Surgery
of the Nose
A
nose job (technically known as Rhinoplasty), or surgery to
reshape the nose, is one of the most common of all plastic
surgery procedures. Rhinoplasty can reduce or increase the
size of your nose, change the shape of the tip or the bridge,
narrow the span of the nostrils, or change the angle between
your nose and your upper lip. It may also correct a birth
defect or injury, or help relieve some breathing problems.
The
best candidates for a Rhinoplasty Surgery
Rhinoplasty surgery can enhance your appearance and your
self-confidence, but it won't necessarily change your looks
to match your ideal, or cause other people to treat you
differently. Before you decide to have plastic surgery,
think carefully about your expectations and discuss them
with your surgeon.
The
best candidates for rhinoplasty surgery are people who are
looking for improvement, not perfection, in the way they
look. If you're physically healthy, psychologically stable,
and realistic in your expectations, you may be a good candidate.
Age may
also be a consideration. Many surgeons prefer not to operate
on teenagers until after they've completed their growth
spurt around 14 or 15 for girls, a bit later for boys. It's
important to consider a teenager's social and emotional
adjustment, too, and to make sure it's what they, and not
their parents, really want.
All
Rhinoplasty Surgery carries some uncertainty and risk
When
rhinoplasty surgery is performed by a qualified plastic surgeon,
complications are infrequent and usually minor. Nevertheless,
there is always a possibility of complications, including
infection, nosebleed, or a reaction to the anesthesia. You
can reduce your risks by closely following your surgeon's
instructions both before and after plastic surgery.
After rhinoplasty plastic surgery, small burst blood vessels
may appear as tiny red spots on the skin's surface; these
are usually minor but may be permanent. As for scarring, when
rhinoplasty surgery is performed from inside the nose, there
is no visible scarring at all; when an "open" technique
is used, or when the procedure calls for the narrowing of
flared nostrils, the small scars on the base of the nose are
usually not visible.
In
about one case out of ten, a second procedure may be required
for example, to correct a minor deformity. Such cases are
unpredictable and happen even to patients of the most skilled
surgeons. The corrective surgery is usually minor.
Planning your Rhinoplasty Surgery
Good communication between you and your physician
is essential. In your initial consultation, the surgeon will
ask what you'd like your nose to look like, evaluate the structure
of your nose and face, and discuss the possibilities with
you. He or she will also explain the factors that can influence
the procedure and the results. These factors include the structure
of your nasal bones and cartilage, the shape of your face,
the thickness of your skin, your age, and your expectations.
Your surgeon will also explain the techniques and anesthesia
he or she will use, the type of facility where the rhinoplasty
surgery will be performed, the risks and costs involved, and
any options you may have.
Most
insurance policies don't cover purely cosmetic surgery; however,
if the procedure is performed for reconstructive purposes,to
correct a breathing problem or a marked deformity following
injury, the procedure may be covered. Check with your insurer,
and obtain pre-authorization for your plastic surgery.
Be sure
to tell your surgeon if you've had any previous nose surgery
or an injury to your nose, even if it was many years ago.
You should also inform your surgeon if you have any allergies
or breathing difficulties; if you're taking any medications,
vitamins, or recreational drugs; and if you smoke. Don't
hesitate to ask your doctor any questions you may have,
especially those regarding your expectations and concerns
about the results.
Preparing for your Rhinoplasty Surgery
Your surgeon will give you specific instructions on how
to prepare for surgery, including guidelines on eating and
drinking, smoking, taking or avoiding certain vitamins and
medications, and washing your face. Carefully following
these instructions will help your surgery go more smoothly.
While
you're making preparations, be sure to arrange for someone
to drive you home after your surgery and to help you out
for a few days if needed.
Where your Rhinoplasty Surgery will be performed
Rhinoplasty surgery may be performed in a surgeon's office-based
facility, an outpatient surgery center, or a hospital. It's
usually done on an outpatient basis, for cost containment
and convenience. Complex procedures may require a short
inpatient stay.
Types of anesthesia
Rhinoplasty surgery can be performed under local or general
anesthesia, depending on the extent of the procedure and
on what you and your surgeon prefer. With local anesthesia,
you'll usually be lightly sedated, and your nose and the
surrounding area will be numbed; you'll be awake during
the surgery, but relaxed and insensitive to pain. With general
anesthesia, you'll sleep through the operation.
The Rhinoplasty Surgery
Rhinoplasty usually takes an hour or two, though
complicated procedures may take longer.
During surgery the skin of the nose is separated from its
supporting framework of bone and cartilage, which is then
sculpted to the desired shape. The nature of the sculpting
will depend on your problem and your surgeon's preferred
technique. Finally, the skin is redraped over the new framework.
Many plastic surgeons perform rhinoplasty from within the
nose, making their incision inside the nostrils.Others prefer
an "open" procedure, especially in more complicated
cases; they make a small incision across the columella,
the vertical strip of tissue separating the nostrils.
When the surgery is complete, a splint will be applied to
help your nose maintain its new shape. Nasal packs or soft
plastic splints also may be placed in your nostrils to stabilize
the septum, the dividing wall between the air passages.
After
your Rhinoplasty Surgery
After rhinoplasty plastic surgery particularly
during the first twenty four hours your face will feel puffy,
your nose may ache, and you may have a dull headache. You
can control any discomfort with the pain medication prescribed
by your surgeon. Plan on staying in bed with your head elevated
(except for going to the bathroom) for the first day.
You'll notice that the swelling and bruising around your
eyes will increase at first, reaching a peak after two or
three days. Applying cold compresses will reduce this swelling
and make you feel a bit better. In any case, you'll feel
a lot better than you look.
Most of the swelling and bruising should disappear within
two weeks or so. (Some subtle swelling unnoticeable to anyone
but you and your surgeon will remain for several months.)
A little bleeding is common during the first few days following
surgery, and you may continue to feel some stuffiness for
several weeks. Your surgeon will probably ask you not to
blow your nose for a week or so, while the tissues heal.
If you have nasal packing, it will be removed after a few
days and you'll feel much more comfortable. By the end of
one or, occasionally, two weeks, all dressings, splints,
and stitches should be removed.
Getting back to normal
Most rhinoplasty patients are up and about within
two days, and able to return to school or sedentary work
a week or so following surgery. It will be several weeks,
however, before you're entirely up to speed.
Your surgeon will give you more specific guidelines for
gradually resuming your normal activities. They're likely
to include these suggestions: Avoid strenuous activity (jogging,
swimming, bending, sexual relations any activity that increases
your blood pressure) for two to three weeks. Avoid hitting
or rubbing your nose, or getting it sunburned, for eight
weeks. Be gentle when washing your face and hair or using
cosmetics.
You can wear contact lenses as soon as you feel like it,
but glasses are another story. Once the splint is off, they'll
have to be taped to your forehead or propped on your cheeks
for another six to seven weeks, until your nose is completely
healed.
Your
surgeon will schedule frequent follow-up visits in the months
after surgery to check on the progress of your healing.
If you have any unusual symptoms between visits, or any
questions about what you can and can't do, don't hesitate
to call your doctor.
Your new look
In the days following surgery, when your face is
bruised and swollen, it's easy to forget that you will be
looking better. In fact, many patients feel depressed for
a while after plastic surgery it's quite normal and understandable.
Rest assured that this stage will pass.
Day by day, your nose will begin to look better and your
spirits will improve. Within a week or two, you'll no longer
look as if you've just had surgery. Still, healing is a
slow and gradual process. Some subtle swelling may be present
for months, especially in the tip. The final results of
plastic surgery may not be apparent for a year or more.
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| Incisions
are made inside the nostrils or at the base of the nose,
providing access to the cartilage and bone, which can
then be sculpted into shape.. |
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| Trimming
the septum improves the angle between the nose and upper
lip. |
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| The
surgeon removes a hump using a chisel or a rasp, then
brings the nasal bones together to form a narrower bridge.Cartilage
is trimmed to reshape the tip of the nose. |
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| If
the nostrils are too wide, the surgeon can remove small
wedges of skin from their base, bringing them closer
together. |
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To
improve the nasal airway,the shape or position of the
septum may be altered. Or, the deviated portion of the
septum may be partially removed.
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| A
splint made of tape and an overlay of plastic, metal,
or plaster is applied to help the bone and cartilage
of the nose maintain their new shape. |
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After surgery, the patient
has a straighter bridge, a well defined nasal tip, and
an improved angle between the nose and upper lip.
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