Nose surgery, Rhinoplasty, (the most common of all plastic surgery procedures) is intended to reduce or increase 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.
How is the surgery performed?
During a typical 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. The skin is then re-draped 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.
Will the surgery result in permanent scarring?
Most of the incisions are inside the nose and therefore not visible. Occasionally, small excisions of skin are indicated at the base of the nostrils to shape the nostrils and nasal tips. The scars from these are usually inconspicuous after a few weeks.
How long does the procedure take?
The operation ordinarily takes one and a half to two and a half hours, depending on the complexity of the deformity.
How long is the recovery time?
The majority of the swelling subsides in 10 to 12 days, and one can usually expect to return to full social activity and work within two weeks after the operation. A small amount of swelling, usually not evident to others, persists for several weeks or months.
Will I need 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, your nose and the surrounding area will be numbed and you'll be awake during the surgery, but relaxed and insensitive to pain. With general anesthesia, you'll sleep through the operation.
Am I a good candidate for Rhinoplasty?
The best candidates for rhinoplasty are physically healthy, psychologically stable, and realistic in their expectations.
Rhinoplasty can be performed to meet aesthetic goals or for reconstructive purposes to correct birth defects or breathing problems.
Many surgeons prefer not to operate on teenagers until after they've completed their growth spurt, around 14 or 15 years old 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.
During your initial consultation, you will be asked what you'd like your nose to look like. The surgeon will evaluate the structure of your nose and face, discuss the factors that can influence the procedure, surgical techniques and the end results. Photographs are taken and used for operative planning. Tracings are made on the photographs and used to outline the goals of the operation. The tracings are a guideline and not a guarantee of results. If there is sunburn on the nose or obvious infections, the operation will need to be canceled and rescheduled.
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.
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.
The nostrils and nasal passages may be packed with small dressings, which are in place only a short time and will be removed by the surgeon. If a submucous resection is performed in conjunction with the rhinoplasty, the packing will remain longer.
Rest as much as possible when you return home. It is normal to feel drowsy or sluggish the entire day. You may feel especially dizzy or uncomfortable upon standing up or walking, so be sure that support from a person or object is nearby.
Take pain medication as needed and as directed. *DO NOT take pain medication on an empty stomach. Avoid alcoholic beverage.
You can expect to have nasal congestion with minimal bloody drainage for the next two to three weeks after surgery. This congestion is caused by crusts that form in the nose. The crusts will be removed during the following office visits. Mouth breathing and sleeping on two pillows to facilitate drainage will help. Chap Stick Lip Balm is ok for dry lips.
You may have temporary decrease in taste and smell.
Any yellow or green nasal discharge should be reported to your doctor as this may signify an infection.
If a splint has been used, leave it on until your follow-up appointment with your physician.
If you are a smoker, refrain from smoking for two weeks after surgery.
Although the nose usually looks quite good three weeks after the operation, improvement may be expected for the next several months. The tip of the nose will remain stiff and numb for several weeks, but this gradually returns to normal as the healing progresses.
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