Rhinoplasty

Introduction

Rhinoplasty is the surgery that changes the shape of the nose, and it is one of the most frequently performed surgical procedures in plastic surgery. Rhinoplasty can reduce or increase the size of the nose, reshape the tip or the back of the nose, narrowing the nostrils or change the angle between the nose and upper lip. It also repairs the defects, injuries and respiratory problems.

If you're considering undergoing a 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`s preferences. Please ask your surgeon about anything you don't understand.

Who is the best candidate for rhinoplasty?

The ideal candidates to undergo a rhinoplasty are people looking for an improvement, not for an absolute perfection in their appearance. If you have a good overall health, you are psychologically stable and realistic in your expectations, you would be a good candidate. 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.

Age must also be taken into account. Most plastic surgeons prefer not to perform a rhinoplasty until the pubertal “growth spurt” is complete, ages 14–15 for girls and older for boys. It is also important to consider the emotional and social adjustment of adolescents, and be sure that them, and not their parents, are the ones who want to undergo rhinoplasty.

Appearance after rhinoplasty:

the patient has a more balanced nose.

The surgery

Rhinoplasty is performed in the operating room, within a clinic or hospital. Normally, the patient remains in the hospital the night after surgery, being discharged the next day.

Rhinoplasty can be performed under local anesthesia along with sedatives or, more frequently, under general anesthesia, depending on the extent of the procedure and on the surgeon`s preferences.

Sometimes, if the base of the nose is too wide, it may be necessary to remove
few small wedges of skin. The incisions are made inside or in the
base of the nose, allowing the cartilage and bone to be remodeled.

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. 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, which consists of a small incision across the columella.

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 avoid bleeding and to stabilize the septum.

Returning to normality/getting back to normality

After surgery-particularly during the first 24 hours, your face may feel puffy, your nose may ache, and you may have a dull headache; you can control any discomfort with pain medication. You must stay in bed with your head elevated during the first day (except when going to the bathroom). 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 it might seem by your 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. You must 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.

A splint will be placed on the nose during the postoperative period.

Most rhinoplasty patients are up and about within two days, and able to return to school or to work a week or so following surgery. It will be several weeks, however, before you're entirely up to speed. Even though your surgeon will give you specific guidelines, include these suggestions: avoid strenuous activity (jogging, swimming, bending…) for two to three weeks, avoid hitting your nose or sunbaths for eight weeks, be gentle when washing your face and apply your makeup with care. You can wear contact lenses as soon as you feel like it, but if you wear glasses you must take certain precautions. Your plastic surgeon will see you frequently 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.

Are there risks? Are there any guarantees?

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; even in open rhinoplasty the scar is imperceptible. In about one case out of ten, a second procedure may be required to correct a minor defect. Such cases are unpredictable and happen even to patients of the most skilled surgeons.

The results

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 is normal to feel this way. 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 will be apparent after approximately one year.

Aesthetic nose surgery: summary

Rhinoplasty is the surgical procedure performed to correct deformities of the nose. It basically consists in modifying the structure of the nasal bone and cartilage, for a new shape meant to improve facial harmony. When it is used to also correct the deviated septum in order to improve breathing function, then it is called rhinoseptoplasty.

The surgery, usually performed under general anesthesia or, in selected cases, under local anesthesia with sedatives, begins by approaching the nose through internal incisions, so there is no visible external scar. The surgeon cuts and shapes the nasal bones and cartilages in order to obtain the desired shape. In some cases incisions are also made at the base of the nostrils. To help shape and support the nasal pyramid, there are often used as grafts the patient's own tissues (cartilage, bone) or, more rarely, synthetic materials.

After the intervention, which usually takes about an hour, a nasal tampon packing is placed usually removed the next day, except if there has been a septoplasty in which case it leaves two or three days. It is applied to the nose plaster splint is continued for one week.

After the intervention, which usually takes about an hour, a nasal pack will be placed in your nostrils, which is usually removed the next day, except if septoplasty has been performed, in which case it is kept for two or three days. A splint will be applied over the nose for one week.

It is not unusual to have a postoperative edema, as well as ecchymosis (bruises) that usually fade away after a week. Most patients can return to their normal life in about 8-10 days.

One cannot judge the result of a rhinoplasty until several months have passed, even a year. This is how long it takes for the tissue to stabilize and the scars to mature. The aim of rhinoplasty is you to have a "new" nose that will match your expression, looking natural while still being harmonious with your face; in other words, the surgical intervention is not to be noticed.

In some cases, due to severe initial anatomic changes, disturbances in tissue healing or postoperative trauma, perfection will not be achieved (asymmetry, contour irregularities in the nose, etc.) therefore, you might need a surgical retouch; that can only be done after six months.

The information contained on this page cannot, and does not replace the information provided individually by your plastic surgeon. In case of doubt, your plastic surgeon will provide appropriate clarifications. If you are planning to undergo an intervention or Aesthetic Plastic Surgery, see a specialist in Plastic, Reconstructive and Aesthetic Surgery.