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(RHINOPLASTY)

Rhinoplasty is a cosmetic surgical procedure, used to change the shape, size or overall appearance of the nose. It’s also one of the most common of all cosmetic procedures. Rhinoplasty can be used to increase or decrease the size of the nose, to change the shape of its bridge or tip, and to widen or narrow the nostrils. Breathing problems can also be corrected through nose surgery. After rhinoplasty, a patient's appearance can change dramatically, offering greater confidence and self-image.

The Surgery
Nose surgery is usually done on an outpatient basis, however complex procedures may require a short stay. Surgery can be performed under local or general anesthesia and typically takes up to two hours to perform. Many plastic surgeons perform rhinoplasty from within the nose. Small incisions are made inside the nostril, separating the tissue from the cartilage or bone in order to sculpt into the desired shape. Others prefer an "open" procedure. This technique includes an incision across the small skin between the two nostrils. After surgery a splint will help your nose maintain its new shape. Some surgeons choose to pack the nose after the surgical procedure. The nostrils may be packed 24-72 hours.

The Recovery
During the initial recovery process you’ll feel mostly pressure and stuffiness and may have a headache. Swelling and bruising around the eyes is to be expected as well. You may experience some bleeding and will likely want to change your bandages several times a day for the first few days. After 3-5 days, the splint and any packing will be removed. You should be able to return to work after a couple of days. It will take several weeks before you’re completely back to normal.

The Best Candidate for Nose Surgery
The best candidates for nose surgery are patients with realistic expectations looking to improve the way they look. If you're physically healthy and psychologically stable, you may be a good candidate. Age may also be a factor. Teenagers are best treated after their growth spurt, around age 14-15 for girls and 15-16 for boys.

The Risks
As with any surgery, there are risks that include: infection, bleeding and reaction to anesthesia. After nose surgery small burst blood vessels may appear as tiny red spots on the skin's surface; these are usually minor but may be permanent. In rare cases, a second procedure may be required and the corrective surgery is usually minor. You can reduce risk by closely following the instructions provided by your plastic surgeon before and after the procedure.

Background

Aesthetic (cosmetic) surgery of the nose, also called rhinoplasty, can improve the shape, size and general appearance of the nose. The goal is a natural look that achieves a harmonious balance with the patient’s other facial features. Plastic surgeons usually recommend that patients wait until they are at least 14 or 15 before undergoing rhinoplasty. Assuming good health, there is no upper age limit. Rhinoplasty is sometimes performed in conjunction with a facelift or other rejuvenative surgery to correct aging changes of the nose such as a drooping tip.

Technique

Alterations may be made to increase or decrease the nasal bridge, reduce the size or width of the nose, narrow the nostrils, change the angle between the nose and the upper lip, or reshape the tip. Often incisions will be placed inside the nose, where they will not be visible. Sometimes, a very short incision is made across the vertical strip of tissue that separates the nostrils, called the columella. This technique is called an "open rhinoplasty." Through whatever small incisions are made, work is done on the cartilage and bone that form the framework of the nose. Sometimes, the position of certain bones may need to be altered slightly in order to make the nose look narrower and straighter. If the nose needs to be built up in certain areas, this can be done using nasal cartilage, or perhaps bone or cartilage from another site.

Benefits

• High patient satisfaction when expectations are realistic.
• Significant complications from rhinoplasty are infrequent.
• Results are permanent, except for changes associated with the aging process.
• Incisions are usually inconspicuous.
• Patients may be able to return to work a week to ten days after surgery. Most normal activities including exercise can usually be resumed within three weeks.

Other Considerations

• Every surgery carries some risk. Potential complications include bleeding, infections and reactions to anesthesia. Numbness of the skin is usually temporary. Noticeable swelling may last for several weeks. Minor residual swelling may continue for many months. Bruising around the eyes and cheeks is most apparent during the first three days following surgery.
• Occasionally additional surgery may be necessary. Since the healing process is gradual, the patient should expect to wait up to one year to see the final results.
• Patients must avoid exposing their reshaped nose to direct sunlight, and must be conscientious about using sun block.