Nose surgery

What you need to know about nose reshaping surgery or rhinoplasty?

One of the most common plastic surgery procedures, rhinoplasty is performed to reshape, reduce or augment a person’s nose, remove a hump, narrow nostril width, change the angle between the nose and the mouth, or to correct injury, birth defects, or other problems that affect breathing. Rhinoplasty can improve your look and can boost your self-confidence. Rhinoplasty is usually an outpatient procedure performed under either local or general anesthesia and lasts one to two hours.

Who can have nose surgery?

Many young people want nose surgery; however, the procedure should wait until after the teenage growth period that occurs in the mid-teens. This growth period normally occurs from the ages of 18 for girls and somewhat later for boys.

The rhinoplasty procedure

After a thorough examination, this plastic surgery procedure can be performed under local anesthesia – when you are awake, or under general anesthesia - when you are asleep. The procedure normally requires an hour or two in surgery, depending on the amount of nose reshaping to be done. The incision is made in a hidden place, normally inside the nose, except for nasal wing operations.

Two types of nose surgery include; open versus closed.
Closed nose surgery: For minor reshaping, many surgeons make incisions within the nose. The skin of the nose is then separated from the bone and cartilage, which forms its supporting framework. Once exposed, bone and cartilage can be removed, reshaped, augmented, or rearranged to achieve the desired new shape. For example, to make the nose narrower, cartilage can be removed down the front spine of the nose. After the cartilage and bone have been changed, the nose tissues are re-draped over the newly shaped structures and the incisions are closed.
Open nose surgery: For major nose reshaping, the incisions are not made inside the nose. Instead, incisions are made in the vertical strip of skin separating the nostrils. This more complex procedure is referred to as "open" rhinoplasty.

After the surgery

Immediately, after the incisions have been closed, soft puffy material may be used inside the nose to maintain the structure along the nasal air passages. Also, after surgery, an external splint is applied to help the nose maintain its new shape. The splint provides some additional protection for the nose during the healing process. The external splint is usually worn for six to eight days. A tampon is put inside the nose to lessen bleeding and to enhance the clinging of the lifted mucous membrane. The tampon is removed within 24-48 hours of the operation.

Recovery after nose surgery

One day hospitalization under medical supervision is required. The patient gets antibiotics. The nose area will be bruised and swollen after the surgery. This bruising may extend to the eyes and all areas of the face. Common post-surgery instructions include a cold compress to reduce swelling, pain medication to reduce discomfort, and elevating your head for the first twenty-four hours.
Most of the swelling and bruising should disappear after a week. You may experience limited bleeding the first few days. Normally, after two weeks, all stuffing, splints, and other post-surgical dressings are removed.

The most important instruction after nose surgery: Blowing your nose should be avoided for the first couple of weeks. The patient must not lean forward or do physical work for two to three weeks. When removing the plaster from the nose, the correction of the nose becomes visible, although the final shape may still not be seen because of the existing swelling. A more refined result is seen in four to six weeks. However, we may see the actual final result only after half a year since in the meantime there could be several smaller changes.

Complications

Most frequent complications of the operation are bleeding, inflammation, temporary numbness, breathing difficulty and asymmetry. If there are excisions (e.g. nasal-wing reduction), there may be a difficult wound healing. In a very rare case there may be a necrobiosis of a small part of the skin on the nose-ridge.

Are there any additional procedures that can be performed at the same time?
If you are having the rhinoplasty procedure, you may also need to consider other facial procedures to achieve balance and proportion.