Rhinoplasty

 

 There is no surgical procedure that is more surgeon-dependent than that of rhinoplasty. There are a myriad of factors involved when planning a nasal surgery. If one starts on the outside of the nose and works inward, the first concern is the skin covering the cartilaginous and bony framework. Thick, oily skin tends to form thick scars and is much more difficult to manage than patients with thin skin. However, thin skin is less forgiving from the standpoint of showing any imperfections in the underlying bone or cartilage.

A rhinoplasty or "nose job" is simply altering the bony and cartilaginous framework to create a more appealing and attractive nose that fits each particular face. The surgical procedure itself is broken down into altering the cartilages of the tip area, lowering the cartilage of the septum and upper lateral cartilages and finally smoothing out irregular bone on the top of the nose and usually fracturing the nasal bone to narrow the nose.

The second part of a rhinoplasty is that which deals with the internal anatomy. This is the septum and turbinates are baffles in the nose that affect one’s ability to breathe through the nose. Probably 95% of the population has a deviated septum that is in reality not related to nose trauma or nasal fracture but simply is genetic in origin and develops at puberty. In order to open up the airway, this piece of bone and cartilage that sits in the middle of the nose needs to be reduced and/or smoothed out to achieve a straight anatomy on the inside of the nose thereby improving the airway. On the sides of the nose, the turbinates are "hotdog" shaped structures that become engorged with blood with change in position, temperature, humidity and in general air quality. Frequently, these need to be surgically reduced in size to open the airway. 

 

 

Good candidates for rhinoplasty, or surgery of the nose, are individuals who are healthy, psychologically stable and have realistic expectations about what surgery can accomplish.

Although many young people consider rhinoplasty, it is oftentimes better to wait after an individual has completed his or her mid-teen growth spurt. For girls, this falls between the age of 14 and 15 and for boys, this is usually somewhat later. Parents should also consider their child's social and emotional adjustment, and make sure they fully understand the procedure and sincerely want to make a change.

 

 

Rhinoplasty is a surgical procedure that reshapes the nose by reducing or increasing its size, removing the hump, changing shape of tip or bridge, narrowing span of nostrils, or changing angle between nose and upper lip. The procedure takes from one to three hours and is performed under general or local anesthesia.

During surgery your surgeon will separate the skin of the nose from the supporting bone and cartilage. The bone and cartilage are then sculpted to the desired shape. Afterwards the skin is redraped and a splint is put in place to assure that the nose retains its new shape.

 

 

Your surgeon will give you instructions preparing for surgery and guidelines on eating, smoking, drinking and medications or vitamins to take or avoid taking. You will want to arrange for someone to drive you home following your procedure.

 

 

For the first day or two following your rhinoplasty surgery, you will want to stay in bed with your head elevated. Your face will feel puffy, your nose may ache and you may have a dull headache. Other side effects include temporary swelling and bruising around the eyes and nose, which may peak two to three days after surgery. Bleeding is also common during this time.

Recovery time is variable for rhinoplasty, depending upon the amount of work done on your nose. Usually patients return to work between one and two weeks and resume strenuous activities within two to three weeks. You will want to avoid hitting the nose as well as direct sunlight for two months following surgery. It may one year or longer for the final results of the rhinoplasty to be evident.

Risks of rhinoplasty include infection, small burst blood vessels resulting in tiny, permanent red spots, or incomplete improvement requiring additional surgery.