papers in the medical literature related to rhinoplasty andThey are invited to speak at educational conferences, and this is usually one sign that their peers are acknowledging expertise in rhinoplasty surgery.
Ensure that the surgery is performed in an accredited surgical facility or hospital. You will also likely feel comfortable with your surgeon. Find a surgeon who can explain in understandable terms to you what will happen during the surgery.
