Rhinoplasty

For men, Rhinoplasty is the second most popular plastic surgery procedure, behind liposuction. It is the fifth most popular cosmetic surgical procedure for women.. Reshaping or improving the appearance of the nose can be done in a number of ways; by reducing the size, by straightening, raising or lowering, by removing bumps, curves or ridges and by contouring the shape of the bridge of the nose in alignment with the tip.

While many young people are unhappy with their noses, there are certain age-related factors that should be taken into account when a young person desires Rhinoplasty. It is generally recommended that the patient wait until after their growth spurt, to ensure that their nose is fully developed before surgery. This is usually between the ages of 15 and 17 for boys

Before you decide to undergo Rhinoplasty, you should be certain that it is really what you want. Changing your nose drastically will alter your appearance quite a bit.

Surgical and Common Names

 

The Procedure

The actual Rhinoplasty surgical procedure typically takes between one and two hours.  If you are having reconstructive work done, or you are having a more complicated procedure, the surgery may take somewhat longer. Your plastic surgeon can tell you what to expect in your particular case.

When your plastic surgeon performs your Rhinoplasty, the skin of your nose will be separated from the bone and cartilage that supports it.  This bone and cartilage framework is then sculpted to achieve the shape that you and your plastic surgeon agreed on.  There are a number of different techniques that your plastic surgeon may employ, depending upon what results you want to achieve, and what methods your plastic surgeon prefers.  Once the cartilage and bone have been sculpted into their new shape, your skin will be redraped over them.

There are two ways to approach Rhinoplasty. Your plastic surgeon may work from inside the nose, making the incisions inside your nostrils. This is known as the "closed technique" or "closed Rhinoplasty method."  Alternatively, your plastic surgeon may use the "open technique" or "open Rhinoplasty method."  In this method, your plastic surgeon makes the incision across your columella, which is the strip of tissue that separates your nostrils.  The open method is often used in more complicated cases because it give the plastic surgeon more working room.

Once your Rhinoplasty is complete, a splint will be put on your nose to help support the new shape.  Packing or soft plastic splints may be placed inside your nostrils to help stabilize the interior structure of your nose.

 

Post Operative

During the first day or so after your Rhinoplasty, your nose will probably ache.  (If you have allergies, think, "flower show". If you don't have allergies, think "really bad head cold.")  Your face will feel swollen and puffy. You may have a headache.

Before your surgery, your plastic surgeon will probably have given you a prescription for pain medication. Hopefully you had it filled, because this is where you'll want to have it handy.  Normally, you can control any pain using the medicine your doctor prescribed.

Except for trips to the bathroom, plan on staying in bed with your head elevated.

Over the course of the first day, and for several days after that, the swelling and bruising will increase.  Black eyes are not unusual and you may look like you were on the losing end of a fist fight.  Applying cold compresses around - but not directly to - you nose will reduce the swelling and make you feel better.  Most people who have had Rhinoplasty report that the look more beat-up than they feel.

Within a week or two of your surgery, most of your bruises will be gone. The swelling generally goes away within the first week.  You may see some swelling or slight bruises after the first two weeks, but other people you ask will not notice. (In this case, go with their opinion).

You will probably feel stuffy for a few days after your surgery. During the first few days, you may have some bloody nasal discharge.  Small amounts of blood are pretty standard, but any sustained bleeding or large volumes of blood should be reported to your plastic surgeon immediately.  Even though you feel stuffy, try not to blow your nose for at least seven days. Otherwise, you'll disturb the wounds.

If you have nasal packing, your doctor will remove it when you have one of your post-op visits, typically a few days after your surgery.  With the packing removed, you will feel better almost instantly.  By the end of two weeks, often earlier, all of the packing, dressing, splints and sutures will be removed. Your plastic surgeon can give you a much better timetable than we can.

Most Rhinoplasty patients recover quickly and are able to move around shortly after surgery. You may not wish to return to work for approximately 2 weeks as you may suffer severe bruising and swelling around the eyes

 

Result

After 2 weeks your bruising and swelling should have subsided and no one will be able to tell that you have had surgery. The result is a natural appearance with your nose more in proportion to the rest of your face.

You will probably be up on your feet and moving about the house by the end of day two. If you have a desk job or if you are a student, you should be able to get back to work/school within 7 to 10 days after your surgery. If your job is strenuous (lifting, climbing, etc.) you can expect to be on limited duty for three weeks to a month.

During the first month after your surgery, you can gradually ramp up your activity level.  Go easy on anything that raises your blood pressure or induces stress.  Some of these activities are weight lifting, running, swimming and diving, bending, climbing and sex.)

Be very careful when you wash your face so that you do not bump your nose. (Actually, be careful whatever you do -- and don't bump your nose.)  Avoid harsh nose blowing and do not rub your nose.

Wear sunscreen and stay out of the sun so that you don't get burned.

 

Corrective Lenses

If you wear contacts, you should be able to put them back in within a matter of days after your surgery. If you wear eyeglasses, you cannot allow them to rest on the bridge of your nose one your splint is removed.  Be sure to discuss eyeglasses with your plastic surgeon.  There are a number of work-arounds, but none of them are pretty and almost all look dorky. (Think forehead-tape to hold up your glasses.)  It is not usual to have to keep the weight of your glasses off your nose for two full months, until you are completely healed.

 

Follow Up Visits

Your plastic surgeon's will schedule a series of follow up visits to occur after your Rhinoplasty.  These appointments will give your surgeon the opportunity to monitor your progress.  If you notice any problems between scheduled visits, call your surgeon's Hospital right away.  Don't wait until the next scheduled appointment.

 

Long Term Healing

Healing takes time. Some swelling, usually noticeable only to you, may persist for several months.  You can expect to see the final results of your Rhinoplasty six to twelve months after your surgery. Because they get less blood flowing through them, the areas around the tip of your nose may be the slowest to heal.

 

Risk

Complications with Rhinoplasty are rare. Nevertheless, there is always a possibility of infection, nosebleeds, or a reaction to the anaesthesia. You can reduce your risks by closely following your surgeon's instructions both before and after surgery.

Following surgery, small blood vessels may appear on the skin's surface. These are usually minor, and can be corrected with a laser, which eradicates the capillaries.

As for scarring, when Rhinoplasty is performed from inside the nose, there is no visible scarring at all; when an "open" technique is used, or when the procedure calls for the narrowing of flared nostrils, the small scars on the base of the nose are usually not visible.