The nose is one
of the most prominent features of the person's face. Men and women
who are dissatisfied with the shape or size of their nose can improve
their appearance through a procedure called rhinoplasty. Rhinoplasty
is a surgical procedure in which deformities of the nose are corrected
by removing, recontouring or rearranging bone and or cartilage. Nasal
deformities can be a result of inheritance, trauma or a birth defect
as in cleft deformities. In addition to the aesthetic reasons, patients
seeking surgery may have a functional problem such as breathing obstruction,
which can be corrected by the operation.
During
the consultation we will discuss the patient's expectations and how
the nose should look in relation to other facial features. It is important
for the patient to understand that the goal of surgery is not to achieve
perfection but rather to improve the appearance. Photographs and computer
imaging is frequently used for this operation to show the patient
the anticipated result and help the surgeon understand the patient's
desires. The timing of nasal reconstruction will depend on many factors.
In general, cosmetic rhinoplasty should be delayed until a patient's
facial development is approaching maturity.
Surgical
Procedure:
Rhinoplasty
can be performed on an outpatient basis under general anesthesia or
local anesthesia with IV sedation. Most of the incisions are inside
the nose therefore visible scarring is limited. In some cases a small
incision is made at the base of the nose just above the lip. This
incision heals well and is rarely visible. Each operation is different,
but basically by removing, reshaping and sometimes adding to the nasal
bones and cartilages we modify the framework of the nose. The skin
of the nose is then redraped over the new framework. In some cases,
it is necessary to narrow the base of the nose. In these cases, some
skin is removed from both sides of the nostrils. In some cases the
procedure will be combined with chin and/or cheek augmentation.
Recovery:
Following
surgery, a small plastic splint is placed over the nose, which remains
in place for about a week. The patients can wash or bathe normally
after surgery. The nostrils are cleaned several times a day with cotton
tip applicators wet with peroxide. Some swelling, bruising and stuffiness
are normal after surgery. It is important to realize that each operation
is individualized according to the patient's anatomy and their desires.
In many cases, the surgery requires only changes of cartilage, in
which case recovery is quicker and bruising and swelling are less
likely. In general, bruising resolves within 7-14 days. The major
part of the swelling resolves with in three to six weeks but the nose
continues to improve for as long as a year after the operation. Pain
associated with the procedure is mild to moderate and is well controlled
with oral medication.
During
the healing process, great care must be taken to protect the nose
from injury. Eyeglasses should be adjusted to minimize pressure on
the nose. Although patients are up and around the day after the procedure,
strenuous exercise, particularly those that might elevate the blood
pressure, must be avoided for four to six weeks. Most patients can
return to their daily activities within one week.
