What is a rhinoplasty?
Nose surgery, also known as rhinoplasty, is a nose-reshaping procedure performed to improve the shape and function of the nose. Cosmetic surgery of the nose is a powerful, exacting surgery that can produce subtle improvements or dramatic changes. The appearance of the nose is the result of a delicate balance of skin, cartilage, and bone.
Who’s nose is am I going to have?
There is not one standard for an aesthetically pleasing nose. The best nose for you is the nose that fits your face. Most patients want seek surgery for a nose that may not be proportionate to the rest of the face, has bulbous, drooping or upturned tips, or that is crooked or deviated to one side. Rhinoplasty can adjust the size of the nose to achieve facial balance, change the wide of the bridge of the nose and remove humps on the nose that are noted in a profile view.
Nose surgery is good option for those whose facial growth is complete, are physically healthy, do not smoke and have a positive and realistic goals in mind.
During Your consultation
At your first consultation, Dr. Brown will discuss your goals and desires and take photographs. These pictures are enlarged to life size and used to identify key anatomic landmarks which are used to identify “normal” facial angles and distances. At our second consultation, we will review these workups together and plan our surgical approach. The surgery itself is performed as an outpatient and recovery is usually complete within two weeks including resolution of most of the bruising. Not all patients need internal splints/ but most will have a hard external splint for a week.
Rhinoplasty is considered a cosmetic surgery, although sometimes a portion of the procedure can be covered by insurance if there is a functional issue such as a deviated septum or difficulty breathing.
Prior to surgery
To get ready for surgery there are a number important steps. We will obtain recent blood work and sometimes obtain medical clearance from your primary doctor.
You must stop smoking. In most cases Dr. Brown will not perform a facelift on anyone who is actively smoking. You must avoid taking Aspirin, anti-inflammatories and herbal supplements for 3 weeks prior to surgery as this increases the risk of bleeding. Certain hormones must also be stop as these increase the risk of Deep vein thrombosis.
The procedure
There are two ways to perform a rhinoplasty one of which is called “closed” technique that involved only incision on the inside of the nose. This is reserved for relatively minor changes to the shape of the nose. The other technique called the “open” rhinoplasty involves a small incision on the columella (skin between the nostrils) of the nose that connects to incisions on the inside. This allows for reshaping of the top or dorsum of the nose as well as the tip. The open technique allows of the control of the cartilage and boney structures of the nose. Regardless of technique the structures of the nose are adressed in sequence to achieve the desired result. Surgery to correct a deviated septum or harvest cartilage are also done in the same setting.
The surgery is typically performed under a general anesthesia. Local anesthetic is used which reduces the amount of post-operative pain. The nose is covered in bandages and a small nasal covering called a splint. These remain on for one week.
Recovery
The nasal bandage and sometime some soft silicone tubes inside the nose are removed in 5 to 7 days after surgery. There is typically some drainage from the nose for the first few days. The nose is treated with some warm saline sprays to keep the tissue inside the nose from drying out and crusting. Most swelling and bruising around the nose and eyes is gone in 2-3 weeks. Mild swelling can be present in the nasal tissue for several months.
Risks
- Anesthesia Risks
- Bleeding
- Infection
- Poor wound healing or scaring
- Change in skin sensation
- Septal perforation
- Difficulty breathing
- Unsatisfactory nasal appearance
- Skin discoloration and swelling
- Possibility of revisional surgery