Rhinoplasty /
Nose Surgery
Candidates for Rhinoplasty
Candidates for rhinoplasty have finished their facial growth. Girls should typically be at least 15 or 16 years old; boys should be at least 17 or 18. Patients considering rhinoplasty should be in overall good health and not smoke. It is important that candidates have realistic expectations about what rhinoplasty can do. Although undergoing rhinoplasty may boost self-confidence, it should not be viewed as a cure-all for personality or relationship issues, and should not be the result of social pressure.
Add in a before and after picture
Goals of Rhinoplasty
During rhinoplasty, the surgeon may attempt to do one or more of the following:
Remove a hump
Modify the bridge
Reshape the tip
Reshape or resize the nostrils
Repair an injury
Open breathing passages
Increase or decrease size
Rhinoplasty can involve modifying bone, skin or cartilage, or all three.
There are several goals of rhinoplasty. Dr. Ramachandra firmly believes that any maneuver performed during elective nasal surgery should at least maintain if not improve the nasal breathing.
The Rhinoplasty Procedure
Rhinoplasty, which takes from 2 to 3 hours, is usually an outpatient procedure performed under general anesthesia. Two techniques are typically used. In closed rhinoplasty, incisions are made within the nostrils. In open rhinoplasty, an incision is made across the columella, the tissue between the nostrils. With both methods, the soft tissues covering the nose are gently lifted, and the bone and cartilage are sculpted to the desired shape.
If additional cartilage is needed to augment the nose, it is frequently taken from the patient‘s nasal septum. If larger sections of tissue are required, cartilage may be surgically removed from the ear or other parts of the body as well. If the patient has a deviated septum, the septum and inner structures of the nose are adjusted to improve breathing. The tissues are then redraped and stitched closed. If necessary, nostrils are reshaped in the final stage of rhinoplasty.
Recovery from Rhinoplasty
Immediately after surgery, the patient’s nose and eye area are usually bruised and swollen. External and internal nasal splints remain in place for the first 5 days. During this period, the patient may experience some nasal pain or a dull headache, as well as some bleeding and nasal drainage. Most patients feel like themselves within a few days and are able to return to regular activities in about a week.
To increase comfort, and decrease bleeding and swelling, rhinoplasty patients are advised to follow these post-surgical directives:
Sleep with head of bed elevated
Avoid strenuous activities
Take baths instead of showers
Avoid blowing the nose
Avoid becoming constipated
Avoid exaggerated facial expressions
Brush the teeth gently
Avoid pulling clothing over the head
Use sunscreen that has an SPF of 30 or higher
Limit dietary sodium
Do not use ice packs
Although the vast majority of swelling resolves after 2 weeks or so, minimal swelling may be present for as much as a year.
Risks of Rhinoplasty
Complications associated with rhinoplasty are rare and, when they occur, usually minor. Surgical risks in general include infection or adverse reaction to anesthesia. In the case of rhinoplasty, specific risks include the following:
Recurring nosebleeds
Difficulty breathing through the nose
Permanent numbness in or around the nose
Persistent pain
Discoloration of skin on the nose
Scarring
Perforation of the nasal septum
It is possible that a patient is not satisfied with the results of the rhinoplasty. In such a case, a second surgery, called a revision rhinoplasty, may be performed at a later date.
