Rhinoplasty

The following are some common reasons why you may want to consider rhinoplasty:

• Your nose is too large or too small
• Your nose does not seem to fit with the rest of your face
• Your nose is crooked, badly shaped, or out of alignment
• You have nasal blockage inside your nose and have trouble breathing
• You have a birth defect that you would like improved
• You would like improvement, not perfection, in the appearance of your nose

If you are in good general health, have a positive attitude and realistic expectations, you are most likely a good candidate for this procedure.

Your surgeon will provide thorough preoperative instructions, answer any questions you may have, take a detailed medical history, and perform a physical exam to determine your fitness for surgery.

In advance of your procedure, your surgeon will ask you to:

• Stop smoking at least six weeks before undergoing surgery to promote better healing
• Avoid taking aspirin, certain anti-inflammatory drugs, and some herbal medications that can cause increased bleeding
• Regardless of the type of surgery to be performed, hydration is very important before and after surgery for safe recovery.

Rhinoplasty is usually performed on an outpatient basis. Be sure to arrange for someone to drive you home after surgery and to stay with you at least the first night following surgery. If your surgery involves septal work or is a revision of prior work, it may require an overnight stay.

After numbing the area, your surgeon will make incisions to access the bones and cartilage that support the nose. There are two general techniques for making the incisions: open and endonasal.

By adding or removing bone and cartilage and adjusting the supporting structures inside the nose, the size of your nose can be reduced or increased and the nose may be shortened or lengthened.

• Tip grafts made of cartilage can be used to remodel the tip of your nose, making it more uplifted, longer, shorter, or thinner.
• Your skin and other soft tissues will remodel to assume the shape of the underlying structure.
• In some patients, tissue fillers or fat grafts can be added to increase volume in desired areas.

We can provide projected images of how a rhinoplasty can change your appearance with our Vectra 3D. In the Vectra illustration the images shown below are the pre-op profile, rhinoplasty, and then rhinoplasty combined with chin augmentation.

Your surgeon will discuss how long it will be before you can return to your normal level of activity and work. After surgery, you and your caregiver will receive detailed instructions about your postoperative care, including information about:

• Normal symptoms you will experience
• Potential signs of complication.

Immediately after rhinoplasty

After surgery you may be asked to wear a nasal splint over your nose for support. The splint will protect your nose while you sleep and shield it from accidental bumps. You may also have a small triangular bandage beneath the tip of your nose. Nasal packing will be placed inside your nose for additional support; it acts as an internal splint to hold everything in place and to keep the airway clean and free of crusts. Expect some swelling and bruising and possibly some discomfort. Your face will be puffy, and the areas around your nose and eyes will be bruised and swollen after surgery. We may recommend cold compresses to help minimize the swelling and reduce pain. You may need to keep your head elevated and relatively still for the first few days after surgery. We will prescribe a pain medication to deal with any pain you may experience. You will have to limit your activities for a few days to weeks.

Recovery time frame after rhinoplasty

It is vitally important that you follow all patient care instructions provided to you. We will also provide detailed instructions about the normal symptoms you will experience and any potential signs of complications. It is important to realize that the amount of time it takes for recovery varies greatly among individuals. You will need to wait for several weeks before you can engage in exercise or athletics.

The first two weeks

All surgical packing within your nose will be removed within four to seven days after surgery. The splint and bandages on your nose will be removed in a week to ten days. It takes about ten to fourteen days before most of the swelling and bruising improves. Your return to work or school depends on how much exertion your job or your school activities require. Most normal activities including exercise can usually be resumed within three weeks. You should avoid strenuous exercise, straining, bending, and lifting until cleared to do so by your plastic surgeon.

After the first two weeks

Minor swelling of your nose may persist for up to a year but most likely will not be noticeable to others. It will be a few months before you can expose your reshaped nose to direct sunlight, and it may be a number of weeks before you can wear glasses without special support, such as tape, if the bones in your nose were altered.

There are two main incision approaches: the open approach and the internal (endonasal) approach.

In addition to incision options, there are various methods for augmenting your nose or smoothing surface deformities.

• Autologous cartilage grafts taken from your nasal septum (the wall inside the nose that divides one air passage from the other) offers the best chance for a natural result. If cartilage and bone have already been removed from the nasal septum, then ear or rib cartilage and sometimes bone from the skull are other options.
• Although solid silicone implants are available for nasal surgery, these are foreign materials that may become infected or react poorly with your nasal tissues and have to be removed. That is why natural cartilage, if a supply is available, is the most trouble-free option.
• Fillers or fat grafts may also be injected to smooth the nose, to camouflage deformities or indentations, or to add volume in desired areas

Your rhinoplasty will be performed in our AAAA Certified Outpatient Ambulatory Surgery Center. Most rhinoplasty procedures take at least one to four hours to complete but may take longer.

• Medications are administered for your comfort during the surgical procedure.
• General anesthesia is commonly used during rhinoplasty, although local anesthesia or intravenous sedation may be desirable in some instances.
• For your safety during the surgery, various monitors will be used to check your heart, blood pressure, pulse and the amount of oxygen circulating in your blood.
• Your surgeon will follow the surgical plan discussed with you before your operation.
• After your procedure is completed, you will be taken into a recovery area where you will continue to be closely monitored. You will have a splint placed outside your nose to support its new shape as it heals. Nasal packing may also be used inside the nose to provide additional support.

You will probably be permitted to go home after a short observation period unless you and your plastic surgeon have made other plans for your immediate postoperative recovery.

Nose surgery is also known as rhinoplasty, nose reshaping, or nose job.

When to Consider Nose Surgery

• If you are unhappy with the shape, size or angle of your nose
• If your nose is too large, too small or not in proportion to the rest of your face
• If you have breathing problems resulting from irregularities inside your nose
• If you have a nasal hump or a nasal tip that is drooping, too elevated or wide

Related Procedures:

Many people who consider a rhinoplasty also consider chin augmentation, brow lift or eyelid surgery.