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If you're considering rhinoplasty...
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.
If you're considering rhinoplasty, this information
will give you a basic understanding of the procedure-when
it can help, how it's performed, and what results you can
expect. It can't answer all of your questions, since a lot
depends on the individual patient and the surgeon. Please
ask your surgeon about anything you don't understand.
THE BEST CANDIDATES FOR RHINOPLASTY
Rhinoplasty 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 surgery, think carefully about your expectations
and discuss them with your surgeon.
The best candidates for rhinoplasty 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.
Rhinoplasty can be performed to meet aesthetic
goals or for reconstructive purposes-to correct birth defects
or breathing problems.
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 teenagers' social and
emotional adjustment, too, and to make sure it's what they,
and not their parents, really want.
ALL SURGERY CARRIES SOME UNCERTAINTY
AND RISK
When rhinoplasty 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 surgery.
After 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 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 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 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, the procedure may be covered.
Check with your insurer, and obtain pre-authorization for
your 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 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 SURGERY WILL BE PERFORMED
Rhinoplasty 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 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 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 SURGERY
After 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 rhinoplasty may not be apparent
for a year or more.
In the meantime, you might experience some
unexpected reactions from family and friends. They may say
they don't see a major difference in your nose. Or they may
act resentful, especially if you've changed something they
view as a family or ethnic trait. If that happens, try to
keep in mind why you decided to have this surgery in the first
place. If you've met your goals, then your surgery is a success.
Back to Procedures
Information provided by American
Society of Plastic Surgeons. |
