Rhinoplasty is surgery to the nose that is used to change the shape of the nose.
It is used to change the appearance of the nose or its function or both. The upper portion of the nose is bone and the lower portion is cartilage. Rhinoplasty can modify bone, cartilage, skin or all.
It can be used to:
Nose surgery is considered elective when it is done for cosmetic reasons. In these cases, the purpose is to change the shape of the nose to one that the patient finds more desirable. Many surgeons prefer to perform cosmetic nose surgery after the nasal bone has finished growing. This is around age 14 or 15 for girls and a bit later for boys.
Risks of any surgery are:
After surgery, tiny blood vessels that have burst may appear as tiny red spots on the skin surface. These are usually minor, but are permanent. There are no visible scars if the rhinoplasty is performed from inside the nose. If the procedure narrows flared nostrils, there may be small scars at the base of the nose that are not usually visible.
Before scheduling rhinoplasty, you must meet with your surgeon to discuss important factors that determine whether the surgery is likely to work well for you. This meeting generally includes:
Before rhinoplasty, you may also need to:
Rhinoplasty requires local anesthesia with sedation or general anesthesia, depending on the complexity of the surgery and your surgeon’s preferences.
Rhinoplasty may be done inside the nose or through a small external incision at the base of the nose, between the nostrils. Your surgeon will likely readjust the bone and cartilage underneath your skin.
Your surgeon can augment your nasal bone or cartilage in several ways, depending on how much needs to be added, the structure of your nose and available materials. For small changes, the surgeon may use cartilage harvested from deeper inside your nose or from your ear. For larger requirements, the surgeon can use cartilage from the rib, implants or bone from other parts of the body.
After the surgery, you’ll be in a recovery room, where the staff monitors your return to wakefulness. You might leave later that day or, if you have other health issues, you might stay overnight.
After the surgery
After the surgery you need to rest in bed with your head raised higher than your chest, to reduce bleeding and swelling. Your nose may be congested because of swelling or from the splints placed inside your nose during surgery. In most cases, the internal dressings remain in place for one to seven days after surgery. Your doctor also tapes a splint to your nose for protection and support. It’s usually in place for about one week.
Slight bleeding and drainage of mucus and old blood are common for a few days after the surgery or after removing the dressing. Your doctor may place a “drip pad” — a small piece of gauze held in place with tape — under your nose to absorb drainage. Change the gauze as directed by your doctor. Don’t place the drip pad tight against your nose.
To further decrease the chances of bleeding and swelling, your doctor may ask that you follow these precautions for several weeks after surgery:
In addition, don’t rest eyeglasses or sunglasses on your nose for at least four weeks after the surgery, to prevent pressure on your nose. You can use cheek rests, or tape the glasses to your forehead until your nose has healed.
Some temporary swelling or black-and-blue discoloration of your eyelids can occur for two to three weeks after nasal surgery. Swelling of the nose takes longer to resolve. Limiting your dietary sodium will help the swelling go away faster. Don’t put anything such as ice or cold packs on your nose after surgery.
Your nose changes throughout your life whether you have surgery or not. For this reason, it’s difficult to say when you have obtained your “final result.” However, most of the swelling is gone at a year.
Open and closed rhinoplasty are two different surgical techniques. Both involve incisions made inside the nose. However, in closed rhinoplasty, all incisions are made through the nostrils, while open rhinoplasty involves an incision across the columella (the soft tissue dividing the nostrils).
One advantage of closed rhinoplasty is that it leaves no visible scarring. However, an open rhinoplasty procedure may provide better access and visibility for a surgeon performing delicate and complex alterations of nasal structures. When performing open rhinoplasty,
In the initial phase of your recovery, you may have bruising around the eyes, painful tenderness of the nose, and swelling and puffiness of the face. Cold packs can help reduce the swelling and medications will be provided to control any post-surgical pain.
You will return home after the procedure with a splint on your nose which will remain in place for approximately one week. Most patients report that recovery from rhinoplasty is more uncomfortable than painful.
Most patients can return to work in approximately 1 week after the procedure. However, it is important to avoid strenuous activities for at two to three weeks after rhinoplasty surgery.
Rhinoplasty is a generally safe surgical procedure, but as with any surgery, things can go wrong. The most common risks during a rhinoplasty procedure are infection, adverse reaction to the anesthesia, and excessive bleeding. There is also the slight possibility that you will need additional surgery in the future. Another risk in regards to cosmetic rhinoplasty is that you may be unhappy with the procedure — rhinoplasty has the highest rate of revision in cosmetic surgery.
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